Cardiology
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TAVR in Bicuspid Aortic Valves
Investigators assessed the Society of Thoracic Surgeons/American College of Cardiology transcatheter aortic valve replacement (TAVR) data, with a focus on the use of newer TAVR devices in patients with bicuspid aortic valve vs. tricuspid aortic valves. They found the outcomes post-procedure and for one year are not significantly different between the two types of native valve anatomy. -
Antiplatelet Agents Add to Bleeding Risk, Do Not Add Benefit in TAVR Patients Already on Oral Anticoagulation
In a randomized trial of patients already on anticoagulation undergoing transcatheter aortic valve replacement, adding clopidogrel to oral anticoagulation increased the incidence of serious bleeding vs. oral anticoagulation alone, but did not improve cardiovascular outcomes.
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Hyperdynamic Left Ventricular Function: Good or Bad News?
A large population study has shown a U-shaped relationship between left ventricular ejection fraction (EF) and mortality, with a nadir at 60-65%. The authors identified a new group at high risk for death: those with an EF ≥ 70%.
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Osilodrostat Tablets (Isturisa)
Osilodrostat should be prescribed to adult patients with Cushing's disease for whom pituitary surgery is not an option or has not been curative.
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Cannabis in the Treatment of Headache and Migraine
The authors of this observational study found nearly a 50% reduction in self-reported headache and migraine severity following use of inhaled medicinal cannabis.
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Warfarin or DOACs for Atrial Fibrillation in Chronic Kidney Disease?
A large outpatient observational study of patients with atrial fibrillation and chronic kidney disease who were anticoagulated revealed that, compared to warfarin, direct oral anticoagulants exhibited less all-cause mortality and major bleeding with at least equivalent efficacy at preventing stroke.
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Anatomic vs. Functional Testing in Older Coronary Artery Disease Patients
An analysis of the PROMISE trial by age showed cardiovascular death or myocardial infarction was predicted by a positive stress test in patients with symptoms suggesting myocardial ischemia who were > age 65 years.
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Pharmacotherapy Considerations for COVID-19
A summary of selected pharmacotherapy options proposed to treat COVID-19.
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This ECG Was in Your ‘Pile to be Read’
Imagine the ECG in the figure was one of many tracings you received to read from a group of patients seen by other providers in your clinic. Unfortunately, no clinical information about this patient was available. How would one interpret this tracing? Considering no clinical information regarding what happened to the patient was available, what is the next step?
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Rimegepant Orally Disintegrating Tablet (Nurtec ODT)
Rimegepant should be prescribed to treat acute migraine with or without aura in adults.