Clinical
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A New Technique for Predicting Outcomes in Asymptomatic AS
An international study of patients with moderate or asymptomatic severe aortic stenosis has demonstrated that increased amounts of left ventricular fibrosis, as measured by cardiac magnetic resonance imaging, is associated with worse outcomes.
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PCI in TAVR Patients with Severe Coronary Lesions Shows Benefits
In this randomized trial of patients undergoing transcatheter aortic valve replacement (TAVR), with an average of one severe coronary stenosis, percutaneous coronary intervention in addition to TAVR reduced the incidence of the combined endpoint of all-cause mortality, myocardial infarction, and urgent revascularization at two years.
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Screening for Atrial Fibrillation in Older Adults
A two-week ambulatory electrocardiogram monitor in a large group of individuals 70 years of age or older with no history of atrial fibrillation (AF) showed a very low incidence of AF (4.4%), almost all of which was paroxysmal. In less than 2% of the subjects did it represent ≥ 2% of the monitoring time. However, some patients had hours of AF, raising a concern for thromboembolic risk.
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Biomarker Enhances Screening for Atrial Fibrillation
A large Swedish population study of screening for atrial fibrillation (AF) in 75-year-old individuals that was enhanced by N-terminal pro-B-type natriuretic peptide (NT-proBNP) stratification did not identify more AF cases or prevent thromboembolic outcomes compared to unscreened control subjects. However, a low NT-proBNP (< 125 ng/L) did identify individuals at low risk for AF and thromboembolic events in whom screening could be safely forfeited.
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A New Drug for Heart Failure with Preserved Ejection Fraction?
The addition of the nonsteroidal mineralocorticoid receptor antagonist finerenone to standard therapy reduced the incidence of recurrent heart failure and death compared to placebo in patients with heart failure and mildly reduced or preserved left ventricular ejection fraction and was generally well tolerated.
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Beyond the Symptoms: A Primary Care Approach to Depression Management
In the vast mosaic of primary care, depression often remains in the shadows, embedded in patient care but easily overlooked. Left unrecognized, the prognosis worsens and complicates the management of other chronic conditions. However, with timely identification and effective treatment, the course of depression can be altered significantly. A comprehensive understanding of this condition, coupled with effective treatment strategies, empowers the primary care physician to mitigate the potentially debilitating effects of this condition.
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An ECG in Disguise?
How would you interpret the two-lead rhythm strip shown in the figure? Hint: Is there a pattern?
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Nalmefene Injection (Zurnal) and Intranasal Nalmefene HCl (Opvee)
The U.S. Food and Drug Administration has approved the first nalmefene autoinjector for the emergency treatment of known or suspected opioid overdose. Nalmefene is an opioid antagonist and an analog of naltrexone. It was granted a priority review and accelerated approval with a breakthrough therapy designation. It is distributed by Purdue Pharma L.P. as Zurnal.
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A Review of HIV Pre-Exposure Prophylaxis
Human immunodeficiency virus (HIV) pre-exposure prophylaxis is a tool for preventing HIV, especially among high-risk populations. Three medication options are available. Regular screening for HIV and sexually transmitted infections is required, and adherence is crucial for effectiveness. PrEP is underused but increasingly covered by insurance, offering an important preventive option in sexual healthcare.
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Clarifying the Risk of Aortic Aneurysm Development
A large, cross-sectional study of adults by aortic computed tomography angiography has shown that aortic aneurysms (AAs) are more frequent in men than women. While increasing age and body surface area were common risk factors for AA, hypertension was associated with thoracic AA, and hypercholesterolemia and smoking were risk factors for abdominal AA.