Clinical Cardiology
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Is Illicit Substance Use Associated with Atrial Fibrillation?
An observational study of a huge cohort of patients admitted to California hospitals showed patients who used cocaine, methamphetamine, opiates, and cannabis were at a higher risk of developing atrial fibrillation vs. those with similar risk factors who did not use the substances.
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Another Marker of Severe Mitral Regurgitation
A small retrospective study showed Doppler echocardiography-derived left ventricular ejection time is an independent predictor of adverse outcomes in patients with moderate or worse mitral valve regurgitation.
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The Right Dose at the Right Time: Improving Hypertension Outcomes
An online study of evening vs. morning administration of patients’ usual antihypertensive medications, with a median five-year follow-up, revealed there is no difference in major cardiovascular outcomes between the two periods.
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Are Renal Artery Denervation Efficacy Claims Too Good to Be True?
Three-year follow-up data from the SYMPLICITY HTN-3 trial of renal denervation provide support for long-term safety of this technique and suggest blood pressure benefit.
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Hot Trials from the European Society of Cardiology Annual Congress
Some highlights from two key studies presented in Barcelona, Spain, between Aug. 26 and Aug. 29, 2022, along with Dr. Crawford’s personal commentary on both.
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Importance of Medication Adherence in Ischemic Heart Disease
The results of a subanalysis of the ISCHEMIA trial indicated about one-quarter of patients in both conservative and invasive strategy groups were nonadherent to recommended medical therapy at baseline. Nonadherence was associated with worse health status in both groups at baseline and after one year.
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Ejection Fraction and Outcomes in Bicuspid Aortic Valve Disease
A study of patients with bicuspid aortic valve and moderate or more aortic valve disease revealed the cutpoint for considering aortic valve replacement should be moved from < 50% to < 60% in the guidelines.
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Is Routine Stress Testing After Coronary Revascularization Necessary?
A multicentered study of routine stress testing at one year post-percutaneous coronary revascularization compared to usual care in patients with at least one high-risk coronary anatomic or clinical feature failed to show improved clinical outcomes at two years follow-up.
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The Dental Procedure-Infective Endocarditis Link Controversy Continues
Infective endocarditis was more common with dental surgery or tooth extractions in the preceding four weeks in high-risk patients. Researchers abrogated this risk with antibiotic prophylaxis before the procedure.
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Cerebral Embolic Protection Device Disappoints in TAVR/Stroke Trial
In this largest-to-date randomized trial of stroke prevention in transcatheter aortic valve replacement patients, use of the Sentinel cerebral embolic protection device did not significantly affect the incidence of periprocedural stroke.