Clinical Cardiology
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Comparing CT Angiography to Invasive Angiography for Stable Chest Pain Patients
A trial of initial coronary CT angiography vs. invasive angiography revealed outcomes over a median 3.5-year follow-up were similar, but procedure-related complications were more common in the invasive group.
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Thrombolysis vs. Surgery for Thrombosed Mechanical Prosthetic Valves
A study of patients with obstructive prosthetic valve thrombosis that deployed low-dose, slow infusion thrombolysis or surgery using shared decision-making, showed thrombolysis was highly effective and resulted in fewer major complications than surgery.
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Comparison of Treatments Highlights Poor Outcomes for TAVR Patients with Infective Endocarditis
In this analysis of a large registry of transcatheter aortic valve replacement patients with confirmed endocarditis, most were treated with antibiotics without surgery. In-hospital and one-year mortality rates were high and were not much better in patients who underwent surgery.
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Gastrointestinal Bleeding on Anticoagulants: Predicting Colorectal Cancer in Afib Patients
A large Danish registry study showed that in atrial fibrillation patients on oral anticoagulants and who experience a lower gastrointestinal bleed (LGIB), the incidence of a subsequent diagnosis of colorectal cancer is significantly higher than in those without a LGIB.
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Yoga for the Mind, Body, and Autonomic Nervous System
Randomization to yoga in addition to standard care to treat vasovagal syncope led to better outcomes than standard care alone, with reductions in syncopal and presyncopal events and improvement in quality of life scores at one year.
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Extra Coronary Vascular Involvement in Spontaneous Coronary Artery Dissection
When viewing cardiac MRI and peripheral angiography of patients with spontaneous coronary artery dissection, investigators observed peripheral arterial abnormalities, including fibromuscular dysplasia, in about one-quarter.
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Searching for the Best Echo Parameter to Predict Aortic Stenosis Outcomes
In a study of two large echocardiographic databases, the authors observed maximum aortic velocity exhibits a strong linear relationship, with the risk of mortality starting at velocities of 100 cm/s, whereas calculated aortic valve area was not related to mortality until the valve area was <1.5 cm2.
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Interatrial Shunt Device for Heart Failure Disappoints
Placement of an interatrial shunt device in patients with heart failure with preserved or mildly reduced ejection fraction did not lower the rate of heart failure events or improve health status.
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Is Cannabis Use a Marker for Atherosclerotic Cardiovascular Disease?
Admitted cannabis use was associated with an increase in the pooled risk of atherosclerosis score in a graded fashion based on the frequency of use, which was consistent across subgroups based on the presence of hypertension, obesity, and hyperlipidemia.
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How Certain is a Negative Echocardiogram for Excluding Infective Endocarditis?
Applying the proposed strict negative criteria for infective endocarditis (IE) on the first echocardiogram indicated this approach largely prevented unnecessary repeat tests unless clinically indicated for continued suspicion of IE.