Clinical Cardiology
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Screen Older Heart Failure Patients for Transthyretin Cardiac Amyloidosis
A screening study of heart failure patients ≥ age 60 years, left ventricular ejection fraction ≥ 40%, and left ventricle wall thickness ≥ 12 mm revealed 6.3% prevalence of transthyretin cardiac amyloidosis, a highly treatable disease.
Value of Optimal Medical Therapy After Revascularization
Patients with three-vessel or left main coronary artery disease randomized to coronary bypass surgery vs. percutaneous therapy on optimal medical therapy at five years with three or four of the recommended drugs recorded a lower 10-year all-cause mortality rate vs. those on ≤ 2 drugs.Early Physical Rehabilitation in Acutely Hospitalized Heart Failure Patients
A tailored, progressive physical rehabilitation program started in the hospital and continued for three months in older, relatively frail acute heart failure admissions resulted in significantly improved physical function vs. usual care but did not reduce six-month readmission rates.The Difficulty of Showing Benefit of Cerebral Protection Devices During TAVR
In this trial of cerebral protection in transcatheter aortic valve replacement, the TriGUARD device was safe vs. historical controls, but failed to meet its primary efficacy endpoint.Coffee Consumption and Tachyarrhythmias
An analysis demonstrated an inverse association of coffee consumption and cardiac arrhythmias, which was not altered by genetic variations in caffeine metabolism, age, or sex.Alcohol Consumption and Atrial Fibrillation
An analysis of the UK Biobank database revealed low levels of alcohol consumption, especially with wine and spirits, is associated with the lowest incidence of atrial fibrillation.When in Doubt, Take It Out: Left Atrial Appendage Occlusion
In a randomized trial of patients with atrial fibrillation, left atrial appendage occlusion during elective cardiac surgery was associated with lower rates of ischemic stroke or systemic embolism after 30 days.Iron Therapy for Acute Heart Failure
Giving intravenous ferric carboxymaltose to stabilized post-acute heart failure patients with iron deficiency improved quality of life vs. placebo-treated patients within four weeks, which persisted during subsequent therapy for up to 24 weeks.Anticoagulation Plus Antiplatelet Therapy in Chronic Atherosclerosis
An analysis of the COMPASS trial for the secondary endpoint of mortality showed the combination of low-dose rivaroxaban and aspirin significantly lowered the all-cause mortality rate vs. low-dose aspirin alone.Important Lessons About Edge-to-Edge Repair
This analysis of mitral surgery after failed transcatheter edge-to-edge repair demonstrates high rates of valve replacement as opposed to repair. Surgical mortality was higher than predicted but was significantly lower in high-volume centers.