Clinical Cardiology
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Paclitaxel-Eluting Devices: Is It Time to Stop Worrying?
Paclitaxel-eluting devices vs. bare metal stents in peripheral arterial disease showed no significant difference in all-cause mortality, contradicting the results of a controversial meta-analysis.
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Is There an Ideal Time to Administer Antihypertension Medications?
Taking all antihypertensive agents before bed vs. upon awakening in hypertensive patients showed there was less hypertension during sleep and few cardiovascular events over a six-year follow-up.
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How to Record Reliable Blood Pressure Measurements
A small, community-based study to detect hypertension revealed one week of twice-daily home blood pressure (BP) measurements are more reliable and more accurately predict increased left ventricular mass than clinic or 24-hour ambulatory BP monitoring.
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Giving the Cold Shoulder to Drug Therapy for Atrial Fibrillation
In two randomized trials published simultaneously, cryoballoon ablation proved superior to drug therapy for prevention of arrhythmia recurrence in patients with paroxysmal atrial fibrillation.
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A New Treatment for Refractory Hyperlipidemia
In patients with familial hypercholesterolemia who are not at target LDL cholesterol levels on maximum-tolerated doses of statins and PCSK9 inhibitors, evinacumab, which inhibits angiopoietin-like 3, reduces LDL by more than 50% at the highest doses with few side effects requiring drug discontinuation vs. placebo.
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Expanding Uses for Direct Oral Anticoagulants: Bioprosthetic Heart Valves?
A randomized, controlled trial of rivaroxaban vs. warfarin in patients with atrial fibrillation and a bioprosthetic valve revealed rivaroxaban is noninferior to warfarin for the prevention of major cardiovascular events and the avoidance of major bleeding events over 12 months.
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Time is of the Essence with Colchicine Treatment of Myocardial Infarction
An analysis of the COLCOT study of colchicine administration after myocardial infarction (MI) showed the benefit of this therapy for preventing subsequent cardiovascular events was greatest when therapy was initiated within three days after MI onset.
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Left Ventricular Size, Function Predictors of Outcomes in Chronic Aortic Regurgitation
In a large cohort of asymptomatic patients with hemodynamically significant chronic aortic regurgitation, volumetric left ventricular size and function measurements were equally discriminant in identifying patients at higher risk for mortality vs. traditional linear measurements.
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What Causes MINOCA?
A systematic imaging protocol of coronary angiography, optical coherence tomography, and cardiac MRI in women clinically diagnosed with myocardial infarction with non-obstructive coronary artery disease revealed a cause in 84%, with three-quarters exhibiting an ischemic etiology.
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Prophylactic PCI for Vulnerable Plaques
In this proof-of-concept trial, treatment of non-flow limiting vulnerable plaque by PCI with bioabsorbable stents resulted in no significant difference in lesion-related events compared with optimal medical therapy, but there was a trend toward less angina driven revascularization in the stented group.