Clinical Cardiology
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Can Antibiotics Sterilize an Infected Heart Valve Before Surgery?
In a study of the relationship between the duration of antibiotic therapy and a positive surgically excised heart valve culture in patients with infective endocarditis, researchers observed positive valve culture incidence decreases exponentially on antibiotic therapy for 14 days then plateaus with no effect after 21 days of therapy.
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The Prognosis of Severe Mitral Annular Calcification
This retrospective review of the natural history of severe calcific mitral valve stenosis demonstrates such patients die often partly because of a high comorbidity burden and partly as a result of the valve stenosis.
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Renal Denervation Makes a Comeback
This retrospective review of the natural history of severe calcific mitral valve stenosis demonstrated such patients have a high mortality partly because of a high comorbidity burden and partly because of valve stenosis. Although often symptomatic, symptoms did not predict mortality.
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Is Exercise ECG Testing Dead?
A post-hoc analysis of the SCOT-HEART trial demonstrated exercise ECG is predictive of future coronary heart disease events and mortality. However, coronary CT angiography is more accurate for the detection of coronary artery disease and is more strongly associated with future coronary events.
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Clinical vs. Genetic Risk for Coronary Disease
A study of the utility of a polygenetic score for coronary artery disease risk was compared to the pooled cohort equation (PCE) for determining which primary prevention patients would benefit from statin use. Only at the top 5% risk stratum did the genetic score exceed an odds ratio for coronary disease of 2. Using these data would increase statin recommendations by 4% vs. the PCE.
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Coronary Calcium to Guide Aspirin Primary Prevention
Researchers analyzed the MESA study to determine the comparative value of the pooled risk equation vs. CT coronary artery calcium score for determining which aspirin-naïve patients < age 70 years without overt coronary artery disease would benefit most from primary prevention with aspirin. They found a calcium score of > 100 was superior for this determination.
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Subclinical Leaflet Thrombosis: Not Just a TAVR Phenomenon
Imaging-defined leaflet thrombosis was common and similar between transcatheter aortic valve replacement and surgical aortic valve replacement bioprosthetic valves. These findings showed no apparent relationship to valve hemodynamics or to clinical outcomes, including stroke.
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Where Does Vericiguat Fit into the Heart Failure Medication Algorithm?
Vericiguat reduced cardiovascular death and heart failure hospitalization, although no reduction in overall mortality was observed over a short follow-up period.
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MUCH Ado About WUCH
In a long-term, fixed-drug therapy of hypertension study, masked uncontrolled and white coat uncontrolled hypertension exhibited poor reproducibility over four years. This calls into question studies showing higher rates of adverse outcomes with one baseline blood pressure assessment used to categorize patients.
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Thin Evidence Supporting the Obesity Paradox in STEMI
This largest-to-date analysis of six randomized studies of ST-elevation myocardial infarction revealed no association between body mass index and infarct size, one-year mortality, or heart failure hospitalization.