Clinical Cardiology
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Are Anti-Inflammatory Drugs Useful in Malignant Pericardial Effusion?
Researchers studied patients with malignant pericardial effusion treated with pericardiocentesis and then anti-inflammatory agents if signs of adhesions or constriction were observed in post-drainage echocardiograms. Compared to NSAIDs and steroids, the authors found colchicine administration for 60 days reduced the rate of subsequent all-cause mortality and recurrent pericardial effusion.
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Using Sacubitril/Valsartan to Treat Heart Failure with Preserved Ejection Fraction
An analysis of renal outcomes in the PARAGON-HF trial revealed sacubitril/valsartan slows progression of kidney disease in patients with heart failure with preserved ejection fraction compared to valsartan alone.
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The Effect of Age on Cholesterol-Lowering Therapy
Investigators analyzed data on the effect of age on cardiovascular (CV) outcomes and LDL cholesterol-lowering by alirocumab vs. placebo in recent acute coronary syndrome patients. They found alirocumab can lower the rate of CV events regardless of age — and produce increasing absolute benefit with age.
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Another Affirmation for Rhythm Control in Atrial Fibrillation
A rhythm control strategy implemented less than one year after atrial fibrillation diagnosis was associated with significant reduction in adverse cardiovascular outcomes when compared to usual care.
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U.S. Readmission Rates for TAVR
An analysis of the Nationwide Readmission Database revealed one-fifth of transcatheter aortic valve replacement patients are readmitted a median of 31 days after discharge. Medical comorbidities are the most common reason.
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TAVR Outcomes in Patients on Chronic Corticosteroid Therapy
A 12-year experience with transcatheter aortic valve replacement at one Paris hospital demonstrated chronic systemic corticosteroid use increases the incidence of major 30-day complications and all-cause mortality at one year.
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When Is TAVR Futile?
A study of all patients who underwent transcatheter aortic valve replacement over eight years in France was used to develop a futility score that would help predict who would not live one year after the procedure. This simple clinical score based on comorbidities predicted who would live one year with 95% specificity.
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Which Acute Myocardial Infarction Patients Need a Blood Transfusion?
A randomized trial of a restrictive blood transfusion strategy vs. a more liberal strategy in patients with acute myocardial infarction and anemia showed the restrictive strategy is noninferior to the liberal strategy for preventing the primary outcome of death, reinfarction, stroke, or emergency revascularization.
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Does BAMI Spell the End for Cell-Based Therapy After Acute Myocardial Infarction?
Investigators tested the mortality benefit of intracoronary bone marrow cells in patients with successfully reperfused acute myocardial infarction. They observed no effect on mortality.
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Pulmonary Artery Denervation: A Promising Treatment Option for CTEPH
A trial of patients with residual chronic thromboembolic pulmonary hypertension following pulmonary endarterectomy showed pulmonary artery denervation is superior to medical management with riociguat.