Clinical Cardiology
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Is It Acceptable to Die of Aortic Stenosis Without a TAVR?
Investigators performed a retrospective analysis of 544 patients undergoing transcatheter aortic valve replacement (TAVR) at one center to assess the contribution of a frailty score to the Society of Thoracic Surgeons (STS) risk score for predicting mortality post-procedure. The frailty score was found to be an independent predictor of 30-day and one-year mortality and additive to the STS score.
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Prognostic Value of Left Ventricular Strain in Chronic Aortic Regurgitation
A retrospective observational study of the incremental value of echocardiographic global longitudinal strain (GLS) for predicting mortality in asymptomatic patients with moderate to severe aortic regurgitation and normal left ventricular function showed that GLS was a predictor of mortality. However, GLS was not as robust as undergoing surgery was for predicting mortality.
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Vegetarian Diet vs. Mediterranean Diet to Reduce Cardiovascular Risk
A randomized, open, cross-over study of a vegetarian diet (VD) compared to the Mediterranean diet (MD) over three months showed that both reduced body weight and body fat mass. The VD decreased LDL cholesterol, and MD reduced triglyceride levels. The MD reduced inflammatory markers, and the VD reduced vitamin B12 levels.
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Is the Type of Myocardial Infarction Important?
An observational study of hospitalized patients with type 1 or 2 myocardial infarction (MI) or myocardial injury showed that mortality is higher in type 2 MI or myocardial injury patients compared to type 1 MI patients.
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Creatinine Bumps and Renal Tubular Injury in Acute Heart Failure
In patients with acute heart failure who receive aggressive diuresis, worsening renal function identified by a rise in serum creatinine or cystatin C is not indicative of kidney tubular injury.
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Real-world Study of Left Atrial Appendage Occluder Devices Raises New Concerns
A large observational study from France of two devices used commonly for occlusion of the left atrial appendage in patients with atrial fibrillation showed that device-related thrombus was not uncommon and was associated with subsequent stroke.
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The Pulmonary Embolism Rule-out Criteria in Low-risk Patients
A cluster randomized trial of the pulmonary embolism rule-out criteria (PERC) compared to usual care for patients estimated to be at low risk of pulmonary embolus (PE) in EDs showed that PERC was non-inferior to usual care at identifying patients who would be free of symptomatic PE at three months, resulting in less use of healthcare resources.
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Risk of Endocarditis Revisited
The authors of a population-wide study of hospitalizations and deaths from infective endocarditis (IE) in England confirmed the high risk of IE in certain cardiac conditions, but showed that other conditions thought to be low risk also are at higher risk and found new higher-risk categories not previously identified. Investigators suggested these data should be considered when the antibiotic prophylaxis guidelines are revised.
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Coffin Nail for Omega-3 Fatty Acids?
A meta-analysis of 10 randomized, controlled trials of omega-3 fatty acids for the prevention of coronary heart disease and major vascular events showed no significant effect on fatal and non-fatal coronary heart disease or any major vascular event. These results do not support the use of omega-3 fatty acids supplements in patients with prior coronary heart disease.
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Methamphetamine-associated Pulmonary Hypertension and Cardiomyopathy Are Distinct Diseases
In a large study of methamphetamine users, female sex was associated with presence of pulmonary hypertension, whereas male sex, hypertension, and alcoholism were associated with cardiomyopathy. Both pulmonary hypertension and cardiomyopathy patients exhibited substantially increased mortality.