Clinical Cardiology
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High-Impact Clinical Trials from the European Society of Cardiology Congress 2023
The following is an overview of important cardiology research presented Aug. 25 through Aug. 28 in Amsterdam and online during the ESC Congress 2023.
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Is Planned Complete Revascularization After Myocardial Infarction Wise for Older Patients?
Among patients at least age 75 years presenting with acute myocardial infarction and multivessel coronary disease, physiology-guided complete revascularization led to a lower risk of major adverse cardiovascular events at one year vs. culprit lesion-only percutaneous coronary intervention.
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Supine Blood Pressure Readings May Reveal Hidden Health Risks
Measuring a patient’s blood pressure while he or she is lying down could help clinicians learn more about possible underlying heart problems.
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Reconsidering Aspirin Therapy for Elderly Patients
A post-hoc analysis of the ASPREE trial revealed that in presumably healthy elderly subjects, taking low-dose aspirin daily over three years was associated with a significant drop in hemoglobin and ferritin levels vs. placebo, even when patients with major bleeding events were excluded.
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Social Determinants Play Outsized Role in Black/White Cardiovascular Health Gap
Lower income levels, less education, tighter insurance access raise risk for cardiovascular disease mortality.
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This Leadless Dual-Chamber Pacing System Is Coming
The initial 90-day experience with a dual-chamber leadless pacemaker system showed reliable atrial pacing and atrioventricular synchrony, with complication rates similar to conventional lead-based systems.
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Researchers Report on the Efficacy of the Subcutaneous Implantable Cardioverter-Defibrillator
An FDA-mandated post-approval study of the subcutaneous cardioverter-defibrillator system in a real-world population revealed excellent safety and efficacy over five years.
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Clinical Outcomes of Left Bundle Branch Area Pacing vs. Biventricular Pacing
Researchers compared biventricular pacing to left bundle branch area pacing (LBBAP) for cardiac resynchronization among patients living with heart failure caused by reduced left ventricular ejection fraction, along with either LBB block or need for ventricular pacing. The combined endpoint of all-cause mortality rates or heart failure hospitalizations was significantly lower with LBBAP.
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Detecting Left Ventricular Thrombi
A study of early post-ST-elevation myocardial infarction patients who underwent echocardiographic testing and cardiac MRI showed echo misses about two-thirds of cardiac MRI-discovered left ventricular thrombi. However, an echo apical wall motion score can identify most patients in whom echo may miss thrombi for the selective use of cardiac MRI.
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Rates of Ad Hoc PCI Remain Higher for Multivessel and Left Main Disease
In this retrospective analysis of patients from the New York state percutaneous coronary intervention (PCI) and coronary artery bypass grafting databases, ad hoc PCI was performed frequently among patients with left main and multivessel disease. Also, variability in ad hoc PCI use among hospitals and physicians for these populations was high.