Clinical Publication
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Predicting the Tolerability of Sacubitril/Valsartan in Advanced Heart Failure
An analysis of the sacubitril/valsartan run-in period for chronic, advanced heart failure patients showed 18% could not tolerate the lowest dose, usually because of hypotension or renal dysfunction. Investigators identified six predictors of non-tolerance, which may help clinicians choose the best candidates.
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The Value of Stress Testing in Patients with Known Coronary Artery Disease
A comparison of adenosine stress single-photon emission CT, PET, and MRI in stable patients with known coronary artery disease (CAD) showed PET to be more sensitive for detecting invasive fractional flow reserve-identified ischemic lesions. However, the sensitivity was disappointing. Patients with known CAD and new symptoms should be referred directly to invasive coronary angiography.
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Rivaroxaban Monotherapy for Atrial Fibrillation in Coronary Artery Disease Patients
For patients with atrial fibrillation and stable coronary artery disease, rivaroxaban monotherapy was superior to dual therapy for preventing thrombotic and bleeding events and was associated with a lower mortality rate.
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Smoking Cessation After Atrial Fibrillation Diagnosis Could Lower Dementia Risk
A cohort study of patients with atrial fibrillation (AF) in South Korea revealed patients who stopped smoking after AF diagnosis were at lower risk for developing dementia than those who continued smoking.
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Is the Canadian Syncope Risk Score Valid?
Researchers found the Canadian Syncope Risk Score accurately predicts which patients are low risk for discharge. However, since it is driven largely by the physician’s final risk classification at ED discharge, the score’s clinical utility is uncertain.
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Comparing CT Angiography to Invasive Angiography for Stable Chest Pain Patients
A trial of initial coronary CT angiography vs. invasive angiography revealed outcomes over a median 3.5-year follow-up were similar, but procedure-related complications were more common in the invasive group.
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Baricitinib Tablets (Olumiant)
Baricitinib is the first FDA-approved systemic treatment of alopecia areata.
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What Do You Think Happened?
You are asked to interpret the tracing in the figure without the benefit of any history. What do you think happened? How acute are these findings?
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Researchers Suggest Checking Blood Pressure in Both Arms
After taking two readings, use the higher measurement for diagnosis. Guidelines recommend this practice, but data were lacking.
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Dancing to Improve Balance and Quality of Life in Healthy Seniors
This prospective cohort study found that healthy volunteers aged 63-80 years who participated in 18 months of a dance intervention experienced an increase in more hippocampal regions and greater improvements in balance compared to their age- and sex-matched peers who underwent 18 months of an aerobic fitness intervention.