Clinical
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Angiotensin II Raises Blood Pressure in Patients with Vasodilatory Shock
The ATHOS-3 trial represents an important proof of concept trial regarding angiotensin II as a new vasopressor in the armamentarium to treat vasodilatory shock.
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Antibiotics and Adverse Events: Doctors, Do No Harm
A retrospective study found that among 1,488 hospitalized patients who received an antibiotic, 298 (20%) experienced at least one antibiotic-associated adverse drug event. Furthermore, 287 (19%) of the antibiotic regimens were not clinically indicated, and 56 (20%) of these were associated with an adverse drug event.
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Natriuretic Peptide-guided Therapy Does Not Improve Systolic Heart Failure Outcomes
A recent meta-analysis of 11 trials showed a significant reduction in all-cause mortality with natriuretic peptide-guided therapy, although the individual trial results varied substantially.
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Is a Dabigatran Reversal Agent Effective?
Dabigatran is an attractive oral anticoagulant for patients who demonstrate indications for oral anticoagulation but are at high risk of bleeding.
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Transcatheter Mitral Valve Replacement as an Alternative to Other Surgical Options
A large registry study of transcatheter mitral valve replacement (TMVR) in patients with degenerated mitral valve bioprostheses or failed mitral annuloplasty repairs who were at high risk for repeat surgery showed that TMVR can be performed successfully. However, the initial and long-term results are better in the degenerated bioprothesis group.
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Can Medical Therapy Improve Functional Mitral Regurgitation?
Among patients who presented with heart failure with reduced ejection fraction and severe functional mitral regurgitation, mitral regurgitation improved in 38% of patients with medical management. Improvement in mitral regurgitation was associated with increased survival.
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Patent Foramen Ovale Intervention Rises to Occasion in Cryptogenic Stroke
After years of uncertainty, three large randomized trials have shown a benefit to patent foramen ovale closure in reducing recurrence after cryptogenic stroke in the right patients.
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Late-breaking Clinical Trials From the European Society of Cardiology Congress, August 2017
Recent findings of several important clinical trials in atrial fibrillation management were presented as part of the “Hot Line” sessions at this year’s European Society of Cardiology Congress in Barcelona, Spain. A selection particularly relevant to the general cardiology community is presented here.
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Management of Chronic Hypertension in Pregnancy
Chronic hypertension complicates about 5% of pregnancies and has been associated with higher rates of intrauterine growth restriction (IUGR), stillbirth, and, most importantly, superimposed preeclampsia. Although the condition is far from being solved, there have been some major inroads made into its understanding through contemporary investigation.
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The LNG IUS and Stress Reactivity: A Mechanism for Mood Effects or False Signal?
Users of the levonorgestrel (LNG) intrauterine system showed an exaggerated response to stress compared to women using a combined LNG pill or those with natural cycles.