Internal Medicine
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Permanent His-bundle Pacing Cardiac Resynchronization: The Way Nature Intended
When used as either a primary alternative to biventricular pacing or a rescue therapy for failed biventricular pacing, permanent His-bundle pacing was associated with significant QRS narrowing, an increase in left ventricular ejection fraction, and an improvement in New York Heart Association functional class.
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Age-stratified NT-proBNP Thresholds Identify Acute Heart Failure
In patients presenting to the ED with acute dyspnea, age-based NT-proBNP cutpoints help diagnose acute heart failure.
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Are Beta-blockers Indicated for Heart Failure at all LVEF Levels?
A meta-analysis of 11 trials of beta-blockers for heart failure showed that beta-blockers increased left ventricular ejection fraction and reduced cardiovascular mortality in patients in sinus rhythm with baseline ejection fractions < 50%, including those in the 40-49% range.
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CABG vs. PCI in Diabetes With Multivessel Coronary Artery Disease and LV Dysfunction
A propensity score-matching analysis of all patients undergoing coronary angiography in Alberta, Canada, identified a subgroup with diabetes, multivessel coronary artery disease, and left ventricular ejection fraction < 50% who were undergoing revascularization and could be separated into a group undergoing percutaneous coronary intervention (PCI) and another coronary artery bypass grafting (CABG). At five years' follow-up, the CABG group experienced significantly fewer major cardiac or cerebral vascular events compared to PCI and a low risk of stroke that was similar to that observed with PCI.
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TAVR in Lower-risk Patients: How Low Should We Go?
A meta-analysis of studies comparing transcatheter aortic valve replacement (TAVR) to surgical aortic valve replacement over a two-year follow-up in low surgical risk patients exhibits a higher mortality in the TAVR group, prompting the authors to recommend caution in applying TAVR to low-risk patients until randomized trials are completed.
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Clinical Briefs
In this section: improving cardiovascular outcomes in type 2 diabetes patients; digging deeper into penicillin allergies; and treating osteoporosis.
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Apalutamide Tablets (Erleada)
Apalutamide is indicated for the treatment of patients with non-metastatic, castration-resistant prostate cancer.
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Providers Facilitate Transmission of Resistant Organisms
A closer look at the role providers play in the transmission of carbapenem-resistant Enterobacteriaceae.
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Physician Burnout: A Multi-specialty Perspective
Although different specialties address the problem of physician burnout, studies suggest the most effect is gained from organizational interventions.
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Another Reason to Get the Flu Shot Every Year
In a case-control study, among older adults, repeated vaccination for influenza was twice as effective in preventing severe influenza compared to non-severe influenza in patients who were admitted to the hospital.