Clinical Cardiology Alert – February 1, 2024
February 1, 2024
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Do Patients with Heart Failure Feel Better on Dapagliflozin?
An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.
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Safety and Tolerability of Inclisiran
A pooled analysis of seven relatively short-term ORION studies of inclisiran vs. placebo for lowering low-density lipoprotein cholesterol that assessed safety and tolerability for up to six years showed that inclisiran has similar rates of adverse events, excluding injection site reactions, as placebo treatment and is associated with fewer major adverse cardiovascular events.
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Long-Term Follow-Up Confirms Efficacy of Invasive Strategy in Very Old Patients with Non-ST Elevation ACS
In this long-term analysis of patients in the After Eighty Study, with a mean age of 85 years and non-ST-elevation acute coronary syndrome, an invasive strategy showed a reduction in a composite endpoint of major adverse cardiovascular events and was associated with a significant improvement in event-free survival compared with a conservative approach.
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To Stress Test or Not Post-PCI
A prespecified subgroup analysis of diabetic patients in the POST-PCI study, which randomized patients post-percutaneous coronary intervention to routine stress testing vs. standard care at one year and followed for two years, has shown that adverse cardiac outcomes and death rates were not improved by routine stress testing.
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Risk Factors for Atrial Fibrillation
A United Kingdom Biobank study of new onset atrial fibrillation (AF) has shown strong associations with hypertension and obesity at all ages and acute illnesses/surgery in older individuals. Genetics was less important, but in those at low genetic risk, obesity and hypertension were strong predictors of AF.