Clinical Cardiology Alert – May 1, 2020
May 1, 2020
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A large population study has shown a U-shaped relationship between left ventricular ejection fraction (EF) and mortality, with a nadir at 60-65%. The authors identified a new group at high risk for death: those with an EF ≥ 70%.
Antiplatelet Agents Add to Bleeding Risk, Do Not Add Benefit in TAVR Patients Already on Oral Anticoagulation
In a randomized trial of patients already on anticoagulation undergoing transcatheter aortic valve replacement, adding clopidogrel to oral anticoagulation increased the incidence of serious bleeding vs. oral anticoagulation alone, but did not improve cardiovascular outcomes.
Investigators assessed the Society of Thoracic Surgeons/American College of Cardiology transcatheter aortic valve replacement (TAVR) data, with a focus on the use of newer TAVR devices in patients with bicuspid aortic valve vs. tricuspid aortic valves. They found the outcomes post-procedure and for one year are not significantly different between the two types of native valve anatomy.
Researchers identified subjects with no known coronary artery disease drawn from a large international, multicenter registry of coronary CT angiography. Subjects were divided into matched pairs with and without a subsequent acute coronary syndrome event. The authors demonstrated those with a high density of calcium plaques experienced the fewest events, suggesting high-density calcium plaques are stable.
Investigators determined about half of serious cardiac complications of pregnancy are preventable.