Clinical Cardiology Alert – June 1, 2020
June 1, 2020
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Does Anticoagulant Therapy Affect Outcomes in Left Ventricular Mural Thrombus Patients?
Left ventricular thrombus is an uncommon finding but one associated with a high incidence of all-cause mortality and major adverse cardiac and embolic events. Total regression of left ventricular thrombus on anticoagulant therapy reduced mortality.
Warfarin vs. DOAC for Left Ventricular Thrombi
A large, multicenter, observational study of the relative efficacy of warfarin vs. direct oral anticoagulants (DOACs) for left ventricular thrombi has shown that DOAC use is associated with a higher risk of embolic events than warfarin. Investigators advised caution with off-label use of DOACs.
Benefits of Exercise in Established Atrial Fibrillation
A large, long-term, prospective, Norwegian population study of patients with established atrial fibrillation revealed physical activity at or above recommended levels reduces all-cause and cardiovascular mortality vs. atrial fibrillation patients who are inactive.
Thin Evidence Supporting the Obesity Paradox in STEMI
This largest-to-date analysis of six randomized studies of ST-elevation myocardial infarction revealed no association between body mass index and infarct size, one-year mortality, or heart failure hospitalization.
MUCH Ado About WUCH
In a long-term, fixed-drug therapy of hypertension study, masked uncontrolled and white coat uncontrolled hypertension exhibited poor reproducibility over four years. This calls into question studies showing higher rates of adverse outcomes with one baseline blood pressure assessment used to categorize patients.