Cardiology General
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Hot Trials from the European Society of Cardiology Annual Congress
Below are some highlights from four key studies presented in Barcelona, Spain, between Aug. 26 and Aug. 29, 2022, along with Dr. Crawford’s personal commentary on each.
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REVIVED Shows No PCI Benefit for Patients with Coronary Disease, Reduced EF
Researchers randomly assigned patients with an ejection fraction ≤ 35% and severe coronary disease to percutaneous coronary intervention or optimal medical therapy alone. After 3.4 years median follow-up, researchers noted no significant differences between groups in terms of all-cause death or heart failure hospitalization.
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Statins Plus Ezetimibe vs. Statins Alone
A comparison of rosuvastatin 10 mg/day plus ezetimibe (10 mg/day) to 20 mg/day of rosuvastatin alone showed non-inferiority in three-year major cardiovascular outcomes, with lower LDL cholesterol levels and fewer episodes of drug discontinuation or dose reductions in the combination therapy group.
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Importance of Discordant Grading of Moderate Aortic Stenosis
A study of patients with moderate aortic stenosis by Doppler echocardiographic calculated valve area revealed 40% exhibit discordant measures, where pressure gradient is lower than expected. These patients died more often than those with concordant measurements, especially those where the discrepancy was caused by low flow.
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Those Anterior T Waves
The ECG in the figure was obtained from a man in his 60s who was seen in the field for new chest pain. How might one interpret this tracing?
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Are SGLT2 Inhibitors Effective for HFpEF Patients Without Diabetes?
After comparing empagliflozin to placebo for patients with heart failure and preserved left ventricular ejection fraction, researchers found no differences in the significant reduction of the primary outcome of cardiovascular death or heart failure hospitalization over 36 months based on whether patients were diabetic.
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Measure Stroke Risk with Asymptomatic Severe Carotid Artery Stenosis
A community-based, retrospective, observational study of patients with asymptomatic severe carotid artery stenoses showed the crude stroke risk over five years was about 5%. Patients whose stenoses progress to high grade or start at that severity were at the highest risk for stroke.
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COVID-19 Infection More Likely to Inflame Heart Than Vaccine
Researchers noted patients were much more likely to be afflicted with myocarditis after a SARS-CoV-2 infection than after receiving a vaccine.
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Are SGLT2 Inhibitors Effective for HFpEF Patients Without Diabetes?
After comparing empagliflozin vs. placebo for patients with heart failure and preserved left ventricular ejection fraction, researchers found no differences in the significant reduction of the primary outcome of cardiovascular death or heart failure hospitalization over 36 months based on whether patients were diabetic.
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Predicting the Tolerability of Sacubitril/Valsartan in Advanced Heart Failure
An analysis of the sacubitril/valsartan run-in period for chronic, advanced heart failure patients showed 18% could not tolerate the lowest dose, usually because of hypotension or renal dysfunction. Investigators identified six predictors of non-tolerance, which may help clinicians choose the best candidates.