Cardiology Topics
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Surgical Risk of Mitral Valve Repair, Updated
A contemporary update of the Society of Thoracic Surgeons risk calculator for operative mortality and morbidity in nonemergent primary mitral valve repair for regurgitation shows an operative mortality rate of 1.2%, with a conversion to replacement of 6%, in more than 53,000 patients.
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ECMO-Supported CPR Disappoints for Treating Out-of-Hospital Cardiac Arrest
For patients with out-of-hospital cardiac arrest that was refractory to initial resuscitation efforts, adding extracorporeal membrane oxygenation to standard CPR did not result in a significant improvement in survival with favorable neurologic outcome.
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Long-Term Maintenance Therapy After Percutaneous Coronary Intervention
An extended six-year follow-up of the HOST-EXAM study revealed the consistent benefit of the primary endpoint of fewer major cardiovascular events and less bleeding with clopidogrel vs. low-dose aspirin monotherapy in post-percutaneous coronary intervention patients who were on dual antiplatelet therapy for one year.
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Effectiveness of Dietary Supplements on Lipid and Inflammatory Biomarkers
In a comparison of rosuvastatin 5 mg/day, six common dietary supplements marketed for improving heart health, and placebo, none reduced high-sensitivity C-reactive protein levels. Only rosuvastatin significantly reduced LDL cholesterol levels compared to placebo.
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For Older Americans, More Steps Lead to Better Cardiovascular Health
In a meta-analysis, researchers found walking 6,000 to 9,000 steps daily lowered the risk of cardiovascular disease by 40% to 50% vs. walking 2,000 steps daily.
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Chlorthalidone vs. Hydrochlorothiazide: Which Is Superior for Treating Hypertension?
Randomly switching half of patients with hypertension on hydrochlorothiazide to chlorthalidone did not produce any difference in major cardiovascular outcomes.
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A Patient with Pneumonia
The ECG in the figure was obtained from an elderly man who was admitted to the hospital with pneumonia. This ECG was obtained after his admission when he began to complain of chest pain. There are two important findings on this patient’s ECG. Can you identify them?
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Some Acute Chest Pain Patients Can Be Discharged Safely
Guideline authors recommend implementing high-sensitivity cardiac troponins and clinical decision pathways to safely discharge low-risk patients without additional testing. However, the decision pathway is not meant to replace the emergency physician's clinical judgment.
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Low-Fat vs. Mediterranean Diet for Secondary Prevention
A study of stable coronary heart disease patients comparing the Mediterranean diet to a low-fat diet over a seven-year follow-up showed the Mediterranean diet was superior at preventing major cardiovascular events.
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Is It Better to Up-Titrate Medications Faster in Acute Heart Failure Patients?
Early intensive up-titration of guideline-recommended therapy in patients admitted for heart failure reduced 180-day readmission and all-cause mortality rates at the cost of more adverse events (but not serious or fatal ones).