Cardiology
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A Hidden Rhythm
The only clinical information available for this tracing is that the ECG was obtained from an older woman. Without any other background, where should we go from here?
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Improving Statin Tolerance in Elderly Patients
In a post-hoc analysis of the RACING trial, researchers found the combination of moderate-intensity statin and ezetimibe therapy vs. high-intensity statin therapy alone in older subjects resulted in similar reductions in cardiovascular events over three years, but fewer adverse effects with the combination therapy.
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American Heart Association Urges Improvement in Stroke Care
In a scientific statement, the group offered tactics to eliminate the racial and ethnic inequities that exist in stroke incidence, prevalence, treatment, and outcomes.
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Age and Sexual Dimorphism in Aortic Regurgitation
Among patients with chronic, significant aortic regurgitation, women and older men without symptoms indicating the need for aortic valve replacement maintained smaller left ventricular volumes than young men and developed adverse clinical events at lower left ventricular volumes.
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Cardiac MRI Predicts Outcomes in Aortic Regurgitation
Cardiac MRI could be used to make management decisions when treating patients living with chronic, asymptomatic aortic regurgitation with preserved left ventricular function, especially when trying to predict severity and possibility of adverse outcomes.
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Valve Replacement Risk and Lifetime Management of Aortic Valve Disease
The authors of an analysis of more than 31,000 patients from the Society of Thoracic Surgeons’ database identified patients undergoing surgical aortic valve replacement (SAVR) after prior transcutaneous AVR (TAVR) or SAVR. SAVR after TAVR raised the risk of mortality vs. SAVR after SAVR.
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Direct Oral Anticoagulants vs. Warfarin When Treating Renal Dysfunction
A patient-level meta-analysis of five pivotal trials of direct oral anticoagulants (DOACs) vs. warfarin for patients with atrial fibrillation and creatinine clearance levels ranging from normal to 25 mL/min revealed standard-dose DOACs exhibit superior safety and efficacy compared to adjusted-dose warfarin and lower-dose DOACs.
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Does Running Prevent Coronary Artery Disease?
In this cross-sectional review of the Master Athlete Heart study, the authors found lifelong endurance sport participation was not associated with a more favorable coronary plaque composition vs. a healthy lifestyle. Lifelong endurance athletes exhibited more coronary plaques.
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Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
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Unexpected Low Voltage on an ECG
A registry study of hypertrophic cardiomyopathy (HCM) patients and elite athletes in Italy revealed low voltage on ECG is not uncommon in HCM and may be a marker for more left ventricular scarring on cardiac imaging — and a poor prognosis.