Clinical Cardiology
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Researchers Suggest Checking Blood Pressure in Both Arms
After taking two readings, use the higher measurement for diagnosis. Guidelines recommend this practice, but data were lacking.
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The Value of Stress Testing in Patients with Known Coronary Artery Disease
A comparison of adenosine stress singe photon emission CT, PET, and MRI in stable patients with known coronary artery disease (CAD) showed PET to be more sensitive for detecting invasive fractional flow reserve-identified ischemic lesions. However, the sensitivity was disappointing; thus, patients with known CAD and new symptoms should be referred directly to invasive coronary angiography.
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Rivaroxaban Monotherapy for Atrial Fibrillation in Coronary Artery Disease Patients
For patients with atrial fibrillation and stable coronary artery disease, rivaroxaban monotherapy was superior to dual therapy for preventing thrombotic and bleeding events and was associated with a lower mortality.
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Reducing the Need for Invasive Coronary Angiography Before TAVR
Among those undergoing evaluation for transcatheter aortic valve replacement, coronary CT angiography and CT-derived fractional flow reserve demonstrated good diagnostic performance, potentially preventing invasive coronary angiography for many patients.
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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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Echocardiographic Assessment of Right Ventricular Function
A study of a cardiac resynchronization therapy registry demonstrated right ventricular free wall strain by speckle tracking 2D echocardiography is more sensitive for detecting right ventricular dysfunction vs. other echo measures of right ventricular function.
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Echo vs. Cardiac MRI for Grading Mitral Regurgitation Severity
A comparison of echocardiographic-measured severity of mitral regurgitation with that of cardiac MRI-determined severity demonstrated poor agreement in the diagnosis of severe mitral regurgitation. Only cardiac MRI was predictive of left ventricular reverse remodeling after mitral valve surgery.
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Bifurcation Disease Predicts Worse Outcomes for PCI at 10 Years
In this analysis of the SYNTAX Extended Survival study, the presence of one or more bifurcation lesions resulted in a higher risk for all-cause death among patients who were treated with percutaneous coronary intervention.
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Secondary Prevention Statin Adherence and Major Adverse Cardiovascular Events
A study of adherence to statin therapy after an atherosclerotic cardiovascular event demonstrated full adherence for five years was associated with significantly lower major adverse cardiovascular events, although only 5% of these patients achieved full compliance for five years.
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A Growing Body of Evidence Supports Left Bundle Branch Pacing
Several late-breaking trials presented at the annual Scientific Sessions of the Heart Rhythm Society add to the data for left bundle branch pacing as an alternative to biventricular pacing for cardiac resynchronization therapy.