Clinical Cardiology
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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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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.
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Provocative Testing with Intracoronary Acetylcholine as Part of Cardiac Catheterization Evaluation
In this systematic review and meta-analysis of invasive coronary provocation testing, intracoronary acetylcholine was found to be a safe procedure, with low rates of major complications.
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Clinical Significance of Mitral Annular Calcification
Researchers found mitral annular calcification to be uncommon, and few experience associated moderate to severe mitral stenosis or regurgitation. However, the latter group recorded a high mortality rate over three years follow-up, which was significantly lower in those who underwent valve interventions, even when corrected for younger age, fewer comorbidities.
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Appropriate Management of Thoracic Aortic Aneurysms
Among patients with arch and descending thoracic aorta aneurysms followed over a mean 20 months, aneurysm-related mortality was predicted by the size and growth rate of the aneurysms, along with age and sex.
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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.