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Clinical Cardiology

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  • Risk Factors for Atrial Fibrillation

    A United Kingdom Biobank study of new onset atrial fibrillation (AF) has shown strong associations with hypertension and obesity at all ages and acute illnesses/surgery in older individuals. Genetics was less important, but in those at low genetic risk, obesity and hypertension were strong predictors of AF.

  • To Stress Test or Not Post-PCI

    A prespecified subgroup analysis of diabetic patients in the POST-PCI study, which randomized patients post-percutaneous coronary intervention to routine stress testing vs. standard care at one year and followed for two years, has shown that adverse cardiac outcomes and death rates were not improved by routine stress testing.

  • Long-Term Follow-Up Confirms Efficacy of Invasive Strategy in Very Old Patients with Non-ST Elevation ACS

    In this long-term analysis of patients in the After Eighty Study, with a mean age of 85 years and non-ST-elevation acute coronary syndrome, an invasive strategy showed a reduction in a composite endpoint of major adverse cardiovascular events and was associated with a significant improvement in event-free survival compared with a conservative approach.

  • Safety and Tolerability of Inclisiran

    A pooled analysis of seven relatively short-term ORION studies of inclisiran vs. placebo for lowering low-density lipoprotein cholesterol that assessed safety and tolerability for up to six years showed that inclisiran has similar rates of adverse events, excluding injection site reactions, as placebo treatment and is associated with fewer major adverse cardiovascular events.

  • Do Patients with Heart Failure Feel Better on Dapagliflozin?

    An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.

  • A New Intervention Criterion for Ascending Aortic Aneurysm

    A large retrospective study from the Yale University Aortic Institute database of unoperated patients with ascending thoracic aneurysms has shown that the risk of an adverse aortic event rises significantly at 5.0 cm to 5.4 cm in maximum diameter and supports moving the guideline for surgical intervention from 5.5 cm to 5.0 cm.

  • Anti-Ischemic Therapy for Microvascular Angina

    A small, invasive study of coronary microvascular disease patients has shown that those with a coronary flow reserve < 2.5 may benefit from anti-ischemic therapy.

  • Atorvastatin vs. Rosuvastatin in Patients with Coronary Artery Disease

    A large trial of moderate doses of rosuvastatin vs. atorvastatin in patients with coronary artery disease has shown that both drugs are equivalent at reducing major adverse cardiovascular and cerebral events, but rosuvastatin is associated with higher rates of new- onset diabetes and cataract surgery.

  • Apixaban vs. Aspirin for Subclinical Atrial Fibrillation

    A randomized controlled trial of apixaban vs. low-dose aspirin therapy for subclinical atrial fibrillation detected by implanted electrophysiologic devices showed that apixaban is associated with fewer strokes, but more major bleeding episodes compared to aspirin.

  • Percutaneous Coronary Intervention vs. Placebo for Stable Angina Patients

    In this randomized trial of patients with stable angina and objective evidence of ischemia, percutaneous coronary intervention resulted in a significant reduction in angina compared to a placebo procedure.