Oct 31st, 2019 - Adherence to medical therapy worsened over time following percutaneous coronary intervention (PCI), according to data from the Veteran Affairs. Five years after discharge, adherence rates had dropped roughly 15 percentage points for statins, β-blockers, and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and by almost 70 points for P2Y12 inhibitors. (Circulation: Cardiov...

Oct 31st, 2019 - Medicare patients undergoing left atrial appendage (LAA) occlusion with the Watchman device in routine practice tended to be sicker than the trial populations, translating into higher mortality rates in the real world, researchers found. Among more than 13,000 Medicare beneficiaries with atrial fibrillation (Afib) who underwent LAA closure for stroke prevention, death and readmission rates were...

Oct 30th, 2019 - A resorbable collagen plug venous closure device got patients on their feet faster than did manual compression alone after a catheter-based electrophysiology procedure, according to the AMBULATE trial. Vascular closure with the Vascade MVP device led to faster recovery after cardiac ablation, and with less pain medication use, than seen with randomization to manual compression: Time to ambulati...

Oct 29th, 2019 - Electrical cardioversion without routine extra anticoagulation around the procedure may be feasible for people who've already received left atrial appendage (LAA) occlusion, according to a small retrospective study. Patients with a Watchman implant who received direct current cardioversion for atrial fibrillation (Afib) did not experience any thromboembolic complications from the procedure, rep...

Oct 29th, 2019 - As a cardiologist, patients often ask me for ways to lower their cholesterol without taking statins. They wonder how effective and viable alternatives can be and what strategies they can use to lower their cholesterol in other ways. I often tell my patients at the Ohio State University Wexner Medical Center that diet is key. A focus on a plant-based diet, reducing saturated fat, and increasing ...

Oct 29th, 2019 - After ransomware attacks or other hacks, hospitals' heart attack mortality rates are higher, speculated to be due to delays in care from stronger passwords and other cybersecurity remediation. (PBS.org) Subcutaneous implantable cardioverter-defibrillators may have a special advantage for adults with congenital heart disease, who may have limited or no venous access to the heart, but nearly half...

Oct 28th, 2019 - It would be wrong to count out death as a risk of catheter ablation of atrial fibrillation (Afib), according to real-world data. Early procedure-related mortality, occurring during index admission or readmission within 30 days after discharge, occurred in 0.46% of the 60,203 cases recorded in the Nationwide Readmissions Database in 2010-2015. That rate "exceeds the rates of procedural death rep...

Oct 24th, 2019 - Familial hypercholesterolemia comes with higher risk of aortic stenosis compared to the general population, according to a Norwegian registry study. Whether early initiation of LDL cholesterol-lowering therapy could prevent aortic stenosis might be ideally tested in this group, investigators concluded. (JAMA Cardiology) The retrograde approach was associated with more in-hospital major complica...

Oct 23rd, 2019 - Antihypertensive medications are better taken before bed than are upon awakening in the morning, according to a Spanish multicenter trial. Night-time blood pressure (BP) drug regimens nearly halved risk of cardiovascular disease (CVD) death, MI, coronary revascularization, heart failure, or stroke compared with day-time regimens over a median of 6.3 years (adjusted HR 0.55, 95% CI 0.50-0.61). E...

Oct 23rd, 2019 - In a count of U.S. specialists able to give type 2 diabetes care in the U.S., cardiologists came out on top, researchers reported. Topping off at nearly 23,000 cardiologists across the U.S. in 2016, there were an estimated 81 incident diabetes cases per cardiologist that year, ranging from 30:1 in the District of Columbia to 154:1 in Alaska, according to Ravi Patel, MD, of the Northwestern Univ...

Oct 23rd, 2019 - Patients fresh out of cardiac valve surgery are no exception to the general underutilization of cardiac rehabilitation in the U.S., according to an observational cohort study. Enrolling in a comprehensive program of supervised exercise, cardiac risk factor modification, and psychosocial support was associated with reduced risks of re-hospitalization (adjusted HR 0.66, 95% CI 0.63-0.69) and mort...

Oct 22nd, 2019 - A protein used by ticks to facilitate sucking our blood may actually be a good antithrombotic that doesn't promote bleeding, based on a rabbit model of cardiopulmonary bypass surgery. (Journal of the American College of Cardiology) Alfred Bove, MD, PhD, past president of the American College of Cardiology, passed away Oct. 17 at the age of 81. (Cardiovascular Business) The FIND FH machine-learn...

Oct 21st, 2019 - A comprehensive depression screening and treatment program didn't help acute coronary syndrome (ACS) survivors more than usual care or what they could achieve on their own, a 1,500-person trial showed. Mean quality-adjusted life-years fell by an identical 0.06 over 18 months whether patients were randomized to systematic depression screening plus notification of primary care clinicians and trea...

Oct 21st, 2019 - Bone fractures are a risk to be considered when choosing the oral anticoagulant for a patient with non-valvular atrial fibrillation (Afib), a study suggested. The risk of poor osteoporotic outcomes was significantly lower with direct oral anticoagulant (DOAC) compared with vitamin K antagonist (VKA) therapy, as follows: Any fracture: 3.09% vs 3.77% (adjusted HR 0.85, 95% CI 0.74-0.97) Major ost...

Oct 20th, 2019 - The FDA approved dapagliflozin (Farxiga) to reduce heart failure (HF) hospitalization risk in adults with type 2 diabetes at elevated risk due to established cardiovascular disease or multiple risk factors for it, AstraZeneca announced. Dapagliflozin is the first selective inhibitor of sodium-glucose cotransporter 2 (SGLT2) to gain that particular supplemental indication. Just last month, SGLT2...

Oct 17th, 2019 - Gut insulin secretion hormone glucagon-like peptide 1 added incremental prognostic value to the GRACE score in assessing cardiovascular risk among patients with acute MI, found a study in European Heart Journal. A pharmacoinvasive strategy with tenecteplase bested primary percutaneous coronary intervention (PCI) for the treatment of ST-segment elevation MI in an observational study of over 5,50...

Oct 16th, 2019 - Statin use started in childhood for familial hypercholesterolemia (FH) kept atherosclerotic plaque levels normal and was associated with better outcomes in adulthood, long-term follow-up of a clinical trial cohort showed. Mean progression of carotid intima-media thickness was similar for these patients as for their siblings without FH (0.0056 vs 0.0057 mm per year) and remained nonsignificantly...

Oct 16th, 2019 - College football players in a longitudinal study tended to follow a trajectory of cardiovascular (CV) changes leading to a specific kind of adverse CV remodeling. Over the course of 3 years of college football, after adjusting for race, height, and player position, players had significant changes from the beginning of freshman year: Systolic blood pressure: average increase of 11.6 mm Hg (P<0.0...

Oct 16th, 2019 - Angiotensin receptor blockers (ARBs) were associated with a higher risk of death by suicide compared with angiotensin-converting enzyme (ACE) inhibitors, according to a Canadian population-based study of seniors. The excess risk (adjusted OR 1.63, 95% CI 1.33-2.00) persisted even after a sensitivity analysis excluding people with a history of self-harm (OR 1.60, 95% CI 1.29-1.98), reported Tony...

Oct 15th, 2019 - Ape and gorilla hearts look more like those of strength-trained or sedentary humans and less like those who run or do endurance activity, the New York Times reports. Newark Beth Israel Medical Center kept a heart transplant patient on life support for a year after he didn't wake up from the surgery -- all to prop up the program's survival rate. The hospital may have similarly tailored care for ...