Oct 22nd, 2021 - The proliferation of transcatheter aortic valve replacement (TAVR) programs in the U.S. was largely limited to metropolitan areas and hospitals serving relatively affluent patients, a study found. Only 2% of the 583 hospitals with a TAVR program by the end of 2018 were not located in metropolitan areas, and there was only one rural center. Furthermore, half of new programs established in 2012 t...

Oct 19th, 2021 - The American Heart Association warns that progress is slowing in national care for ST-segment elevation myocardial infarction. (Circulation) FDA's internal deliberations on myocarditis risk will delay its decision on authorizing the Moderna COVID-19 vaccine for adolescents. (Wall Street Journal) Takotsubo syndrome disproportionately affects older women in the U.S., though its incidence is risin...

Oct 18th, 2021 - The optimal systolic and diastolic blood pressure (BP) target for each person may depend on his or her individual risk profile, an observational study suggested. Based on the 33,357-patient ALLHAT trial, there appeared to be a U- or J-shaped association between risk of several cardiovascular events and BP, such that going too low in systolic or diastolic BP was not good for the patient. The nad...

Oct 15th, 2021 - Farrukh Awan, MD: I want to share a case with you. This is a real-world case. I saw this person yesterday. I was waiting to talk to you about this. There’s no right or wrong answer with this person. We’ve talked about risk stratification up front. We should risk-stratify all our patients. Getting the cardio-oncologist involved up front is what we’re recommending. We’re recommending everyone get...

Oct 13th, 2021 - Use of half-dose direct oral anticoagulants (DOACs) showed promise as a long-term prophylactic strategy after successful percutaneous left atrial appendage (LAA) occlusion, according to an observational study. Patients following this regimen (n=198) saw fewer combined clotting and major bleeding events in the first 13 months after Watchman device placement compared with peers getting standard a...

Oct 13th, 2021 - People with severe heart failure (HF) appeared to be the ones who benefited meaningfully from omecamtiv mecarbil therapy, according to a post-hoc analysis of the GALACTIC-HF trial. While the overall study population showed only a modest benefit for the direct cardiac myosin activator in HF with reduced ejection fraction, the approximately one-quarter of patients with severe HF saw a substantial...

Oct 13th, 2021 - Delivering a child preterm carried lifelong risk for hypertension, a large population-based study showed. Among more than 2 million women in Sweden, delivery before 37 weeks' gestation was independently associated with a 1.67-fold increased risk (95% CI 1.61-1.74) of developing hypertension in the following 10 years, reported Casey Crump, MD, PhD, of Icahn School of Medicine at Mount Sinai in N...

Oct 12th, 2021 - Should some individuals at risk of atherosclerotic cardiovascular disease start getting coronary artery calcium scans in their mid-to-late 30s? (Journal of the American College of Cardiology) IV thrombolytics may be safe for stroke patients with unruptured intracranial aneurysms, a single-center study found. (Neurology) Major thromboembolism and death were less likely when hospitalized COVID-19...

Oct 12th, 2021 - The U.S. Preventive Services Task Force (USPSTF) signaled that aspirin may be appropriate to initiate for primary cardiovascular prevention in some high-risk adults ages 40 to 59, but not for those 60 and older. The draft recommendation statement is a shift from the 2016 guidance, which called for low-dose aspirin for people in their 50s who have a 10% or greater 10-year cardiovascular disease ...

Oct 6th, 2021 - The 3 most common types of amyloidosis––TTR mutant, TTR wild-type, and amyloid light chain (AL)––have a significant amount of cardiac involvement, making cardiologists essential players in the diagnostic workup and treatment of these patients, explained Kunal Bhatt, MD. These patients’ journeys with this disease will often times include a stop in a cardiologist’s office at some point in time...

Oct 6th, 2021 - Hyman B. Muss, MD, professor of oncology, University of North Carolina, director, Geriatric Oncology, Lineberger Comprehensive Cancer Center, discusses maximizing cardiac function in patients with breast cancer. Muss says oncologists are aware of cardiac toxicity from their experience with anthracyclines. With the advent of anti-HER2 therapy, oncologists now have a larger group of issues relat...

Oct 5th, 2021 - The American Heart Association decried the regulatory loopholes that allow flavored tobacco products to stay on the market and be used by young people. The shift to remote heart failure care during the pandemic was marked by less diagnostic testing and reduced prescription of guideline-directed medical therapies. (Circulation: Heart Failure) COVID-19 patients given antiplatelet therapy in the h...

Oct 4th, 2021 - People who needed permanent pacemaker (PPM) implantation after transcatheter aortic valve replacement (TAVR) did not live shorter lives after the procedure, according to records from the SWEDEHEART registry. In a nationwide cohort study from Sweden, mortality rates reached 44.1% and 34.7%, respectively, over a median 2.7 years among pacemakers recipients and those who didn't need them after tra...

Oct 4th, 2021 - While adding an agent was a less common antihypertensive intensification strategy than boosting dose, it was slightly more effective, a large observational study showed. Among some 178,000 veterans getting treatment intensified for uncontrolled hypertension, only 25% received a new antihypertensive, whereas the rest had the dose of existing medications maximized, found Carole E. Aubert, MD, of ...

Sep 28th, 2021 - In response to a study published in August, FDA is investigating whether women really have worse outcomes after Watchman left atrial appendage occlusion (LAAO) than men. Shorter intervals between measurements: a way to slice a minute off standard protocol for automated office-based blood pressure evaluation. (Hypertension) Transcatheter aortic valve replacement (TAVR) performed well as an alter...

Sep 28th, 2021 - Adding contact aspiration to the initial approach with a stent retriever for large vessel acute ischemic stroke did little to boost near-total or total reperfusion, the ASTER2 trial showed. This high level of reperfusion (expanded Thrombolysis in Cerebral Infarction score of 2c or 3) was achieved at the end of the endovascular procedure in 64.5% of patients treated with contact aspiration and s...

Sep 27th, 2021 - With rapid troponin testing in emergency rooms, people who had acute coronary syndrome ruled out could still learn if they had any heart disease that may be confirmed with outpatient testing, the PRECISE-CTCA study showed. Among 250 people discharged with "normal" high-sensitivity cardiac troponin I (hs-cTnI), those with intermediate hs-cTnI concentrations (between 5 ng/L and the sex-specific 9...

Sep 22nd, 2021 - LDL cholesterol (LDL-C) exposure in younger adulthood predicted later cardiovascular events independent of cholesterol in middle age, large observational cohorts showed. Coronary heart disease significantly correlated with cumulative LDL-C (HR 1.57, P=0.01 for trend) as well as time-weighted average LDL (HR 1.69, P<0.001 for trend) across four studies and a median of 16 years of follow-up. Risk...

Sep 21st, 2021 - People with bicuspid aortic stenosis and low surgical risk did not appear to be at a disadvantage for short-term outcomes after transcatheter aortic valve replacement (TAVR), though longer follow-up and randomized study were urged for such a relatively young cohort. Drawing upon the Transcatheter Valve Therapies (TVT) Registry, investigators found no significant differences in clinical outcomes...

Sep 20th, 2021 - German recipients of the AstraZeneca COVID-19 vaccine showed that severe headache can precede cerebral venous sinus thrombosis by a few days in vaccine-induced immune thrombotic thrombocytopenia (VITT), according to a brief report in the New England Journal of Medicine. Hospitals with multidisciplinary cardiogenic shock teams performed better in shock management and cardiac ICU survival. (Journ...