Cardiology
2020 AHA/ACC Guideline for the Diagnosis and Treatment of Patients With Hypertrophic Cardiomyopathy
23 Nov, 2020 | 09:46h | UTCKey perspectives: 2020 AHA/ACC Guideline for Hypertrophic Cardiomyopathy
News release: Hypertrophic cardiomyopathy guideline encourages shared decision-making – American College of Cardiology
Opinion: Improving care for heart failure with reduced ejection fraction—a potential polypill-based strategy
20 Nov, 2020 | 08:37h | UTC
NICE Guideline: Acute coronary syndromes
19 Nov, 2020 | 09:24h | UTCAcute coronary syndromes – National Institute for Health and Care Excellence
Visual summary: STEMI
Visual summary: NSTEMI/unstable angina
Visual summary: Cardiac rehabilitation and secondary prevention
#AHA20 [not published yet] Randomized trial: After drug-eluting stent implantation, one-month dual antiplatelet therapy (DAPT) followed by aspirin monotherapy was noninferior to 6-12 months of DAPT
19 Nov, 2020 | 09:21h | UTCCommentary: Latest Post-DES Drug Trial Tests Aspirin Monotherapy After 1 Month of DAPT – TCTMD
#AHA20 – Two studies show lower rate of atrial fibrillation recurrence with catheter cryoballoon ablation than with antiarrhythmic drug therapy
18 Nov, 2020 | 09:11h | UTCStudy 1: Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation – New England Journal of Medicine
Commentaries: EARLY AF and STOP AF Put Electrophysiology at a Crossroads – Medscape (free registration required) AND EARLY-AF: First-line Ablation Beats Meds for Recent Paroxysmal A-fib – TCTMD
Commentary on Twitter (thread – click for more)
NEJM published 2 RCTs of #AFib ablation vs AF drugs.
The rub was that the ablation was done EARLY in the course.
Practice had been to try drugs first then do ablation.
EARLY AF and STOP AF studied the procedure early. #AHA20 Thread and my column >>— John Mandrola, MD (@drjohnm) November 18, 2020
#AHA20 – RCT: Sotagliflozin improved cardiovascular outcomes in patients with Diabetes and CKD. Diarrhea, genital mycotic infections, volume depletion, and diabetic ketoacidosis were more common with sotagliflozin than with placebo
18 Nov, 2020 | 09:08h | UTCSotagliflozin in Patients with Diabetes and Chronic Kidney Disease – New England Journal of Medicine (link to abstract – $ for full-text)
#AHA20 – RCT: Sotagliflozin improved cardiovascular outcomes in patients with Diabetes and Recent Worsening Heart Failure. Diarrhea and severe hypoglycemia were more common with sotagliflozin than with placebo
18 Nov, 2020 | 09:06h | UTCSotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure – New England Journal of Medicine (link to abstract – $ for full-text)
#AHA20 – Randomized trial: Among patients with recurrent pericarditis, Rilonacept was associated with lower risk of pericarditis recurrence than placebo
18 Nov, 2020 | 09:04h | UTCPhase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: Rilonacept Prevents Recurrent Pericarditis: RHAPSODY – TCTMD AND Rilonacept inHibition of interleukin-1 Alpha and beta for recurrent Pericarditis: a pivotal Symptomatology and Outcomes stuDY – RHAPSODY – American College of Cardiology AND Trial shows drug effective in 96% of patients with recurrent pericarditis – Cleveland Clinic
Commentary on Twitter
Patients with recurrent pericarditis were treated with the interleukin-1 trap rilonacept. Those who had a response were randomly assigned to receive continued rilonacept or placebo. Rilonacept led to a significantly lower risk of pericarditis recurrence than placebo. #AHA20
— NEJM (@NEJM) November 17, 2020
The ‘Ten Commandments’ for the 2020 ESC Guidelines on Sports Cardiology and Exercise in Patients with Cardiovascular Disease
18 Nov, 2020 | 09:03h | UTCOriginal Guideline and commentary: 2020 ESC Guidelines on sports cardiology and exercise in patients with cardiovascular disease
Opinion: A new important study supports wider use of the polypill
18 Nov, 2020 | 09:01h | UTCRichard Smith: A new important study supports wider use of the polypill – The Lancet
Original study and commentaries: Randomized trial: A polypill comprising statins, multiple blood pressure lowering drugs, and aspirin prevents cardiovascular events among patients at intermediate cardiovascular risk
Commentary on Twitter
"We seem now to have good evidence that the polypill can reduce cardiovascular events and deaths by at least a third and probably by half in those who take the polypill regularly" @Richard56 discusses a new study in @NEJM https://t.co/B2tkN4pkDP
— The BMJ (@bmj_latest) November 17, 2020
#AHA20 – Randomized trial: A polypill comprising statins, multiple blood pressure lowering drugs, and aspirin prevents cardiovascular events among patients at intermediate cardiovascular risk
16 Nov, 2020 | 02:03h | UTCPolypill with or without Aspirin in Persons without Cardiovascular Disease – New England Journal of Medicine (link to abstract – $ for full-text)
News release: New study confirms combo pill alone and with aspirin lowers heart disease risk – American Heart Association
Commentaries: Polypill along with aspirin cuts heart attacks and strokes by up to 40%: International study – McMaster University AND Big study supports cheap combo pill to lower heart risks – Associated Press AND TIPS-3: International Study Looks at Benefits of Polypill and Polypill Plus Aspirin in Reducing CVD Risk – American College of Cardiology
Commentary on Twitter
Public health vs precision medicine. Thinking through a one size fits all drug prevention approach. "Combined Rx w/polypill+aspirin led to lower incidence of CV events than placebo among participants w/o CV disease who were at intermediate CV risk.” #AHA20https://t.co/TsbvPtA1Pl pic.twitter.com/Ylq3AKThII
— Harlan Krumholz (@hmkyale) November 14, 2020
#AHA20 – Randomized trial: In patients with atrial fibrillation and a bioprosthetic mitral valve, Rivaroxaban (20 mg) was noninferior to Warfarin (INR 2-3) for death, MACE, or major bleeding at 12 months
16 Nov, 2020 | 02:01h | UTCRivaroxaban in Patients with Atrial Fibrillation and a Bioprosthetic Mitral Valve – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Rivaroxaban may be as effective as warfarin for bioprosthetic mitral valves, AF – American Heart Association
Commentaries: Rivaroxaban an Option for Patients with Bioprosthetic Mitral Valves and A-fib – TCTMD AND Rivaroxaban for Valvular Heart Disease and Atrial Fibrillation – RIVER – American College of Cardiology AND Rivaroxaban Noninferior to Warfarin for Atrial Fibrillation in Patients with Bioprosthetic Mitral Valves – NEJM Journal Watch
Commentary on Twitter
In a trial comparing rivaroxaban with dose-adjusted warfarin, rivaroxaban was noninferior to warfarin with respect to the mean time until the primary outcome of death, major cardiovascular events, or major bleeding at 12 months. #AHA20
— NEJM (@NEJM) November 14, 2020
#AHA20 – Randomized trial: In patients with systolic heart failure, Cardiac Myosin activation with Omecamtiv Mecarbil led to modest reduction in heart failure events
16 Nov, 2020 | 02:00h | UTCCardiac Myosin Activation with Omecamtiv Mecarbil in Systolic Heart Failure – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: Modest Gains With Omecamtiv Mecarbil in Chronic HFrEF: GALACTIC-HF – TCTMD AND Global Approach to Lowering Adverse Cardiac Outcomes Through Improving Contractility in Heart Failure – GALACTIC-HF – American College of Cardiology
Commentary on Twitter
Among patients with heart failure & a reduced ejection fraction, those who received the cardiac myosin activator omecamtiv mecarbil had a lower incidences of heart-failure events or cardiovascular death at a median of 22 months than those who received placebo. #AHA20
— NEJM (@NEJM) November 13, 2020
#AHA20 – Randomized trial: In patients with refractory hypercholesterolemia, the use of Evinacumab significantly reduced the LDL levels. Larger studies with patient-relevant outcomes are needed.
16 Nov, 2020 | 01:59h | UTCEvinacumab in Patients with Refractory Hypercholesterolemia – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In patients with hypercholesterolemia that is refractory to statin and PCSK9 inhibitor therapy, the use of evinacumab reduced plasma lipid levels by 50%. #AHA20
— NEJM (@NEJM) November 15, 2020
#AHA20 – In patients who had discontinued statins because of side effects, a N-of-1 trial of a statin, placebo, or no treatment found that side effects often attributed to statins were the same for those taking a placebo
16 Nov, 2020 | 01:57h | UTCCommentary: ‘Nocebo effect’ cause of most statin side-effects, study suggests – The Guardian
Original study: N-of-1 Trial of a Statin, Placebo, or No Treatment to Assess Side Effects – New England Journal of Medicine ($ – no abstract available)
Commentary on Twitter
Patients who had discontinued statins because of side effects received four bottles of a statin, four bottles of placebo, and four empty bottles. Each used for 1 month, in random sequence. The symptom burden with placebo was 90% of the symptom burden with the statin. #AHA20
— NEJM (@NEJM) November 15, 2020
#AHA20 – A small phase 2 randomized trial showed significantly improved survival with an early ECMO-facilitated resuscitation for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation
16 Nov, 2020 | 01:56h | UTCCommentaries: Early ECMO-Facilitated Resuscitation for Out-of-Hospital Cardiac Arrest – NEJM Journal Watch AND Advanced REperfusion STrategies for refractory cardiac arrest – ARREST – American College of Cardiology AND Cardiac arrest treatment that uses life support machine boosts survival – NIH News Releases
Commentary on Twitter
Latebreaker at #AHA20 @AHAMeetings—Advanced reperfusion strategies for patients with out-of-hospital #cardiacarrest and refractory ventricular fibrillation (ARREST): a phase 2, single centre, open-label, randomised controlled trialhttps://t.co/1TjdlD6G8h pic.twitter.com/zQoRcxF1jO
— The Lancet (@TheLancet) November 14, 2020
#AHA20 – Randomized trial: In elective percutaneous coronary intervention Clopidogrel led to similar outcomes compared with Ticagrelor with less minor bleeding
16 Nov, 2020 | 01:55h | UTCNews release: Ticagrelor was not superior to clopidogrel to reduce heart attack risk during angioplasty – American Heart Association
Commentaries: Clopidogrel Should Remain Antiplatelet of Choice in Elective PCI: ALPHEUS – TCTMD AND Ticagrelor Not Superior to Clopidogrel for Elective PCI – NEJM Journal Watch
Commentary on Twitter
NEW Research—Clopidogrel vs ticagrelor or prasugrel in patients aged 70 years or older with non-ST-elevation acute coronary syndrome (POPular AGE): the randomised, open-label, non-inferiority trial https://t.co/joepKHbgtu pic.twitter.com/gEyPl2HE80
— The Lancet (@TheLancet) April 30, 2020
#AHA20 – In patients hospitalized for heart failure with iron deficiency, intravenous Ferric carboxymaltose at discharge reduced the risk of heart failure rehospitalizations
16 Nov, 2020 | 01:53h | UTCCommentaries: Intravenous iron reduced rehospitalization risk in people with heart failure – American Heart Association AND AFFIRM-AHF: IV Iron Supplementation Linked to Fewer Repeat Hospitalizations for HF – TCTMD
Commentary on Twitter
Latebreaker at #AHA20 @AHAMeetings—Ferric carboxymaltose for iron deficiency at discharge after acute #heartfailure: AFFIRM-AHF, a multicentre, double-blind, randomised, controlled trial https://t.co/gRKtbsxfba pic.twitter.com/k67HDJMW2b
— The Lancet (@TheLancet) November 14, 2020
#AHA20 – Randomized trial: High-dose Omega-3 fatty acids did not reduce the risk of cardiac events in patients at high cardiovascular risk
16 Nov, 2020 | 01:51h | UTCEditorial 2: Do Omega-3 Fatty Acids Benefit Health?
Commentary on Twitter
In this RCT, omega-3 fatty acids (EPA/DHA) did not reduce major adverse CV events vs corn oil in statin-treated patients at high CV risk
(Compare w Vascepa in REDUCE-IT) https://t.co/7BIs1Rr8YZ#STRENGTHTrial #AHA20 #SteveNissen@ProfSNicholls @Dmozaffarian @ClevelandClinic— JAMA (@JAMA_current) November 15, 2020
[Not Published Yet] #AHA20 – Randomized trial: Fish oil and vitamin D supplements not effective for preventing atrial fibrillation
16 Nov, 2020 | 01:49h | UTCCommentary: Fish Oil, Vitamin D Don’t Prevent A-fib: VITAL Rhythm – TCTMD
USPSTF Statement: Insufficient evidence to recommend screening for high blood pressure in children and adolescents
11 Nov, 2020 | 09:14h | UTCScreening for High Blood Pressure in Children and Adolescents – U.S. Preventive Services Task Force
Author interview: USPSTF Recommendation: Screening for Hypertension in Children and Adolescents
JAMA Patient Page: Screening for High Blood Pressure in Children and Adolescents
Patients with Covid-19 and myocardial injury have increased in-hospital mortality, particularly if echocardiographic abnormalities are present
10 Nov, 2020 | 09:37h | UTC
In patients hospitalized with COVID-19, right ventricular dilation or dysfunction was independently associated with a >2-fold increase in risk for mortality
10 Nov, 2020 | 09:36h | UTCCommentaries: Utility of RV Remodeling Over Risk Stratification in COVID-19 – American College of Cardiology AND Damage to heart’s right ventricle predicts a greater chance of death from COVID-19 – Weill Cornell Medical College
[Abstract Only] Randomized trial: In patients with persistent atrial fibrillation, treatment with catheter ablation + vein of Marshall ethanol infusion increased the likelihood of remaining free of AF, compared with catheter ablation alone
10 Nov, 2020 | 09:32h | UTCEffect of Catheter Ablation With Vein of Marshall Ethanol Infusion vs Catheter Ablation Alone on Persistent Atrial Fibrillation: The VENUS Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary on Twitter
VENUS: randomized trial of vein of Marshall ethanol added to catheter ablation of persistent AF. 13 years in the making… I hope to be faster next time! https://t.co/EfW8d4FOtu
— Miguel Valderrábano (@MiguelVldrbno) October 27, 2020
Systematic review: Inotropic agents and vasodilator strategies for the treatment of cardiogenic shock or low cardiac output syndrome. “At present, there are no convincing data supporting any specific inotropic or vasodilating therapy to reduce mortality in hemodynamically unstable patients with CS or LCOS.”
10 Nov, 2020 | 09:30h | UTC