Cardiology (all articles)
RCT | A 10-y comparison of paclitaxel-coated balloon, paclitaxel-eluting stent, and plain balloon angioplasty for DES in-stent restenosis
20 Mar, 2023 | 13:42h | UTCSummary: The ISAR-DESIRE 3 trial aimed to compare the 10-year efficacy and safety of plain balloon (PB), paclitaxel-coated balloon (PCB), and paclitaxel-eluting stent (PES) for percutaneous coronary intervention (PCI) of drug-eluting stent (DES) in-stent restenosis (ISR).
A total of 402 patients with DES-ISR were randomized to the different treatment groups: 134 patients to PB angioplasty (160 lesions), 137 patients to PCB angioplasty (172 lesions), and 131 patients to PES implantation (168 lesions).
PCB angioplasty and PES implantation had comparable 10-year results in the device-oriented composite endpoint including cardiac death, target vessel myocardial infarction, target lesion thrombosis, or target lesion revascularization, and significantly reduced the incidence of repeat target lesion revascularization compared to PB angioplasty alone. However, an excess of mortality within 5 years associated with PES warrants further investigation.
Article: Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial – European Heart Journal (free for a limited period)
Commentary on Twitter
Coronary artery restenosis treatment with plain balloon, drug-coated balloon, or drug-eluting stent: 10-year outcomes of the ISAR-DESIRE 3 trial 👉https://t.co/NHQpCIaNod #EHJ #ESCYoung @ehj_ed @rladeiraslopes
— European Society of Cardiology Journals (@ESC_Journals) March 8, 2023
SR | Oral Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation
20 Mar, 2023 | 13:41h | UTCSummary: This systematic review and meta-analysis assessed the efficacy of Class I and III antiarrhythmic drugs for maintaining sinus rhythm after catheter ablation of atrial fibrillation (AF). The review included nine randomized controlled trials involving 3,269 participants.
The analysis found that Class I and/or III antiarrhythmic drugs may reduce the recurrence of atrial tachyarrhythmias at 0 to 3 months and likely reduce recurrence at > 3 to 6 months. However, beyond six months, the evidence is uncertain, and the benefit of antiarrhythmic drugs may not persist. Additionally, the use of these drugs post-ablation likely reduces hospitalizations for atrial tachyarrhythmias by approximately 57% at 0 to 3 months.
The use of Class I and/or III antiarrhythmic drugs did not increase the risk of thromboembolic events, myocardial infarction, all-cause mortality, or the need for repeat ablation.
Study shows inflammation is a stronger predictor of CV events than cholesterol in patients receiving statin therapy
20 Mar, 2023 | 13:31h | UTCInflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials – The Lancet (link to abstract – $ for full-text)
Commentaries:
CRP More Predictive of Future Events Than LDL in Statin-Treated Patients – TCTMD
Review | Cardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis
20 Mar, 2023 | 13:21h | UTCCardiac sarcoidosis: phenotypes, diagnosis, treatment, and prognosis – European Heart Journal
M-A | Primary prevention of cardiovascular disease in women with a Mediterranean diet
20 Mar, 2023 | 13:20h | UTCNews Release: Mediterranean diet may cut women’s CVD and death risk by nearly 25% – BMJ Newsroom
Commentary:
Expert reaction to study looking at Mediterranean diet and women’s cardiovascular disease and death risk – Science Media Centre (Recommended reading – “Observational studies of nutrition have been notoriously misleading… Nutritional measures are strongly patterned by social factors and behavioral dispositions, leading to very substantial confounding”)
AHA Scientific Statement | Evaluation and management of pulmonary hypertension in noncardiac surgery
17 Mar, 2023 | 13:12h | UTCTop Things to Know: Evaluation and Management of Pulmonary HTN in Non-Cardiac Surgery – American Heart Association
Review | Cardiac rehabilitation for heart failure: ‘Cinderella’ or evidence-based pillar of care?
17 Mar, 2023 | 13:00h | UTC
Review | Pathophysiological gaps, diagnostic challenges, and uncertainties in cardiac sarcoidosis
17 Mar, 2023 | 12:47h | UTC
Review | Transcatheter interventions for heart failure
17 Mar, 2023 | 12:44h | UTCTranscatheter interventions for heart failure – EuroIntervention
RCT | Pre-hospital rule-out of NSTE-ACS by ambulance paramedics with point-of-care troponin is feasible and cost-saving
16 Mar, 2023 | 13:27h | UTCSummary: Using a point-of-care (POC) troponin measurement, this randomized trial in the Netherlands assessed the safety and healthcare costs of a pre-hospital rule-out strategy for patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
The study included only patients considered at low risk with a HEAR (History, ECG, Age, Risk factors) score ≤3. A total of 863 low-risk participants were randomized to direct transfer to the ED or a pre-hospital rule-out strategy with POC troponin measurement.
The trial found that pre-hospital rule-out of NSTE-ACS in low-risk patients using a single POC troponin measurement is feasible, significantly reduces healthcare costs, and is associated with a low incidence of major adverse cardiac events.
The HEAR score, combined with a POC troponin measurement by ambulance paramedics, accurately identifies low-risk patients for whom ED evaluation is unnecessary. Implementing this pre-hospital rule-out strategy in low-risk patients could significantly reduce healthcare costs through more efficient use of ambulance services and fewer ED visits. It is worth noting, however, that further studies in other localities are necessary before the widespread use of this strategy can be implemented.
Commentaries:
JC: Can we rule out ACS by a single prehospital troponin measurement? – St. Emyln’s
Rule-Out of NSTE-ACS by a Prehospital Troponin Measurement – American College of Cardiology
Review | Improving vasopressor use in cardiac arrest
16 Mar, 2023 | 13:08h | UTCImproving vasopressor use in cardiac arrest – Critical Care
Study identifies outpatient procedures associated with increased risk of myocardial infarction
16 Mar, 2023 | 13:11h | UTCRisk of myocardial infarction after invasive outpatient procedures – Heart
Review | Heart failure with preserved ejection fraction
15 Mar, 2023 | 15:18h | UTCHeart Failure With Preserved Ejection Fraction: A Review – JAMA (free for a limited period)
Author Interview: Diagnosis and Treatment of Heart Failure with Preserved Ejection Fraction – JAMA
ESC Consensus Statement | Inotropic therapy in patients with advanced heart failure
15 Mar, 2023 | 15:14h | UTC
Consensus Paper | Recommendations for the provision of infective endocarditis services
15 Mar, 2023 | 15:13h | UTC
AHA Scientific Statement | Atrial fibrillation occurring during acute hospitalization
14 Mar, 2023 | 14:04h | UTC
RCT | Sotatercept improves exercise capacity in patients with pulmonary arterial hypertension
14 Mar, 2023 | 14:02h | UTCSummary: This multicenter, double-blind randomized trial involved 323 adults with Pulmonary Arterial Hypertension (PAH) who were randomized to receive either subcutaneous sotatercept or placebo every three weeks for 24 weeks.
The primary endpoint was the change from baseline in the 6-minute walk distance. Sotatercept demonstrated a greater improvement in exercise capacity compared to placebo and improved secondary endpoints, including pulmonary vascular resistance and WHO functional class.
Adverse events were more common in the sotatercept group and included epistaxis, dizziness, telangiectasia, increased hemoglobin levels, thrombocytopenia, and increased blood pressure.
Article: Phase 3 Trial of Sotatercept for Treatment of Pulmonary Arterial Hypertension – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries:
STELLAR, ‘Impressive’ Results With Novel Drug Sotatercept in PAH – TCTMD
M-A | Ionizing radiation and cardiovascular disease
14 Mar, 2023 | 13:49h | UTCIonising radiation and cardiovascular disease: systematic review and meta-analysis – The BMJ
News Release: Low dose radiation linked to increased lifetime risk of heart disease – BMJ Newsroom
Review | Orthostatic tachycardia after covid-19
14 Mar, 2023 | 13:48h | UTCOrthostatic tachycardia after covid-19 – The BMJ
Commentary: Key steps for diagnosis and management of orthostatic tachycardia after COVID-19 – News Medical
RCT | Three-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis
14 Mar, 2023 | 13:47h | UTCThree-Year Outcomes After Transcatheter or Surgical Aortic Valve Replacement in Low-Risk Patients with Aortic Stenosis – Journal of the American College of Cardiology (link to abstract – $ for full-text)
News Release: Benefits of TAVR Remain Consistent in Patients at Low Surgical Risk at Three Years – American College of Cardiology
Commentary on Twitter
#ACC23/#WCCardio #JACC LBCT SimPub: Data from the Evolut Low Risk trial demonstrated that #TAVR at 3 years showed durable benefits compared with surgery with respect to all-cause mortality or disabling stroke. https://t.co/PtEEFI1P1t#vhdAS #SAVR #CardioTwitter @kashishgoelmd pic.twitter.com/x0milxBGxO
— JACC Journals (@JACCJournals) March 5, 2023
SR | Myocardial revascularization in patients with ischemic cardiomyopathy: for whom and how
14 Mar, 2023 | 13:46h | UTC
Burden, trends, and inequalities of heart failure globally, 1990 to 2019
14 Mar, 2023 | 13:35h | UTC
Evidence for harmful cardiovascular effects of ambient ozone: Insights from a multi-city time-series study in China
14 Mar, 2023 | 13:32h | UTCOzone pollution and hospital admissions for cardiovascular events – European Heart Journal
News Release: Ozone pollution is linked with increased hospitalizations for cardiovascular disease – European Society of Cardiology
Retrospective Cohort | Arrhythmogenic cardiotoxicity associated with contemporary treatments of lymphoproliferative disorders
14 Mar, 2023 | 13:27h | UTC
RCT | Immediate complete revascularization non-inferior to staged approach in ACS patients with multivessel disease
13 Mar, 2023 | 15:10h | UTCSummary: Patients with an acute coronary syndrome and multivessel disease not presenting with cardiogenic shock usually benefit from complete revascularization by percutaneous coronary intervention (PCI). Complete revascularization involves treating all significant blockages in the coronary arteries, including those not causing symptoms (non-culprit lesions).
The BIOVASC randomized non-inferiority trial investigated whether patients with acute coronary syndrome and multivessel coronary disease should undergo immediate complete revascularization during the index procedure or undergo a staged approach with PCI of the culprit lesion only during the index procedure followed by another procedure within 6 weeks of all non-culprit lesions deemed to be clinically significant. The exclusion criteria were:
- Previous coronary artery bypass surgery.
- Cardiogenic shock.
- Single-vessel coronary disease.
- The presence of a chronic coronary total occlusion.
A total of 1525 patients with acute coronary syndrome and multivessel coronary disease were randomly assigned to either an immediate complete revascularization group (764 patients) or a staged complete revascularization group (761 patients). The primary outcome was a composite of all-cause mortality, myocardial infarction, unplanned ischemia-driven revascularization, or cerebrovascular events at 1 year after the index procedure. The study found that immediate complete revascularization was non-inferior to staged complete revascularization for the primary outcome.
Article: Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial – The Lancet (free registration required)
Commentaries:
Revascularisation in acute coronary syndromes: change in practice? – The Lancet (free registration required)
No Downside to Immediate Complete Revascularization in ACS: BIOVASC – TCTMD
Immediate Complete Revascularization Non-Inferior to Staged Procedure in BIOVASC Trial – HCP Live
Related:
One-Year Outcomes after PCI Strategies in Cardiogenic Shock – New England Journal of Medicine