The Swan Ganz catheter has been used in the clinical practice for years. However, its usefulness remains under discussion and its use keeps dropping. A new analysis published in JAHA might bring it back at least in the context of cardiogenic shock, where it showed improved prognosis and more effective complexity management. Recently, the lack…
AHA 2021 | CRAVE: Coffee Safety in Rhythm Disorders
On the one side, caffeine can increase arrythmias or interfere with sleeping, but on the other hand, it helps people feel more energetic and do more physical activity. These data contribute to the evidence supporting the fact that people who present, or are at risk of presenting supra ventricular arrythmias or atrial fibrillation might not…
Hypertensive Patients: Maximizing Doses or Adding New Drugs
Adding new medication in moderate doses to control hypertension conveniently maximizes efficacy, reduces adverse effects and minimizes costs, among other advantages. On the flipside, patients having to remember a whole list of drugs and their combination will often lead to non-adherence or forgetfulness. The latter has been shown not only by dedicated trials, but also…
ESC 2021 | STEP: Blood Pressure Values in the Elderly, A Never-Ending Debate
The results of the STEP study were presented at the European Society of Cardiology (ESC) 2021 Congress! The main finding from this research was that an ideal target of 110 mmHg or at least <130 mmHg blood pressure (compared with a target of 130 mmHg or at least 150 mmHg) yielded an absolute risk reduction of composite events of…
ESC 2021 | GREENNESS: Surprising New Protective Factor against Cardiovascular Disease
What Is “Greenness”? This factor—which generally refers to the proximity to vegetation, as measured by satellite pictures—could serve as a new protection against cardiovascular disease. During five years (the total research time), this study compared individuals who lived in the lowest tercile of “greenness” with those who lived in the highest tercile (i.e., those who…
ESC 2021 | Empagliflozin in Heart Failure with Reduced and Preserved Ejection Fraction
The full results of the EMPEROR-Preserved study confirm as findings that empagliflozin decreases the risk of death or hospitalization for heart failure (HF) in both patients with reduced and with preserved function. The primary endpoint (a composite of death and hospitalization for HF) was reduced by 21% on a relative basis with sodium/glucose cotransporter 2…
Polypharmacy in Older Adults Elderly: What Medication to Discontinue
Polypharmacy is certainly a problem in the elderly population. Forgetfulness, and drug and dose confusion can lead to multiple problems; in addition, over time, cognitive deterioration will make complicated drug management schemes even more difficult for patients to handle. Aware of this problem, physicians often try to simplify schemes by discontinuing drugs, but what should…
ACC 2021 | Relive Renal Denervation with RADIANCE-HTN TRIO
Endovascular ultrasound renal denervation significantly reduces systolic blood pressure when compared against a sham procedure according to this new study presented at ACC 2021 simultaneously published in the Lancet. Renal denervation reduces ambulatory daily systolic blood pressure by 8 mmHg vs 3 mmHg in the sham procedure branch. This translates into a mean 4.5 mmHg…
ACC 2021 | Sacubitril/Valsartan not Superior to Ramipril after AMI
The combination sacubitril/valsartan following high-risk AMI did not reduce the risk of cardiac failure or cardiovascular risk in patients compared against ramipril. These data were provided by the PARADISE-MI presented today during the scientific sessions at ACC 2021. The combination sacubitril/valsartan had gathered prior evidence (basically from the PARADIGM-HF) for its superiority in terms of total…
Post MI Betablockers for Good?
Patients receiving optimal medical treatment after MI do not seem to benefit from betablockers in the long term, provided they do not present cardiac failure or systolic function deterioration. This study looked into the cardio protection effect of betablockers (BB) after long term follow up in stable patients with no cardiac failure and a history…
Diastolic Pressure Could Play a Dirty Trick on Patients Treated for Hypertension
Having too low diastolic pressure could be linked to an increase in cardiovascular events (J-shape phenomenon). However, current guidelines suggest a target blood pressure under 130/80 mmHg with no lower limit for diastolic pressure. This paper, recently published in JAMA, sought to evaluate the J-shape phenomenon of diastolic pressure in treated patients who reached a target…