Patients undergoing transcatheter aortic valve replacement (TAVR) at hospitals without cardiovascular surgery available are at significantly higher risk. That in itself is a call for attention; however, a propensity-matched analysis shows that the short- and long-term mortality rates are similar among patients treated at hospitals with and without cardiovascular surgery backup. This debate emerged a…
Aortic Stenosis and Dialysis: Is TAVR the Strategy of Choice?
Courtesy of Dr. Carlos Fava. TAVR has been shown beneficial in high and moderate risk patients, but there is a group of patients that require dialysis on account of kidney deterioration. This comorbidity is due to bad cardiovascular evolution associated to diabetes, bleeding and thromboembolic events. For some time, we have been using an…
AHA 2018 | PIONEER-HF: Sacubitril/Valsartan in Acute Decompensated Heart Failure
Treating acute decompensated heart failure patients with an angiotensin receptor inhibitor plus a neprilysin receptor inhibitor significantly reduces N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations and clinical events, according to the PIONEER-HF study presented at the American Heart Association (AHA) Congress Scientific Sessions and published simultaneously in the New England Journal of Medicine (NEJM). The study…
AHA 2018 | New-Generation DES Are Similar to Second-Generation DES Beyond Polymer
Sirolimus-eluting stents with biodegradable polymer did not offer better outcomes compared with instant-classic (and undoubtedly valid) everolimus-eluting stents with durable polymer such as Xience. New-generation drug-eluting stents (DES) offer better outcomes than first-generation devices after a 10-year follow-up, according to the ISAR-TEST 4 trial presented at the American Heart Association (AHA) Congress Scientific Sessions and published…
AHA 2018 | More Evidence for the Impella Device, But Larger Trials Are Necessary
In this pilot study, unloading the left ventricle with the Impella CP circulatory support device and delaying angioplasty by about 30 minutes appeared to be feasible and safe in patients with acute myocardial infarction without cardiogenic shock. This work sought to test the hypothesis that the device reduces ischemia-reperfusion injury. The trial included 50 patients who had the…
AHA 2018 | New Dyslipidemia Guidelines Support Non-Statin Therapy and Coronary Artery Calcium Screening
While the guidelines do not recommend a specific treatment target, they suggest additional therapy in high-risk patients with LDL 70 mg/dL or higher. These new guidelines from the American College of Cardiology (ACC) and the American Heart Association (AHA) start recommending ezetimibe or PCSK9 inhibition in select high-risk patients and proposing noninvasive coronary artery calcium screening…
AHA 2018 | No Benefits with Methothrexate as Anti-Inflammatory Drug
Low-dose methotrexate (a nonspecific anti-inflammatory agent used for the treatment of rheumatoid arthritis and other autoimmune disorders) did not prevent cardiovascular events in patients with a prior infarction or multivessel coronary artery disease, according to this study presented at the American Heart Association (AHA) Congress and published simultaneously in the New England Journal of Medicine…
AHA 2018 | Endoscopic Saphenous-Vein-Graft Harvesting in Patients Undergoing Myocardial Revascularization Surgery
For patients undergoing myocardial revascularization surgery, endoscopic harvesting of saphenous veins in expert hands is similar to traditional methods in terms of events, according to this study presented at the American Heart Association (AHA) Congress and published simultaneously in the New England Journal of Medicine (NEJM). This study, called REGROUP, was able to demonstrate that…
AHA 2018 | New Physical Activity Guidelines Recommend Movement for All Ages
The new 2018 physical activity guidelines continue to recommend the same amount of physical activity (300 minutes of moderate-intensity physical activity per week or 150 minutes of vigorous-intensity physical activity), but they have changed which adults can carry out this moderate- and vigorous-intensity physical activity. Additionally, instead of recommending a target number of minutes of exercise per…
AHA 2018 | Canakinumab Reduces Hospitalization for Cardiac Failure in Respondents
The benefit was dose-dependent reduction, regardless the presence of absence of baseline cardiac failure. Patients with prior MI and hypersensitivity C-reactive protein (hsCRP) showed dose dependent hospitalization reduction for cardiac failure with the new anti-inflammatory drug Canakinumab, according to this study presented at AHA and simultaneously published in Circulation. The difference between Canakinumab and…