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@JAMAInternalMed
article:
Clinical Insights review provides an update on the current recommendations for resistant hypertension management.
Myocardial viability testing does not identify patients with ischemic cardiomyopathy who benefit from PCI. Findings suggest that the extent of dysfunctional yet viable myocardium was not associated with revascularization outcomes.
@revived_BCIS2
LIVE-HCM: Individuals with hypertrophic cardiomyopathy exercising vigorously or competitively do not have a heightened risk of death or arrhythmic events compared to those exercising moderately or those who were sedentary.
Among older adults with atrial fibrillation receiving apixaban or rivaroxaban, treatment with diltiazem was associated with increased risk of serious bleeding compared with metoprolol.
2017 Hypertension Guideline
Begin meds if
- Clinical CVD or
- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or
- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or
1st-line meds =
- Thiazides
- CCBs
- ACE inhibitors or ARBs
Exercise preconditioning triggers adaptive responses of the heart and coronary arteries that protect against ischemia and infarction. This narrative evidence review concludes that even short exercise can create clinically relevant cardioprotection
Coronary microvascular dysfunction (CMD) is abnormal dilation and constriction of the small blood vessels of the heart. Most people w CMD (60%-75%) are women. Diagnosis is by pharmacologic stress imaging.
#AHA19
Secondary MR is not just one disease—Proposal for phenotypic classification of secondary MR with potential implications for medical responsiveness and mitral repair
@yreddyhf
@mayoclinicCV
@jamacardiology
#nish
Transthyretin amyloid cardiomyopathy: a clinically important cause of HFpEF with ventricular wall thickening. Systematic evaluation in the community increases diagnosis & provides therapeutically relevant phenotyping of HFpEF
@abouezzeddine
@MayoClinic
This cohort study found that very high HDL-C levels are paradoxically associated with higher mortality risk in individuals with coronary artery disease.
Lowering LDL-C level with bempedoic acid reduced the total number of CV events in patients with high CV risk, statin therapy intolerance, and elevated LDL-C levels.
In study of patients with HFpEF and pacemakers, moderately accelerated pacing (median pacing rate 75bpm) improved health-related QOL, natriuretic peptide levels, activity levels, and Afib compared w/ standard 60 bpm setting.
@maggieinfeld
@markusmeyermd
Prosthetic heart valve choice should be a shared decision accounting for patients' values + preferences, discussion of indications for & risks of anticoagulation and the potential need for and risk associated with reintervention
@American_Heart
@ACCInTouch
2017 Hypertension Guideline
Begin meds if
- Clinical CVD or
- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or
- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or
1st-line meds =
- Thiazides
- CCBs
- ACE inhibitors or ARBs
In this study, aspirin was not required to maintain outcomes with a fully magnetically levitated LVAD in advanced heart failure, and exclusion of antithrombotic therapy was demonstrated to be safe and associated with a reduction in bleeding events.
#AHA23
This study of 430,000 US adults found that, in the first decade after quitting, former smokers avoided an estimated 64%, 53%, and 57% of the excess cardiovascular, cancer, and respiratory mortality associated with continued smoking, respectively.
There is a rapid clinical impact when initiating dapagliflozin in patients with HFrEF, with particularly large absolute risk reductions in patients with a more recent HF hospitalization.
@ddbergMD
@TIMIStudyGroup
#Statin
therapy is cost-saving for patients with borderline CVD risk & LDL-C {greater than or equal to} 160 mg/dL, highly cost-effective for borderline risk & LDL-C {greater than or equal to} 130 mg/dL
RCT found starting exercise 2 weeks post-sternotomy was as effective as starting at 6 weeks. Clinicians and cardiac rehabilitation professionals can recommend starting exercise training as early as 2 weeks post-sternotomy.
ATTR cardiomyopathy can cause progressive heart failure and even be fatal for some patients. However, several new treatments are now available or in clinical trials to help with symptoms and even improve survival with the disease.
Why does RV function improve with MitraClip? Find out here: Biventricular PV loops before and after MitraClip. RV Ea (afterload) declines as LA pressure and V-wave amplitude fall
A woman in her mid-40s presented to the emergency department after a fall with head trauma. During day 15 of admission, the patient had 3 episodes of torsade de pointes while taking 50 mg of oral metoprolol succinate daily. What would you do next?
Inpatient initiation of sacubitril-valsartan for patients with HFrEF may be associated with reduced hospitalizations, increased quality-adjusted life expectancy, and cost savings compared with no initiation or initiation after hospitalization
Among pts w/ heart failure & mildly reduced ejection fraction or preserved ejection fraction, sodium-glucose cotransporter-2 inhibitors should not be discontinued in response to an initial glomerular filtration rate decline, these data suggest.
#AHA23
2017 Hypertension Guideline
Begin meds if
- Clinical CVD or
- 10y ASCVD risk >= 10% AND SBP >=130 mm Hg / DBP >= 80 mm Hg or
- 10y ASCVD risk >= 10% AND SBP >=140 mm Hg / DBP >= 90 mm Hg or
1st-line meds =
- Thiazides
- CCBs
- ACE inhibitors or ARBs
Analysis shows that initial declines in HF-related mortality from 1999 to 2012 have been entirely undone by subsequent reversals from 2012 to 2021, meaning that contemporary HF mortality rates are higher than in 1999.
In study of patients with HFpEF and pacemakers, moderately accelerated pacing (median pacing rate 75bpm) improved health-related QOL, natriuretic peptide levels, activity levels, and Afib compared w/ standard 60 bpm setting.
@maggieinfeld
@markusmeyermd