Despite limited data on cardiovascular safety, rates of testosterone therapy are increasing dramatically. In a retrospective cohort study of 8,709 male Veterans with a low testosterone level, the authors sought to determine the association between use of testosterone therapy following coronary angiography and patient outcomes of all-cause mortality, myocardial infarction and stroke. […]
Category: General cardiology
Weight reduction results in atrial fibrillation symptom improvement
Obesity is known risk factor for atrial fibrillation (AF). However, the effect of weight reduction on AF symptom burden is unknown. In this study, 150 patients with symptomatic AF who were overweight or obese were randomized to a physician led weight loss program (intervention arm) or self-directed general lifestyle measures (control arm). All patients received […]
Target cooling temperatures in cardiac arrest – should we just focus on avoiding fever instead?
Prior trials of out-of-hospital cardiac arrest of presumed cardiac etiology have demonstrated improved survival and neurologic function when patients are treated with therapeutic hypothermia. Questions remain as to the optimal target temperature for therapeutic hypothermia. In this international study of patients with out-of-hospital cardiac arrest, 950 patients were randomly assigned to therapeutic hypothermia at a […]
Pharmacogenetic warfarin dosing shows marginal to no benefit
The inter-individual variation in warfarin dosing requirements and narrow therapeutic index for anticoagulation necessitates a personalized dosing regimen. Variation in dosing requirements are in part explained by genetic polymorphism in CYP (involved in warfarin metabolism) and VKOR (a warfarin target) genes. A dosing strategy informed by these polymorphism may hold promise to improve anticoagulation control. […]
Influenza vaccine protects against adverse cardiovascular events
Evidence supporting the use of influenza vaccine in patients at risk for coronary artery events largely comes from observational studies or small randomized trials (RCTs). In this study, the authors conducted a systematic review of 6 RCTs (5 published, 1 unpublished) comparing influenza vaccine to placebo on the rate of a composite of major adverse […]
Joint Replacement in Moderate-Severe Osteoarthritis is Associated with Improved Cardiovascular Outcomes
Physical inactivity and non-steroidal anti-inflammatory drug (NSAID) use are established risks for serious cardiovascular events. Osteoarthritis can contribute to these risk factors by reducing patient mobility and NSAID use for symptom relief. Using data from a registry of patients with moderate-severe osteoarthritis, Ravi and colleagues evaluated the relationship between total joint arthroplasty of the hip […]
Clinical Impact of Echocardiography Not Aligned with Appropriateness
Echocardiography is a widely available diagnostic procedure with minimal patient risk. However, there are concerns that echocardiography may be overused relative to clinical need. To this end, appropriate use criteria have been developed to support the effective and efficient use of echocardiography. However, the clinical impact of echocardiography in relation to appropriateness has not been […]
Echocardiographic screening of general population of no benefit
While echocardiographic screening for structural heart disease is recommended in patients with a family history of cardiac arrest or hereditary conditions affecting the heart or great vessels, whether echocardiographic screening is warranted in the general population is unknown. […]
The AQUARIUS trial: Aliskiren does not slow progression of atherosclerosis
The renin-angiotensin-aldosterone system (RAAS) appears to have an important role in the development of atherosclerosis. The Aliskiren Quantitative Atherosclerosis Regression Intravascular Ultrasound Study (AQUARIUS) sought to determine if direct renin inhibition with aliskiren slows atherosclerosis progression in patients with already controlled blood pressure. […]
Dabigatran Unsuitable for Use with Mechanical Heart Valves
Dabigatran and other novel oral anticoagulants are effective and safe for reducing thromboembolic risk in the setting non-valvular AF. However, it remains unclear whether these newer anticoagulants are as effective as warfarin for reducing thromboembolic complications among patients with mechanical heart valves. As oral anticoagulation is a mainstay of therapy in patients with mechanical valves, […]