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 In this study, the authors conducted a systematic review of 6 RCTs (5 published, 1 unpublished) comparing influenza vaccine to placebo on the rate of a composite of major adverse […]
Latest articles
Stent type and interrupted anti-platelet therapy does not correlate with adverse events after non-cardiac surgeries
Guidelines recommend delaying elective surgery in patients with drug eluting stent (DES) for one year after stent implantation to allow completion of 1 year of dual anti-platelet therapy (DAPT) without interruption. This recommendation is based on expert consensus and results in several clinical questions, including whether it is preferable to use a bare metal stent […]
No clinical outcome benefit from IABP support
The IABP-SHOCK II trial is the largest randomized trial of intra-aortic balloon pump (IABP) counterpulation support in cardiogenic shock. At 30-days follow-up, this trial demonstrated no mortality reduction. The current paper reports the longer term outcomes from this trial, given that the benefits of IABP may not be evident in early follow-up. […]
Thrombus aspiration in STEMI fails to demonstrate benefit
Thrombus aspiration during primary PCI for patients presenting with ST elevation myocardial infarction (STEMI) is an intuitively attractive manoeuvre to aid rapid reperfusion, reduce distal embolization and improve microvascular perfusion. Despite limited trial evidence of clinical benefit, the procedure has quickly taken hold in many PCI centres with European and US guidelines agreeing on a […]
Bivalirudin in contemporary STEMI treatment
The novel direct thrombin inhibitor bivalirudin is now widely used as an adjunctive therapy in patients undergoing primary PCI for ST elevation myocardial infarction (STEMI). This stems from trial data demonstrating bivalirudin results in lower bleeding rates and better long term survival as compared with the combination of heparin and a GP IIb/IIIa inhibitor. However, […]
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, […]