Although statins affect mechanisms that lead to postoperative acute kidney injury (AKI), observational studies have failed to demonstrate a consistent effect of statin therapy on the risk of AKI after cardiac surgery. The Statin AKI Cardiac Surgery randomized control trial sought to determine if high-dose, short-term atorvastatin reduced the risk of AKI following cardiac surgery. […]
Latest articles
Genetic similarities in cardiomyopathies
The incidence of peripartum cardiomyopathy is 1 in 4000 pregnant women in Western Europe, but is as high as 1 in 100 in Haiti and Nigeria. Although peripartum cardiomyopathy can resolve, it can also be devastating as evidenced by a 5 to 10% mortality rate and the condition accounting for 4% of all U.S. women […]
TAVR adoption and outcomes in German national practice
The advent of transcatheter aortic valve replacement (TAVR) has afforded an alternative to surgical aortic valve replacement (SAVR) for high-risk or non-operative candidates for aortic valve surgery. However, the adoption of TAVR may not be limited to the patient population for who the procedure has studied and outcomes in routine clinical practice may not reflect […]
Effect of caloric restriction on heart failure with preserved ejection fraction
Therapies that improve outcomes are lacking for heart failure with preserved ejection fraction (HFpEF). The impact of exercise and diet interventions on HFpEF patients has not been studied. In this single center study of 100 patients, the effect of caloric restriction (~400 kcal/day) and or aerobic exercise training (3x a week hour long supervised sessions) […]
COURAGE at 15 years
Although PCI improves morbidity and mortality in the context of an acute coronary syndrome, the benefit of PCI in the setting of stable ischemic heart disease appears limited to symptom relief. This was best demonstrated by the COURAGE trial that randomized 2287 patients with stable angina to either intensive medical therapy alone or medical therapy […]
Ranolazine ineffective as antianginal following incomplete revascularization
Ranolazine is a novel anti-anginal medication that operates via late sodium channel blockade, reducing intracellular calcium during ischemia. Prior studies suggest ranolazine is effective in reducing the symptoms of angina among patients with ischemic heart disease. Although revascularization is often used to address symptoms, incomplete revascularization with residual ischemic symptoms is common. In the current […]
Repair versus replacement for ischemic mitral regurgitation
Whether repair or replacement is the preferred approach to surgical correction of ischemic mitral regurgitation is debated. The Cardiothoracic Surgical Trials Network previously reported 1-year results of a randomized study of these two approached and found no differences echocardiographic or clinical outcomes. This paper reports the 2-year echocardiographic and clinical outcome results from this randomized […]
SPRINT to lower blood pressure targets
Epidemiologic studies have demonstrated increasing cardiovascular risk at a systolic blood pressure above 115 mmHg. However, blood pressure treatment targets are less clear with clinical trials limited to evidence of benefit below 150mmHg. The Systolic Blood Pressure Intervention Trial (SPRINT) sought to determine outcomes following treatment to a target of less than 120mmHg (intensive treatment) […]
Increased radiation exposure with transradial access for coronary procedures
Compared with the transfemoral approach, coronary angiography and percutaneous coronary intervention (PCI) performed via transradial access reduces rates of bleeding and vascular complications. However, the potential for increased radiation exposure to patients and operators may be a barrier to the adoption of the transradial approach. In this systematic review and meta-analysis of 24 published studies […]
Long-term data on fractional flow reserve guided PCI
The Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) trial was a landmark study of the use of fractional flow reserve (FFR) to guide coronary revascularization through the identification of ischemia-inducing stenosis at the time of coronary angiography. The previously published 1- and 2-year results of the FAME trial demonstrated fewer major adverse cardiac […]