Bioprosthetic aortic valves have played a critical role in improving both quality of life and prognosis in patients with severe aortic valve disease. Implanted either surgically (SAVR) or percutaneously (TAVI), they provide restoration of valve function without the need for anticoagulation as required with mechanical valves. This study was the result of clinical evaluation of […]
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Absorbable stents non-inferior….but is that enough?
A coronary artery stent that scaffolds the vessel immediately after angioplasty but disappears over time has been proposed as means to avoid complications of late stent thrombosis and restore physiological vasomotion. Bioabsorbable platforms (termed scaffolds) are designed to slowly dissolve over 2 to 3 years, leaving little or no residue in the vessel. However, conventional […]
Similar Outcomes with Bivalirudin and Unfractionated Heparin During PCI for Acute Coronary Syndromes
Approximately two-thirds of all PCI are performed for acute coronary syndromes. In this setting, the optimal balance of anticoagulation to avoid thrombosis against the risk of major bleeding is a pivotal area of procedural management. Multiple clinical trials have compared bivalirudin and heparin (+/- IIb/IIIa inhibitor), but the optimal strategy remains debated. In particular, changes […]
The Natural History of Takotsubo Cardiomyopathy
In the 25 years since first being described, takotsubo (stress) cardiomyopathy has gained increasing recognition as a common clinical entity. Despite this, our understanding of the natural history of takotsubo cardiomyopathy remains limited. The International Takotsubo Registry has been gathering data on takotsubo cases since 1998 and this publication describes their findings to date. Among […]
Adaptive servo-ventilation increases mortality in systolic heart failure
Central sleep-apnea (CSA) with associated Cheyne-Stokes breathing patterns effects up to 40% of patients with low ejection fraction heart failure. Given that CSA is an independent marker for poor prognosis and mortality, treatment of CSA has been identified as a potential target to improve heart failure outcomes. This study randomized 1325 patients with low ejection […]
Empagliflozin reduces cardiovascular mortality in Type 2 Diabetics
The prevalence of type 2 diabetes is increasing rapidly and represents a major risk factor for cardiovascular disease. Although glycemic control has been shown to reduce microvascular complications, the effect of glycemic control on macrovascular disease is more limited. Furthermore, some glucose lowering drugs have been associated with worse cardiovascular outcomes. Accordingly, ensuring the cardiovascular […]
Revascularization in response to identification of elevated high sensitivity troponin in stable patients does not improve outcomes
Among patients presenting with an acute coronary syndrome, cardiac troponin assays are the standard method for the identification of patients at high risk who benefit from early revascularization. With advances in technology, high-sensitivity troponin (hsTn) assays are now available to identify levels of circulating troponin that were previously undetectable. In this study, the authors sought […]
Leadless pacemakers demonstrate promise
Approximately 10% of patients who receive a pacemaker experience complications related to the use of transvenous leads, the surgical pocket, or the pulse generator. A leadless pacemaker inserted in the right ventricle by way of a transvenous catheter may result in lower complication rates. These leadless pacemakers include electronics, battery, and electrodes all in a […]
A reversal agent for dabigatran
Unlike warfarin, non-vitamin K antagonist oral anticoagulants lack reversal agents for administration in the case of severe bleeding or perioperative management. Idarucizumab is a monoclonal antibody fragment that was developed to reverse the anticoagulant effects of the direct thrombin inhibitor dabigatran. In this safety and efficacy study, idarucizumab was tested in a cohort of patients […]
Lipid Lowering Therapy and Risk of Acute Memory Impairment
Prior data on the use of statin drugs and risk of acute memory impairment has been inconsistent. In this study, Strom and colleagues sought to investigate use of statins in association with acute memory impairment and compare results to non-users and users of non-statin lipid lowering drugs (LLDs). The authors performed a retrospective cohort study […]