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Foreign medical graduates play a substantial role in clinical and biomedical research efforts; thus, Trump-era immigration policies that deny individuals from certain foreign countries threaten such efforts, according to findings published in Annals of Internal Medicine.“Recently proposed changes to U.S. immigration policy, such as President Donald J. Trump’s executive order suspending the entry of persons from several Muslim-majority countries and stricter regulations on work visas, have raised moral, legal and geopolitical questions for the United States,” Dhruv Khullar, MD, MPP, from Weill Cornell Medical College and Columbia University, and colleagues wrote. “They also have engendered clinical and biomedical research concerns for the U.S. medical community.”
Hospital mortality rates for older patients with acute myocardial infarction do not always reflect the rates for younger patients, suggesting that younger adults should be incorporated into assessment of hospital outcomes to achieve the most accurate mortality ranking, according to recent findings published in Annals of Internal Medicine.“Although 30-day [risk-standardized mortality rates (RSMRs)] indicate hospital quality for older patients, whether they also reflect quality for patients aged 64 years or younger is unknown. Despite this uncertainty, outcomes for Medicare beneficiaries are often used as a proxy for hospital quality,” Kumar Dharmarajan, MD, MBA, from Clover Health, Jersey City, N.J., and colleagues wrote. “If data from older patients do not reflect hospital quality more broadly, expanding quality and outcome measurement to include younger patients may be warranted.”
The discontinuation of low-dose aspirin therapy in the absence of major surgery or bleeding may increase the risk for CV events, according to data published in Circulation.
Increased physical activity was linked to reduced mortality risk in patients with stable CHD, according to a study published in the Journal of the American College of Cardiology.Ralph A. H. Stewart, MD, of the Green Lane Cardiovascular Service at Auckland City Hospital in New Zealand, and colleagues analyzed data from 15,486 participants (mean age, 65 years; 19% women) with chronic stable CHD from the STABILITY trial who completed a lifestyle questionnaire on physical activity. The Age, Biomarkers, Clinical-CHD (ABC-CHD) risk score was calculated to estimate overall CHD risk.
Boston Scientific announced that the FDA has approved an MRI labelling for its line of implantable cardioverter defibrillator and cardiac resynchronization therapy defibrillator systems for the management of HF.The family of systems (Resonate) includes an HF diagnostic tool (HeartLogic) that notifies clinicians of a patient’s worsening HF through the evaluation of thoracic impedance, respiration volume and rate, heart sounds, and heart rate and activity, according to a press release from the company. The device can alert clinicians of an impending HF event in a median of 34 days.
Aegerion Pharmaceuticals agreed to plead guilty to two misdemeanor counts of violating the Federal Food, Drug and Cosmetic Act, which involved the misbranding of lomitapide, a treatment for homozygous familial hypercholesterolemia, according to a news release from the FDA.As part of the agreement, Aegerion has agreed to pay $40 million, a company spokesperson confirmed to Cardiology Today.
Patients with asymptomatic severe aortic stenosis who did not adhere to guideline recommendations for serial clinical evaluations had an elevated risk for HF hospitalization and reduced survival rates, according to a study published in JAMA Cardiology.Aisha Ahmed, BS, of the Minneapolis Heart Institute Foundation and Minneapolis Heart Institute at Abbott Northwestern Hospital, and colleagues reviewed electronic medical records from 300 patients (mean age, 79 years; 48% men) with asymptomatic severe aortic stenosis. Records included information on baseline patient characteristics, a comprehensive clinical evaluation and an ECG.
The American Heart Association awarded two hypertension researchers with the Excellence Award for Hypertension Research during the AHA Council on Hypertension, Council on Kidney in Cardiovascular Disease and the American Society of Hypertension Joint Scientific Sessions in San Francisco, according to a press release. Allyn L. Mark, MD, professor of internal medicine-cardiovascular medicine at the University of Iowa Carver College of Medicine, and Richard J. Roman, PhD, chair of pharmacology and toxicology at the University of Mississippi Medical Center, both received their awards and presented lectures on their work during the meeting.
The Regional Hospital of Scranton in Scranton, Pennsylvania, is the first hospital to receive the Cardiovascular Center of Excellence accreditation by the American Heart Association, according to a press release. This accreditation is new from the AHA in collaboration with the American College of Cardiology, recognizing hospitals committed to following treatment guidelines in a comprehensive system of care.
The Heart Rhythm Society issued an expert consensus statement addressing lead management for patients with CV implantable electronic devices, including indications for extraction, outcomes and follow-up and lead survival. The statement is an update to the 2009 Heart Rhythm Society lead extraction clinical document and is based on literature searches on common clinical situations for lead management.
Although CABG has been the standard therapy for patients with left main coronary artery stenosis, new data suggest that PCI with drug-eluting stents may be a valid alternative treatment. Daniele Giacoppo, MD, from the German Heart Center Munich and the Technical University of Munich, and colleagues performed a meta-analysis recently published in JAMA Cardiology comparing long-term safety of PCI with DES vs. CABG in patients with left main coronary artery stenosis.
At a time when the state of health care is in flux, it is critical that physicians engage in the national debate by telling their stories and those of their patients to help create change, according to Andrew W. Gurman, MD, immediate past president of the AMA.“Our country deserves better, and it is up to us as America’s doctors to keep the health and vitality of our patients, our fellow citizens [and] our friends at the forefront of these discussions,” Gurman said in a presentation at the American Society for Surgery of the Hand Annual Meeting. “Our voice is their voice. Our advocacy is their advocacy, and we owe it to a generation of Americans struggling today to pay for health care and to those who come in the future to get this right.”
Adults with out-of-hospital cardiac arrest were less likely to receive bystander treatment and had lower survival if the event occurred in a predominately black neighborhood, according to published findings. “Out-of-hospital cardiac arrest survival rate is 8.3% to 10% annually; however, there is regional variation in the incidence of and survival from OHCA,” Monique Anderson Starks, MD, MHS, of the Duke Clinical Research Institute, and colleagues wrote. “The incidence of OHCA has been consistently higher in black individuals compared with white individuals in the United States. Notable disparities exist in CPR training and the use of bystander CPR in predominantly black vs. white communities.”
Physical activity of any form — whether a gym workout, walking to work or doing household chores — for 150 minutes per week reduces the risk for mortality and CVD, according to findings published in the Lancet.“Physical activity has a protective effect against CVD in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational,” Scott A. Lear, PhD, from Simon Fraser University and St. Paul’s Hospital in Vancouver, Canada, and colleagues wrote.
A novel percutaneous bypass system using the femoral vein as a pathway conferred a high rate of patency with no effect on venous health in patients with very long superficial femoral artery lesions, according to data from VIVA 17.Sean P. Lyden, MD, professor and chairman of the department of vascular surgery, Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic and chief medical officer for Excelerate Strategic Health Sourcing, presented a subanalysis of 50 patients (mean age, 65 years; 84% men) with lesions longer than 25 cm from the DETOUR I trial of the PQ Detour procedure (PQ Bypass), a percutaneous technique in which revascularization is performed via modular stent graft bypass using the femoral vein as a conduit.
Patients with pulmonary arterial hypertension who were treated with carvedilol had improved outcomes, according to a study published in JCI Insight.“New therapies for right-sided heart failure and PAH have lagged behind left-sided heart failure, so there is vital need for new treatments,” W. H. Wilson Tang, MD, director of the Center for Clinical Genomics at the Cleveland Clinic, told Cardiology Today. “The fact that beta-blockers were well-tolerated and effective in lowering heart rates thereby improved the heart efficiency is a key observation, since doctors have been cautioned against using them in this setting for safety concerns. This study provided important new data that advances our knowledge of using this class of drugs in this chronic and life-threatening lung-associated vascular disease.”
The latest Republican legislation attempting to “repeal and replace” the Affordable Care Act drafted by Senators Lindsey Graham (R-S.C.) and Bill Cassidy, MD, (R-La.), and thus deemed the Graham-Cassidy proposal, has gained growing disapproval from several health care organizations, including the AMA and the American College of Physicians. Within the past week, the AMA and the American College of Physicians (ACP) sent separate letters to the Senators conveying their strong opposition to the bill, citing as main concerns the loss of health care insurance for millions of Americans and its failure to “first, do no harm” to patients. The associations also urged the Senate to reject the legislation and reiterated recommendations to ensure affordable, quality coverage that is accessible to all patients across the country.
The American College of Cardiology and the American Heart Association have released updated clinical performance and quality measures to benchmark and improve quality of care for adult patients with STEMI and non-STEMI. “Every 42 seconds, approximately 1 American will suffer an [acute] MI, and the estimated annual incidences of new and recurrent MI events are 550,000 and 200,000 events, respectively,” Hani Jneid, MD, FACC, FAHA, director of interventional cardiology research at Baylor College of Medicine and director of interventional cardiology at the Michael E. DeBakey Medical Center VA Medical Center, Houston, and colleagues wrote. “Fortunately, the rates of hospitalization and 30-day mortality for [acute] MI have been on the decline. This reduction in mortality is likely related to the shift in the pattern of clinical presentation of [acute] MI as well as to improved acute treatments and long-term care.”
South Asian patients with a family history of CHD had an elevated risk for coronary artery calcification, independent of traditional risk factors, according to a letter published in JACC: Cardiovascular Imaging. “Using CAC as a marker of who has developed advanced levels of plaque in their arteries, we found that family history was a strong predictor in South Asians,” Parag H. Joshi, MD, MHS, assistant professor of internal medicine at UT Southwestern Medical Center in Dallas and a Cardiology Today Next Gen Innovator, said in an interview. “It’s a very easy variable to capture when you see a patient, so if you see a patient with South Asian descent, we don’t know a lot about how to accurately gauge their risk, so getting family history information may be a really important aspect of this.”
The FDA recently issued final guidelines outlining its nonbinding recommendations for safe and secure interactions among medical devices and other information systems, calling for devices to be designed with interoperability as an objective.The guideline is intended to highlight what medical device manufacturers should consider to provide a “reasonable assurance of safety and effectiveness” for their interoperable medical devices, and provides manufacturers with design considerations and recommendations regarding information to include in premarket submissions and device labeling.