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USPSTF: Insufficient evidence exists showing benefits of ankle-brachial index for PAD

Tue, 2018-01-16 11:09
The U.S. Preventive Services Task Force has given a class I indication for the use of ankle-brachial index to screen adults for peripheral artery disease and CVD risk, as there is not enough evidence to support or oppose the method, according to a draft recommendation statement released by the task force.
The new recommendation was drafted to replace a 2013 USPSTF recommendation.
“Although the current evidence review was expanded to include a broader population and rage of interventions, the USPSTF has not changed its recommendation from an I statement,” the task force wrote in the

USPSTF: Nontraditional risk factors inadequate to assess CVD risk

Tue, 2018-01-16 11:04
Evidence has not sufficiently shown the benefits and harms of adding high-sensitivity C-reactive protein, ankle-brachial index and coronary artery calcification score to assess CVD risk in patients who are asymptomatic, according to a draft recommendation statement released by the U.S. Preventive Services Task Force.
“The previous recommendation [from 2009] considered the evidence on several risk factors in addition to the [Framingham risk score],” the task force wrote. “The major change in the current recommendation is that the [Pooled Cohort Equation] was used in addition

Low diastolic BP raises CVD risk, does not affect benefit of reduced systolic BP

Tue, 2018-01-16 09:58
Among patients with high systolic BP, low diastolic BP conferred elevated risk for CVD events but did not affect the benefit of intensive vs. standard systolic BP reduction, according to new data from the SPRINT trial.
As Cardiology Today has previously reported, participants in SPRINT randomly assigned to an intensive systolic BP target of less than 120 mm Hg had lower risk for the primary outcome of MI, other ACS, stroke, congestive HF or CV deaths compared with those assigned a standard systolic BP target of less than 140 mm Hg.
In a post hoc analysis, Srinivasan Beddhu, MD, professor of

Myeloproliferative neoplasms significantly increase thrombotic risk

Mon, 2018-01-15 17:19
The rate of arterial and venous thrombosis was significant in patients with myeloproliferative neoplasms, according to research published in Annals of Internal Medicine.
“Patients with myeloproliferative neoplasms have been reported to be at increased risk for thrombotic events, but no population-based study has estimated this excess risk compared with matched control participants,” Malin Hultcrantz, MD, PhD, from Karolinska University Hospital and Karolinska Institutet, Stockholm, and colleagues wrote.
To address this gap in knowledge, Hultcrantz and colleagues evaluated data from

Predictors, safety of next-day discharge after TAVR confirmed

Mon, 2018-01-15 14:49
Among patients who underwent minimalist transfemoral transcatheter aortic valve replacement without complications, next-day discharge was associated with similar 30-day outcomes and better 1-year outcomes vs. longer hospital stay, researchers reported.
Male sex, lack of atrial fibrillation, lower serum creatinine and younger age were among the predictors of next-day discharge in the cohort.
Norihiko Kamioka, MD, from the division of cardiology at Emory University School of Medicine, and colleagues analyzed patients who underwent minimalist transfemoral TAVR with a balloon-expandable valve

Technology may treat fluid overload in congestive HF

Mon, 2018-01-15 10:35
A technology designed to prevent contrast-induced acute kidney injury demonstrated an ability to manage fluids during diuretic therapy in patients with congestive HF, according to findings presented at the Device Therapies for Heart Failure congress.
Researchers conducted a first-in-humans study of the technology (RenalGuard System, RenalGuard Solutions) in 10 patients with congestive HF. According to a press release from the company, the technology measures a patient’s urine output and infuses a specific volume of saline to maintain fluid balance, and clinicians can set a rate beyond

ESC risk model reduces ICD use in hypertrophic cardiomyopathy

Mon, 2018-01-15 10:33
High-risk patients with hypertrophic cardiomyopathy would not have been protected from sudden death through the recommendation of an implantable cardioverter defibrillator using the European Society of Cardiology risk scoring model compared with U.S. guidelines, according to a study published in The American Journal of Cardiology.
Kevin M. W. Leong, MRCP, research postgraduate at the National Heart and Lung Institute at Imperial College in London, and colleagues reviewed data from 288 patients (mean age, 52 years; 66% men) with hypertrophic cardiomyopathy who did (n = 14; mean age, 41 years;

Change in risk score strong predictor of stroke in AF

Mon, 2018-01-15 10:26
Change in a stroke risk score used in patients with atrial fibrillation was a better predictor of stroke than baseline risk score, according to findings.
Researchers hypothesized that Delta CHA2DS2-VASc score, reflecting the change over time in the CHA2DS2-VASc score used to predict stroke risk in patients with AF, would be more predictive of ischemic stroke risk compared with baseline CHA2DS2-VASc score.
Tze-Fan Chao, MD, from the division of cardiology, department of medicine, Taipei Veterans General Hospital in Taiwan, and colleagues analyzed 31,039 patients with AF who did not take

Trial Scoreard: PREMIUM

Mon, 2018-01-15 09:10
Researchers evaluated patent foramen ovale closure in patients with migraines.

Trial Scoreard: PRESERVE

Mon, 2018-01-15 09:10
Researchers compared IV isotonic sodium bicarbonate with IV isotonic sodium chloride and oral-N-acetylcysteine with placebo in high-risk patients after angiographic procedures.

Trial Scoreard: HEROIC

Mon, 2018-01-15 09:10
Researchers characterized long-term clinical and functional characteristics of takotsubo cardiomyopathy.

Trial Scoreard: DECIDE-LVAD

Mon, 2018-01-15 09:10
Evaluation of effectiveness of the DT LVAD shared decision support intervention in patients with end-stage HF considered for LVAD implantation.

Trial Scoreard: CRESCENT-II

Mon, 2018-01-15 09:10
Comparison of tiered comprehensive cardiac CT protocol vs. functional testing in patients with stable angina and suspected CAD.

Trial Scoreard: BRUISE CONTROL-2

Mon, 2018-01-15 09:10
Researchers analyzed the interruption of novel oral anticoagulants at the time of device surgery in patients with moderate to high risk for thromboembolic events.

Trial Scoreard: ALPS

Mon, 2018-01-15 09:10
Researchers evaluated the impact of amiodarone or lidocaine vs. placebo on patients with nonshockable-turned-shockable out-of-hospital cardiac arrest.

Trial Scoreard: ATTRACT

Mon, 2018-01-15 09:10
Evaluation of pharmacomechanical catheter-directed thrombolysis vs. optimal standard therapy in patients with symptomatic proximal deep vein thrombosis.

New guideline widens hypertension definition, incorporates CV risk

Mon, 2018-01-15 09:10
A newly released, long-awaited guideline published by the American Heart Association, the American College of Cardiology and nine other societies has expanded the definition of hypertension and could have tremendous implications for management of the condition, and for public health.
According to the new guideline, hypertension is now defined as systolic BP 130 mm Hg/diastolic BP 80 mm Hg, which the guideline authors propose will lead to a new diagnosis in approximately 14% more Americans, with 45.6% of U.S. adults now considered to have hypertension. The hypertension definition change was

Looking ahead: Top trends for 2018

Mon, 2018-01-15 09:10
Editor's Note: Cardiology Today asked members of its Editorial Board to identify what they believe will be the top three trends for 2018. Here are some of the results. View more reactions from 2017 and predictions for 2018 online at Healio.com/Cardiology.
Click here to see our Editorial Board's top trends for 2018.
View more reactions from 2017 and predictions for 2018 online at Healio.com/Cardiology.

ICHECK’D: Mnemonic approach assists in caring for patients receiving direct oral anticoagulant

Mon, 2018-01-15 09:10
Since 2010, the FDA has approved four direct oral anticoagulants as alternatives to warfarin: dabigatran etexilate, rivaroxaban, apixaban and edoxaban tosylate.
Direct oral anticoagulants are selective inhibitors of one clotting factor, either thrombin (IIa) or activated factor X (Xa). Multiple clinical trials comparing warfarin or low-molecular-weight heparin vs. a direct oral anticoagulant have demonstrated either noninferiority or superiority of the direct oral anticoagulant. Based on these clinical trials, the FDA approved direct oral anticoagulants for the following indications:

CVD in cancer survivors: Stick to the basics of prevention

Mon, 2018-01-15 09:10
Continued improvements in cancer prevention and treatment with a subsequent decline in mortality rates have led to a rapidly growing population of survivors such that the American Cancer Society predicts that by 2024 there will be 19 million long-term cancer survivors in the United States. As a result, we are witnessing a paradigm shift with a growing emphasis on reducing long-term morbidity and mortality in cancer survivors.
CVD is the most common reason for hospitalization and the leading cause of non-cancer-related death for survivors. Yet, proven preventive strategies appear to be

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