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Lowering of Systolic BP Beyond Current Targets Gets Boost in New Analysis

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New results from a network meta-analysis make the case for reducing systolic blood pressure down to levels well below the currently recommended treatment targets.

In their study published May 30, 2017, in JAMA: Cardiology, investigators report that patients treated to 120 to 124 mm Hg had the lowest risk of cardiovascular events and all-cause mortality, a finding that supports lowering the systolic blood pressure treatment target in certain patients with hypertension.

Last Updated on Saturday, 12 August 2017 19:04

Anticoagulation in Pregnant Women With Mechanical Heart Valves: A Balancing Act

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Women with mechanical heart valves require anticoagulation during pregnancy in order to prevent thromboembolic events, but each drug regimen risks harming either the mother or fetus. Now, a new meta-analysis published online this week in the Journal of the American College of Cardiology may help clinicians navigate that balancing act.

Last Updated on Sunday, 02 July 2017 04:52

Seven Next-Generation Bioresorbable Scaffolds Show Promise but Face Major Hurdles

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PARIS, France—Early data on a handful of new, second-generation bioresorbable scaffold (BRS) devices presented at the EuroPCR 2017 meeting seem to be exciting engineers and clinicians alike, but questions remain with regard to the proper trajectory for research in this field.

Last Updated on Sunday, 04 June 2017 06:48

Triage Strategy for Urgent Management of Cardiac Tamponade

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At present, no formal guidelines are available from major medical and Cardiology societies to guide clinicians managing cardiac tamponade. For the first time, a position statement has been made available from the European Society of Cardiology to provide updated, evidence-based recommendations for triage and clinical management of patients with cardiac tamponade.

Last Updated on Sunday, 04 June 2017 06:30

Update on 2007 SCAI/ACCF/AHA Expert Consensus Document on Percutaneous Coronary Intervention without On-Site Surgical Backup

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Recently, the 2007 SCAI/ACCF/AHA Expert Consensus Document on Percutaneous Coronary Intervention without On-Site Surgical Backup has been updated. The consensus document has found no indication of increased mortality or a greater need for emergency bypass surgery (CABG) for heart attack or elective PCI patients at centres without on-site cardiac surgery.

Last Updated on Sunday, 04 June 2017 06:28

Update on ad hoc percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) in stable coronary artery disease (CAD) patients with type 2 diabetes

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The 2012 clinical-practice guidelines for patients with stable CAD from the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons has been updated. The focused update discourages PCI prematurely after coronary angiography in patients with diabetes, and recommends CABG as the optimum treatment strategy in stable complex CAD patients with diabetes.

Last Updated on Tuesday, 19 August 2014 12:15

FFR- and IVUS-Guided PCI Do Not Reduce Mortality Long-Term

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Determination of appropriate treatment strategy for coronary artery stenosis by means of coronary angiography is subjected to variation in subjective assessment. To combat this, various tools have been employed including stress testing and intracoronary imaging devicese.g. fractional flow reserve (FFR) and intravascular ultrasound (IVUS)into the cardiac catheter laboratory in recent years. American Heart Association guidelines now recommend that FFR should be used for assessing plaques of intermediate severity (50%-70%).1 Previously, the randomized clinical trials of FFR in the Fractional Flow Reserve Versus Angiography in Multivessel Evaluation (FAME) and FAME 2 studies found the benefit of FFR in relation to PCI.2,3 The FAME 2 trial was terminated early because of a significant reduction in the composite primary end point (of death, myocardial infarction, or urgent revascularization) in the FFR-guided PCI group. However, neither FAME nor FAME 2 found a mortality benefit for FFR-guided PCI. In a new observational study, the use of FFR or IVUS during PCI is not associated with improved long-term mortality rates when compared with standard angiography-guided PCI.4.

Last Updated on Tuesday, 19 August 2014 12:16

Consensus Statement on Use of ICDs in Patients Not Covered by the Guidelines.

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A guideline has been published by the American College of Cardiology Foundation (ACCF), American Heart Association (AHA), and Heart Rhythm Society (HRS) regarding ‘off-label’ use of implantable cardioverter-defibrillators (ICDs). Some patients who are not included or well represented in clinical trials and who, therefore, are not technically covered by formal practice guidelines may benefit from the devices:

Patients with Abnormal Troponin Unrelated to a Myocardial Infarction (MI)

Small troponin leaks sometimes occur in the context of demand ischemia (e.g., tachyarrhythmia, congestive heart failure, pulmonary embolism) or other conditions (renal failure, myocarditis) that are thought to be unrelated to MI. ICD implantation is only recommended in presence of standard primary- or secondary-prevention criteria.

Last Updated on Tuesday, 19 August 2014 12:16

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