Star Update Podcast - Cardiology News Summaries

Abstract Introduction: Patients undergoing acute percutaneous coronary intervention receive dual antiplatelet therapy for secondary prevention. Recurrent myocardial infarction or bleedings are possibly due to under- or overdosing of antiplatelet therapy in relation to body size. Methods: We correlated residual platelet aggregation with body mass index, body surface area, lean body mass and blood v...

Abstract Objective: Beta-blockers are first-line anti-impulse therapy in patients presenting with acute type B aortic dissection (TBAD). However, little is understood about their impact after aortic repair. The aim of this study was to evaluate the role of postoperative beta-blocker use on outcomes of thoracic endovascular aortic repair (TEVAR) in TBAD. Methods: The Vascular Quality Initiative dat...

Abstract Background: This meta-analysis mainly aimed to compare the impact of prasugrel and ticagrelor on platelet reactivity (PR) in patients with acute coronary syndrome (ACS). Methods: We searched four electronic databases to identify randomized controlled trials and cohort studies comparing the impact of prasugrel and ticagrelor on PR in patients with ACS. We performed group analyses according...

· ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute (NSTE-ACS) coronary syndrome are referred to collectively as acute coronary syndrome (ACS) · The latter includes non-ST-segment elevation myocardial infarction and unstable angina pectoris (NSTEMI). Cardiovascular catheterization must be immediately recommended in cases of STEMI. · The management and diagnosis...

The authors aimed to determine the efficacy of comprehensive pharmaceutical care intervention that included face-to-face education about the disease, healthy lifestyle, medication adherence, drug related problems management and goal setting which was added to cardiac rehabilitation program in improving echocardiographic parameters, nutritional status and High sensitivity C-Reactive Protein in pati...

The authors aimed to evaluate the effects of metoprolol succinate in combination with Entresto (Sacubitril Valsartan Sodium Tablets) on cardiac function and coagulation function in patients with congestive heart failure (CHF). A total of 120 patients were included in this study and patients were randomly assigned to control group and study group. In the control group, patients were prescribed with...

Observational studies that failed to take time-dependent confounders into account have lately called into doubt the net therapeutic advantage of ticagrelor over clopidogrel in acute coronary syndrome (ACS). The authors aimed to evaluate the comparative safety and efficacy of ticagrelor vs. clopidogrel in real-life setting by taking into account the non-adherence of the therapy. The following are k...

Transcatheter aortic valve replacement (TAVR) has become a well-established therapy for patients with severe, symptomatic aortic stenosis who are at intermediate-to-high surgical risk over last decade. Aortic stenosis and coronary artery disease (CAD) have similar risk factors and pathogenic pathways, and 40% to 75% of TAVR patients had significant CAD. In patients with severe CAD following aortic...

Ticagrelor lowers ischemia risk in patients who have had a previous heart attack (MI). It's uncertain whether the risks of ischemic stroke and the advantages of long-term P2Y12 inhibition in this cohort are stable over time. The goal of the trial was to see how ischemia risk changed over time and if the efficacy and safety of ticagrelor were the same early and late after randomization. The PEGASUS...

Patients at a high risk of bleeding (HBR) are a common subgroup of those receiving percutaneous coronary intervention (PCI). After a short period of dual antiplatelet treatment (DAPT), early aspirin discontinuation has emerged as a bleeding prevention technique. It has been demonstrated by TWILIGHT trial that ticagrelor monotherapy is an effective and safe bleeding prevention approach for high-ris...

After a minimum term of dual antiplatelet medication, monotherapy with a P2Y12 inhibitor is an emerging strategy for reducing the risk of bleeding after percutaneous coronary intervention (PCI). This Ticagrelor with Aspirin or Alone in High-Risk Patients after Coronary Intervention (TWILIGHT) trial was designed to test the hypothesis that a 3-month course of dual antiplatelet therapy with ticagrel...

The optimal timing of oral P2Y12 inhibitors administration is not well-defined even though they remain the main-stay treatment in the management of patients with non–ST-segment elevation acute coronary syndrome. In the theoretical knowledge, administration of an oral P2Y12 inhibitor before defining coronary anatomy provides more ischemic protection while patients are waiting to undergo coronary an...

In the TICO randomized clinical trial, stopping aspirin was tested as a bleeding reduction method after short-term dual anti-platelet treatment (DAPT). However, ticagrelor monotherapy has not been studied in patients with acute coronary syndromes solely (ACS). The objective of this study was to determine whether moving to ticagrelor monotherapy in patients with ACS treated with drug-eluting stents...

This secondary analysis of an open-label randomized controlled clinical trial evaluated whether low-dose triple combination antihypertensive therapy helps patients with mild to moderate hypertension to stay at target blood pressure longer than usual care. The triple therapy combination pill contained telmisartan 20 mg, amlodipine 2.5 mg, and chlorthalidone 12.5 mg. In this triple FDC therapy versu...

In this post hoc analysis, the frequency of occurrence of an early decline ("dip") in estimated glomerular filtration rate (eGFR) after initiation of dapagliflozin, and its association with outcomes, was evaluated in heart failure patients participated in DAPA- HF trial. The mean change in eGFR between day 0 and 14 was -1.1 with placebo and -4.2 with dapagliflozin, giving a intergroup difference o...

As we know, Lipoprotein(a) [Lp(a)] is an established risk factor for coronary artery disease, large artery stroke, and aortic valve stenosis. The authors measured and genetically predicted lipoprotein(a) [Lp(a)] levels of 4, 35,579 participants from the UK Biobank to investigate the role of Lp(a) in atrial fibrillation (AF) and whether its association is independent of atherosclerotic cardiovascul...

This post hoc analysis of the ADAPT-DES study investigated the predictors of dual antiplatelet therapy (DAPT) discontinuation, associations between different types and timing of DAPT discontinuation with thrombotic events, and the impact of on-treatment high platelet reactivity in 8582 patients who were already receiving aspirin and clopidogrel after undergoing PCI. In result it was seen that appr...

This study compared the dementia incidence rate between users and nonusers of oral anticoagulants (OACs) in a large Australian cohort of primary care patients with atrial fibrillation. During the mean follow‐up time of 3.7 ± 2.0 years, 425 patients had a documented diagnosis of dementia. After propensity matching, the incidence of dementia was significantly lower in OAC users (hazard ratio [HR], 0...

Efpeglenatide, is a novel, exendin-4-based weekly GLP-1 Receptor agonist that is administered subcutaneously, it effectively lowers glucose levels in people with T2DM. Recent guidelines have placed this class of agents as first-line glycemic-lowering therapy in people with baseline CVD, high risk for CVD, or chronic kidney disease (CKD) The AMPLITUDE-O Trial enrolled 4,076 adults with T2DM who had...

Take-Home Message No. 1 Guideline-directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF) now includes 4 medication classes 1) renin-angiotensin system inhibition with angiotensin receptor-neprilysin inhibitors (ARNi), angiotensin-converting enzyme inhibitors (ACEi), or angiotensin (II) receptor blockers (ARB) alone; 2) beta blockers; 3) mineralocorticoid receptor antagonists...

There is a need to identify high-risk features that predict early-onset atherosclerotic cardiovascular disease (ASCVD). The authors provide insights to help clinicians identify and address high-risk conditions in 20- to 39-year age young adults. The authors update current thinking on lipid risk factors such as triglycerides, non-high-density lipoprotein cholesterol, apolipoprotein B, or lipoprotei...

It has been controversial regarding blood pressure (BP) levels at which antihypertensive drug therapy should be started, and the adequate Blood pressure goal to be achieved following antihypertensive drug therapy in women with hypertensive disorders of pregnancy (HDP), which includes chronic hypertension (CH) as well as hypertension occurring at or after 20 weeks of gestation. The Japan Society fo...

Chloride is among the major electrolytes that play a unique role in fluid homeostasis and is associated with cardiorenal and neurohormonal systems. Various HF therapies may cause hypochloremia, and hypochloremia itself can initiate and exacerbate diuretic resistance in HF. The increasing burden of heart failure (HF) and emerging knowledge regarding chloride as a prognostic marker in HF have increa...

Tirzepatide is a dual GIP and GLP-1 receptor agonist under development for the treatment of type 2 diabetes mellitus (T2DM), obesity, and nonalcoholic steatohepatitis. Early phase trials in T2DM indicate that tirzepatide improves clinical outcomes beyond those achieved by a selective GLP-1 receptor agonist like dulaglutide Improved glycemic control was associated with lower circulating triglycerid...

Systematic review and meta-analysis of 10 real-world observational studies including patients with not valvular atrial fibrillation NVAF on apixaban and rivaroxaban was done to compare the efficacy and safety of apixaban and rivaroxaban for the prevention of stroke. Surprisingly, apixaban treatment showed significantly lower hazard of 0.8 or 20% Risk reduction in stroke/systemic embolism compared...