Star Update Podcast - Cardiology News Summaries

Patients who undergo percutaneous coronary intervention (PCI) with drug-eluting stents require dual antiplatelet therapy (DAPT) for at least 6 months for stable ischemic heart disease (SIHD) or 12 months for acute coronary syndromes (ACS) to prevent stent thrombosis and other cardiovascular events (1). The rationale for using DAPT is that aspirin and a P2Y12 antagonist (such as clopidogrel, prasug...

The 3 topic is on the top 10 messages we should know about the American College of Cardiology (ACC)/American Heart Association (AHA)/Society for Cardiovascular Angiography and Interventions 2021 coronary artery revascularization guideline Top 10 Take-Home Messages 1. Treatment decisions regarding coronary revascularization in patients with coronary artery disease (CAD) should be based on clinical...

As we have seen so far Real-world studies have evaluated the use of anticoagulants in obese patients with nonvalvular atrial fibrillation (NVAF), but they have been limited by sample size or the use of diagnosis codes on claims to define obesity. In a retrospective study of 26,522 NVAF patients with body weight of ≥100 kg or a body mass index of ≥30 kg/m2 , were enrolled from Veterans Affairs and...

Lipoprotein (a) [Lp (a)] is associated with an increased risk of myocardial infarction, although the mechanism for this observation remains uncertain. Objectives A study was conducted to investigate whether Lp(a) is associated with adverse plaque progression. Methods In this study Lp(a) was measured in patients with advanced stable coronary artery disease undergoing coronary CT  angiography a...

Background: EXPLORER-HCM demonstrated that mavacamten, a cardiac myosin inhibitor, improves symptoms, exercise capacity, and left ventricular outflow tract (LVOT) obstruction in patients with obstructive hypertrophic cardiomyopathy (oHCM). Objectives: The purpose of this study was to evaluate mavacamten's effect on measures of cardiac structure and function and its association with changes in othe...

Background: The use of β-adrenergic receptor blocking agents in symptomatic patients with obstructive hypertrophic cardiomyopathy (HCM) rests on clinical experience and observational cohort studies. Objectives: This study aimed to investigate the effects of metoprolol on left ventricular outflow tract (LVOT) obstruction, symptoms, and exercise capacity in patients with obstructive hypertrophic car...

1. GIRAF trial was created with a multicenter, randomized, prospective parallel, active-controlled blinded design and conducted in 6 centers in Brazil., the trial assessed multiple cognitive outcomes in a cohort of patients randomized to 110 or 150 mg of dabigatran twice daily or once-daily warfarin. 2. The trial enrolled and randomized 200 patients. For inclusion in the trial, patients needed to...

 1. The study randomized 1,242 patients undergoing knee arthroplasty to one of seven postoperative regimens of milvexian (25 mg, 50 mg, 100 mg, or 200 mg twice daily or 25 mg, 50 mg, or 200 mg once daily) or the anticoagulant enoxaparin (40 mg once daily). The primary efficacy outcome was venous thromboembolism, and the primary safety outcome was bleeding. 2. Results found that in those patie...

The goal of the trial was to evaluate empagliflozin compared with placebo among patients with acute decompensated heart failure. Empagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor, which has been shown to reduce the risk of cardiovascular death or heart failure hospitalization among patients with chronic heart failure. 530 participants with acute heart failure were randomized to e...

The investigational PCSK9 inhibitor of Merck, MK-0616 — comes in pill form, in contrast to the three currently available PCSK9-lowering drugs that must be given in injections separated by weeks to months. In two phase-1 studies with a total of 100 participants, MK-0616 was given daily for 2 weeks on a background of statin therapy for 14 days The drug exhibited a dose-dependent increase in plasma e...

 Prolonged use of dual antiplatelet therapy (DAPT) following PCI may be associated with reduced benefits and greater harms in “real-world” clinical practice in contrast to outcomes of the DAPT Study The study included 8,864 patients from the DAPT study and 568,540 registry patients. Longer-duration P2Y12 inhibitor therapy in the DAPT cohort was associated with a 1.01% decrease in-stent thromb...

In this trial, the safety and efficacy of bentracimab was assessed in reversing the antiplatelet effect of ticagrelor among patients needing urgent surgery or a procedure, or with major bleeding. 150 patients with a mean age of 65 years who either needed urgent surgery or a procedure or with major bleeding were enrolled in an open-label single-arm study. On day 1, patients received an intravenous...

Direct oral anticoagulants have been evaluated in the general population, but proper evidence for their safe use in the geriatric population is lacking. This study compared the bleeding risk of a direct oral anticoagulant (rivaroxaban) and vitamin K antagonists (VKAs) among French geriatric patients aged 80 years and above with non-valvular atrial fibrillation (AF) In this sequential observational...

The role of diuretics in patients with intermediate-risk pulmonary embolism (PE) is controversial. In this multicentre, double-blind trial, normotensive patients with intermediate-risk Pulmonary Embolism were randomized to receive either a single 80 mg bolus of furosemide or a placebo. Eligible patients had at least a simplified PE Severity Index (sPESI) ≥1 with right ventricular dysfunction. The...

Patients at high bleeding risk represent a prevalent subgroup among those undergoing percutaneous coronary intervention. Early aspirin discontinuation after a short course of dual antiplatelet therapy (DAPT) has emerged as a bleeding avoidance strategy. The aim of this study was to assess the effects of ticagrelor monotherapy in reducing the incidence of primary endpoint of 2, 3, or 5 BARC bleedin...

Statin therapy has been associated with increased insulin resistance; however, its clinical implications for diabetes control among patients with diabetes is unknown. To assess this, a large retrospective cohort study was conducted with 12 years data of 83, 022 propensity-scored matched pairs of statin users and nonusers covered by the US Department of Veterans Affairs from fiscal years 2003 to 20...

Severe coronavirus disease-2019 (COVID-19) can progress to an acute respiratory distress syndrome (ARDS), which involves alveolar infiltration by activated neutrophils. The beta-blocker metoprolol has been shown to ameliorate exacerbated inflammation in the myocardial infarction setting. The purpose of this study was to evaluate the effects of metoprolol on alveolar inflammation and on respiratory...

Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist, has favorable effects on cardiorenal outcomes in patients with predominantly stage 3 or 4 chronic kidney disease (CKD) with severely elevated albuminuria and type 2 diabetes. The use of finerenone in patients with type 2 diabetes and a wider range of CKD is unclear. In this double-blind trial, patients with CKD and type 2...

Background: Even when low-density lipoprotein-cholesterol (LDL-C) levels are lower than guideline thresholds, a residual risk of atherosclerosis remains. It is unknown whether triglyceride (TG) levels are associated with subclinical atherosclerosis and vascular inflammation regardless of LDL-C. Objectives: This study sought to assess the association between serum TG levels and early atherosclerosi...

Intro: The HOPE-3 trial (Heart Outcomes Prevention Evaluation–3) found that antihypertensive therapy combined with a statin reduced the first stroke among people at intermediate cardiovascular risk. In this study, secondary analyses of predefined stroke outcomes for each randomized intervention, was reported by stroke subtype, independent predictors, treatment effects in key subgroups, and absolut...

In a Hot Line session today, Professor Steffen (Germany) presented results from the large randomized, open-label TOMAHAWK trial, which undertook to provide a definitive position on the use of early angiography in patients with shockable or non-shockable rhythm. The trial randomized 554 patients with return of spontaneous circulation after OUT OF HOSPITAL CARDIAC ARREST with no obvious extracardiac...

STEP study, presented by Professor Jun Cai (Chinese Academy of Medical Sciences, Beijing, China) in a Hot Line session on 30th August. The STEP study investigated whether intensive treatment (systolic blood pressure [SBP] target below 130 mmHg but no lower than 110 mmHg) could reduce the risk of cardiovascular (CV) events compared with standard treatment (SBP target 130–150 mmHg). In total, 8,511...

In a Hot Line session of 28th August, Professor Marco from Switzerland presented results from the investigator-initiated, open-label MASTER DAPT trial comparing an abbreviated vs. a standard duration of antiplatelet therapy after bioresorbable polymer-coated sirolimus-eluting stent implantation in patients with acute or chronic coronary syndrome who fulfilled one or more high bleeding-risk criteri...

Results from the EMPEROR-­Preserved trial were presented by Professor Stefan from Berlin in a Hot Line session on 27th August. This international double-blind trial enrolled 5,988 symptomatic HFpEF patients (LVEF >40%) with and without T2DM who had elevated N-terminal pro-BNP concentrations (>300 pg/mL in patients without and >900 pg/mL in patients with atrial fibrillation) along with evi...

This is a post hoc analysis of the ARIC study, with the objective to assess the association of diabetes duration with incident heart failure (HF). In this study, 9,734 participants from the ARIC study with mean age of 63 years without HF or coronary heart disease were included and their diabetes duration at Visit 4 was taken as baseline. After 22.5 years of follow up, it was found that, 1. Each 5-...