Cardiology (all articles)
RCT: Propafenone leads to quicker sinus rhythm restoration than amiodarone in supraventricular arrhythmias related to septic shock
1 Oct, 2023 | 15:19h | UTCStudy Design & Population: The research was a two-center, prospective, controlled parallel-group, double-blind trial involving 209 septic shock patients who had new-onset supraventricular arrhythmia and a left ventricular ejection fraction above 35%. Patients were randomized to receive either intravenous propafenone (70 mg bolus followed by 400–840 mg/24 h) or amiodarone (300 mg bolus followed by 600–1800 mg/24 h).
Main Findings: The primary outcomes focused on the proportion of patients in sinus rhythm 24 hours post-infusion, time to the first sinus rhythm restoration, and arrhythmia recurrence rates. No significant difference was observed in 24-hour sinus rhythm rates between the propafenone (72.8%) and amiodarone (67.3%) groups (p=0.4). Time to the first rhythm restoration was significantly shorter for the propafenone group (median 3.7 hours) compared to the amiodarone group (median 7.3 hours, p=0.02). Recurrence of arrhythmia was notably lower in the propafenone group (52%) than in the amiodarone group (76%, p<0.001). In the subgroup of patients with a dilated left atrium, amiodarone appeared to be more effective.
Implications & Limitations: The study suggests that while propafenone doesn’t offer better rhythm control at 24 hours compared to amiodarone, it does provide faster cardioversion and fewer arrhythmia recurrences, especially in patients with a non-dilated left atrium. No significant differences were observed in clinical outcomes, such as ICU or long-term mortality, between propafenone and amiodarone in the trial. Limitations include potential underpowering of the study and the inability to fully account for the impact of multiple covariates involved in the complex therapy of septic shock.
Commentary on Twitter:
Propafenone?70 mg bolus+ 400-840 mg/24h vs amiodarone?300 mg + by 600-1800 mg/24h for SVA in septic shock, RCT
?propafenone not better for rhythm control at 24h but excellent hemodynamic safety profile, cardioverting faster & fewer recurrences#FOAMCc
?https://t.co/GVuoxPD7Hy pic.twitter.com/rRlj00x71p— Intensive Care Medicine (@yourICM) September 13, 2023
Crossover RCT | Using one-size cuff results in major inaccuracy in BP readings across varying arm sizes
11 Aug, 2023 | 15:41h | UTCEffects of Cuff Size on the Accuracy of Blood Pressure Readings: The Cuff(SZ) Randomized Crossover Trial – JAMA Internal Medicine (free for a limited period)
Commentaries:
When it comes to blood pressure cuffs, size matters – MedicalResearch.com
One-size-fits-all blood pressure cuffs ‘strikingly inaccurate,’ study says – CNN
Related:
Commentary on Twitter
Using a regular blood pressure (BP) cuff regardless of individual’s arm size resulted in 3.6 mmHg lower systolic BP when a regular cuff was one size too-large, and 4.8 and 19.5 mmHg higher when a regular cuff was one and two sizes too small. https://t.co/ZKnGfWc9fy
— JAMA Internal Medicine (@JAMAInternalMed) August 7, 2023
Perspective | AI predicted to play major role in cardiac CT and CV care in the coming decade
11 Aug, 2023 | 15:30h | UTCAI Predicted to Play Major Role in Cardiac CT and CV Care in the Coming Decade – TCTMD
M-A | Pharmacist-led home BP telemonitoring enhances control over usual care
11 Aug, 2023 | 15:29h | UTC
Review | An approach to non-left main bifurcation lesions
11 Aug, 2023 | 15:22h | UTCAn Approach to Non-left Main Bifurcation Lesions: A Contemporary Review – US Cardiology Review
Commentary on Twitter
?Do you know how to classify, assess, and treat non-left main bifurcation lesions with PCI?
New #USCardiology Review by @ANazmiCalik, @mirvatalasnag et al. @radcliffeCARDIO
?https://t.co/PeUcLxUerx pic.twitter.com/qh2FdUTbdE
— Amit Goyal MD MAS (@AmitGoyalMD) August 4, 2023
Cohort Study | Younger age at hypertrophic cardiomyopathy diagnosis, male sex among predictors of developing LV systolic dysfunction
11 Aug, 2023 | 15:16h | UTC
Commentary on Twitter
@sarahaboualaiwi and colleagues provide new #clinicalresearch; Left Ventricular Systolic Dysfunction in #HCM diagnosed in childhood, Important insights into prevalence and prognosis from the SHaRe Registry #Circulation @sday_hcm @CSHeartResearch @tikuowens https://t.co/2TJ0XMe3B7 pic.twitter.com/o2mhcNjUfw
— Circulation (@CircAHA) June 2, 2023
Cohort Study | U-shaped relationship between BMI and mortality in heart failure patients
11 Aug, 2023 | 15:12h | UTCBody mass index and survival in people with heart failure – Heart
Commentary on Twitter
Body mass index and survival in people with heart failurehttps://t.co/W20GR5qjTM pic.twitter.com/s2nX2sBZj7
— Heart_BMJ (@Heart_BMJ) August 2, 2023
[News Release] RCT | Semaglutide 2.4 mg reduces cardiovascular risk by 20% in adults with CVD & obesity
9 Aug, 2023 | 15:40h | UTCCommentaries:
SELECT: Semaglutide Cuts CV Events in Adults With Overweight or Obesity – TCTMD
Registry Analysis | Incidence and impact of pacemaker implantation after TAVR with self-expanding valves
8 Aug, 2023 | 13:29h | UTCIncidence, Predictors, and Prognostic Impact of New Permanent Pacemaker Implantation After TAVR With Self-Expanding Valves – JACC: Cardiovascular Interventions (link to abstract – $ for full-text)
Commentaries:
Pacemaker Implantation Still Risky, Not Rare With Self-Expanding TAVI Devices – TCTMD
Review | Interventional cardio-oncology: unique challenges and considerations in a high-risk population
8 Aug, 2023 | 13:27h | UTC
Cohort Study | Habitual calcium supplementation linked to higher CVD incidence and mortality in diabetics
8 Aug, 2023 | 13:24h | UTCAssociations of Habitual Calcium Supplementation With Risk of Cardiovascular Disease and Mortality in Individuals With and Without Diabetes – Diabetes Care (link to abstract – $ for full-text)
Commentary on Twitter
Habitual Ca supplementation was associated with higher risks of CVD in diabetics but not non-diabetics, suggesting that diabetics may need to be cautious about the long-term use of Ca supplements. @ADA_Pubs
Read Here➡️https://t.co/wUBy6KJhaw pic.twitter.com/6FXmwBwnMS
— Diabetes Care, a research journal of the ADA ? (@DiabetesCareADA) July 28, 2023
Cohort Study | Clozapine, but not olanzapine or quetiapine, linked with higher perimyocarditis and heart failure risk
8 Aug, 2023 | 13:14h | UTC
Review | Management of worsening heart failure with reduced ejection fraction
7 Aug, 2023 | 15:03h | UTC
Commentary on Twitter
How do you manage patients with worsening #HFrEF? This review by @SJGreene_md, @JavedButler1 and team provides the latest evidence-based guidance for the medical management of this high-risk population. https://t.co/REAqsrHDjI#JACC #CardioTwitter @ShelleyZieroth @DCRINews pic.twitter.com/rZYD25vCoG
— JACC Journals (@JACCJournals) August 5, 2023
Cohort Study | High-sensitivity troponin’s role in assessing MI and CV death risk in stable CAD patients
7 Aug, 2023 | 15:01h | UTCHigh-Sensitivity Cardiac Troponin for Risk Assessment in Patients With Chronic Coronary Artery Disease – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries:
High-Sensitivity Troponin Assays May Stratify Risk in Chronic CAD – TCTMD
Commentary on Twitter
In patients with chronic CAD, an elevated #troponin identifies those more likely to have MI or CV death. Routine troponin testing in this setting could inform patient selection for additional treatment. https://t.co/T4HfidPwOA#JACC #cvCAD #CardioTwitter #cvPrev #cvMI pic.twitter.com/2IOU8jsFPj
— JACC Journals (@JACCJournals) August 1, 2023
Expert Panel | Assessment and management of older adults undergoing percutaneous coronary intervention
7 Aug, 2023 | 14:55h | UTC
Review | Cardiorenal syndrome in the hospital
7 Aug, 2023 | 14:36h | UTCCardiorenal Syndrome in the Hospital – Clinical Journal of the American Society of Nephrology
Commentary on Twitter
The cardiorenal syndrome refers to a group of complex, bidirectional pathophysiological pathways involving dysfunction in both the heart and kidney. This Review focuses on the cardiorenal syndrome encountered in the hospital setting https://t.co/f05vpOPzCx pic.twitter.com/4Is5A2F1km
— CJASN (@CJASN) July 31, 2023
Review | Primary aldosteronism: a pragmatic approach to diagnosis and management
4 Aug, 2023 | 12:06h | UTCPrimary Aldosteronism: A Pragmatic Approach to Diagnosis and Management – Mayo Clinic Proceedings
Perspective | Cardiac device infection: removing barriers to timely and adequate treatment
4 Aug, 2023 | 11:54h | UTC
Brief Review | How do I diagnose and treat my patient’s amiodarone-induced thyrotoxicosis?
4 Aug, 2023 | 11:52h | UTC
Review | Autoimmunity and postural orthostatic tachycardia syndrome: Implications in diagnosis and management
4 Aug, 2023 | 11:49h | UTC
RCT – 2ry analysis | Omega-3 supplementation linked to increased AF risk in post-MI patients
3 Aug, 2023 | 13:45h | UTCRelated:
M-A: Omega-3 fatty acids supplementation is associated with increased risk of atrial fibrillation.
Commentary from the author on Twitter (thread – click for more)
RCT data consistently show that Omega-3 suppl increase AF risk https://t.co/LQVHfPNtKL
In this substudy of the #OMEMI trial we add novel data from thumb-ECG screening and serum EPA/DHA, supporting a causal relation between omega-3 (EPA) and AF!https://t.co/B9VoDNQpZi
? 1/4 pic.twitter.com/GFYGfVaNMq
— Peder L. Myhre ? (@pmyhre) July 28, 2023
Registry Analysis | Takotsubo syndrome outcomes influenced by trigger type and patient characteristics
3 Aug, 2023 | 13:14h | UTCCommentary: Takotsubo Trigger Type Matters, With Physical Shocks Linked to Worse Outcomes – TCTMD
Perspective | The most important trial in modern cardiology (Critical appraisal of the ISCHEMIA trial)
2 Aug, 2023 | 14:11h | UTCChapter 3: The Most Important Trial in Modern Cardiology – Sensible Medicine
See also:
Chapter 1: What Does it Mean to Discover a Coronary Blockage? – By Dr John Mandrola
Chapter 2: On the meaning of a coronary blockage – By Dr John Mandrola
Related/Original Articles:
ISCHEMIA Trial: Initial Invasive vs. Conservative Strategy for Stable Coronary Disease
ISCHEMIA Trial: Management of Coronary Disease in Patients with Advanced Kidney Disease
Meta-analysis | Even low levels of alcohol consumption may increase blood pressure
2 Aug, 2023 | 14:07h | UTCNews Release: Routinely drinking alcohol may raise blood pressure even in adults without hypertension – AHA Newsroom
BSH guideline for anticoagulant management of pregnant individuals with mechanical heart valves
2 Aug, 2023 | 14:01h | UTC