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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 | UTC

Study 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.

Article: Balik, M., Maly, M., Brozek, T. et al. Propafenone versus amiodarone for supraventricular arrhythmias in septic shock: a randomised controlled trial. Intensive Care Med (2023)

 

Commentary on Twitter:

 


Crossover RCT | Using one-size cuff results in major inaccuracy in BP readings across varying arm sizes

11 Aug, 2023 | 15:41h | UTC

Effects 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:

Brief Review | Why is cuff size so important and other factors that affect accurate blood pressure measurement

[News release – not published yet] Study finds blood pressure cuff size matters, affects blood pressure readings

 

Commentary on Twitter

 


Perspective | AI predicted to play major role in cardiac CT and CV care in the coming decade

11 Aug, 2023 | 15:30h | UTC

AI 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

Adding Pharmacist-Led Home Blood Pressure Telemonitoring to Usual Care for Blood Pressure Control: A Systematic Review and Meta-Analysis – American Journal of Cardiology

 


Review | An approach to non-left main bifurcation lesions

11 Aug, 2023 | 15:22h | UTC

An Approach to Non-left Main Bifurcation Lesions: A Contemporary Review – US Cardiology Review

 

Commentary on Twitter

 


Cohort Study | Younger age at hypertrophic cardiomyopathy diagnosis, male sex among predictors of developing LV systolic dysfunction

11 Aug, 2023 | 15:16h | UTC

Left Ventricular Systolic Dysfunction in Patients Diagnosed With Hypertrophic Cardiomyopathy During Childhood: Insights From the SHaRe Registry – Circulation

 

Commentary on Twitter

 


Cohort Study | U-shaped relationship between BMI and mortality in heart failure patients

11 Aug, 2023 | 15:12h | UTC

Body mass index and survival in people with heart failure – Heart

 

Commentary on Twitter

 


[News Release] RCT | Semaglutide 2.4 mg reduces cardiovascular risk by 20% in adults with CVD & obesity

9 Aug, 2023 | 15:40h | UTC

Novo Nordisk A/S: Semaglutide 2.4 mg reduces the risk of major adverse cardiovascular events by 20% in adults with overweight or obesity in the SELECT trial – Novo Nordisk

Commentaries:

SELECT: Semaglutide Cuts CV Events in Adults With Overweight or Obesity – TCTMD

Expert reaction to Novo Nordisk press release announcing the headline results from their SELECT cardiovascular outcomes semaglutide trial – Science Media Centre

Related: Role of Glucagon‐Like Peptide‐1 Receptor Agonists in Achieving Weight Loss and Improving Cardiovascular Outcomes in People With Overweight and Obesity – Journal of the American Heart Association

 


Registry Analysis | Incidence and impact of pacemaker implantation after TAVR with self-expanding valves

8 Aug, 2023 | 13:29h | UTC

Incidence, 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:

Permanent pacemakers after TAVR: Tracking the impact of modern self-expanding valves – Cardiovascular Business

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

Interventional Cardio-Oncology: Unique Challenges and Considerations in a High-Risk Population – Current Treatment Options in Oncology

 


Cohort Study | Habitual calcium supplementation linked to higher CVD incidence and mortality in diabetics

8 Aug, 2023 | 13:24h | UTC

Associations 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)

Related: The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials – Journal of the American College of Nutrition

 

Commentary on Twitter

 


Cohort Study | Clozapine, but not olanzapine or quetiapine, linked with higher perimyocarditis and heart failure risk

8 Aug, 2023 | 13:14h | UTC

The association between exposure to clozapine, olanzapine, and quetiapine and the outcomes perimyocarditis and heart failure: A population-based cohort study – Psychiatry Research

 


Review | Management of worsening heart failure with reduced ejection fraction

7 Aug, 2023 | 15:03h | UTC

Management of Worsening Heart Failure With Reduced Ejection Fraction: JACC Focus Seminar 3/3 – Journal of the American College of Cardiology

 

Commentary on Twitter

 


Cohort Study | High-sensitivity troponin’s role in assessing MI and CV death risk in stable CAD patients

7 Aug, 2023 | 15:01h | UTC

High-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

High-Sensitivity Cardiac Troponin for Risk Assessment in Chronic CAD – Journal of the American College of Cardiology

 

Commentary on Twitter

 


Expert Panel | Assessment and management of older adults undergoing percutaneous coronary intervention

7 Aug, 2023 | 14:55h | UTC

Assessment and Management of Older Adults Undergoing PCI, Part 1: A JACC: Advances Expert Panel – Journal of the American College of Cardiology

A Geriatric Approach to Percutaneous Coronary Interventions in Older Adults, Part II: A JACC: Advances Expert Panel – Journal of the American College of Cardiology

 


Review | Cardiorenal syndrome in the hospital

7 Aug, 2023 | 14:36h | UTC

Cardiorenal Syndrome in the Hospital – Clinical Journal of the American Society of Nephrology

 

Commentary on Twitter

 

 


Review | Primary aldosteronism: a pragmatic approach to diagnosis and management

4 Aug, 2023 | 12:06h | UTC

Primary 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

Cardiac device infection: removing barriers to timely and adequate treatment – European Heart Journal

 


Brief Review | How do I diagnose and treat my patient’s amiodarone-induced thyrotoxicosis?

4 Aug, 2023 | 11:52h | UTC

How do I diagnose and treat my patient’s amiodarone-induced thyrotoxicosis? – Cleveland Clinic Journal of Medicine

 


Review | Autoimmunity and postural orthostatic tachycardia syndrome: Implications in diagnosis and management

4 Aug, 2023 | 11:49h | UTC

Autoimmunity and postural orthostatic tachycardia syndrome: Implications in diagnosis and management – Cleveland Clinic Journal of Medicine

 


RCT – 2ry analysis | Omega-3 supplementation linked to increased AF risk in post-MI patients

3 Aug, 2023 | 13:45h | UTC

Omega-3 fatty acid supplements and risk of atrial fibrillation and ‘micro-atrial fibrillation’: A secondary analysis from the OMEMI trial – Clinical Nutrition

Related:

M-A: Omega-3 fatty acids supplementation is associated with increased risk of atrial fibrillation.

M-A: Omega-3 fatty acids supplementation increases the risk of atrial fibrillation in patients with lipid disorders.

More data suggests no cardiovascular benefit from Omega-3 supplementation – secondary analysis of STRENGHT trial did not show an association between achieved Omega-3 fatty acid levels and major adverse cardiovascular outcomes in patients with high cardiovascular risk.

RCT: Omega-3 supplements do not reduce cardiovascular events in elderly patients after myocardial infarction

#AHA20 – Randomized trial: High-dose Omega-3 fatty acids did not reduce the risk of cardiac events in patients at high cardiovascular risk

Meta-Analysis of Randomized Trials: Little Benefit from Omega-3 Intake to Reduce Cardiovascular Disease Risk

 

Commentary from the author on Twitter (thread – click for more)

 


Registry Analysis | Takotsubo syndrome outcomes influenced by trigger type and patient characteristics

3 Aug, 2023 | 13:14h | UTC

Trigger‐Associated Clinical Implications and Outcomes in Takotsubo Syndrome: Results From the Multicenter GEIST Registry – Journal of American Heart Association

Commentary: 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 | UTC

Chapter 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: Health-Status Outcomes with Initial Invasive vs. Conservative Care in Stable Coronary Disease

ISCHEMIA Trial: Initial Invasive vs. Conservative Strategy for Stable Coronary Disease

ISCHEMIA Trial: Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease

ISCHEMIA Trial: Management of Coronary Disease in Patients with Advanced Kidney Disease

Follow-up of the ISCHEMIA trial | Similar survival after invasive vs. conservative management of stable coronary disease.

ISCHEMIA Trial 2ry Analysis | Patients with CCD and daily/weekly angina seem to benefit most from complete revascularization

 


Meta-analysis | Even low levels of alcohol consumption may increase blood pressure

2 Aug, 2023 | 14:07h | UTC

Alcohol Intake and Blood Pressure Levels: A Dose-Response Meta-Analysis of Nonexperimental Cohort Studies – Hypertension

News 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

British Society for Haematology guideline for anticoagulant management of pregnant individuals with mechanical heart valves – British Journal of Haematology

 


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