Open access
Open access
Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis – New England Journal of Medicine (free for a limited period)
Commentaries: Partial Oral Treatment of Endocarditis – POET – American College of Cardiology (free) AND New treatment can halve hospital stays for some patients with heart infection – ESC Press Releases (free)
Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery – New England Journal of Medicine (free for a limited period)
“In moderate-to-high-risk patients undergoing cardiac surgery, six-month outcomes show that a restrictive red-cell transfusion strategy is noninferior to a liberal strategy” (via @NEJM see Tweet with Visual Abstract)
2018 AHA/ACC Guideline for the Management of Adults With Congenital Heart Disease (free PDF)
News Release: Societies Release Updated Guideline for Treating Adult Congenital Heart Disease Patients (free)
Key Points to Remember: 2018 AHA/ACC Guideline for Adults With Congenital Heart Disease – American College of Cardiology (free)
Association of Surgical Left Atrial Appendage Occlusion With Subsequent Stroke and Mortality Among Patients Undergoing Cardiac Surgery – JAMA (link to abstract – $ for full-text)
Commentary: Heart surgery: To have or not to have…your left atrial appendage closed – Mayo Clinic, via ScienceDaily (free) AND LAA Closure Tied to Better Heart Surgery Outcomes – MedPage Today (free registration required)
Perspective by Dr. Eugene Braunwald: Aortic Stenosis: Then and Now – Circulation (free for a limited period)
Hybrid Coronary Revascularization in Selected Patients With Multivessel Disease: 5-Year Clinical Outcomes of the Prospective Randomized Pilot Study – JACC: Cardiovascular Interventions (link to abstract – $ for full-text)
Commentaries: Hybrid Revascularization: 5-Year Outcomes – American College of Cardiology (free)
Preoperative 6-Minute Walk Distance Is Associated With Postoperative Cognitive Dysfunction – The Annals of Thoracic Surgery (link to abstract – $ for full-text)
Commentaries: 6-minute walk test predicts cognitive problems after heart surgery – Cardiovascular Business (free) AND Simple walking test helps predict risk for cognitive issues after heart surgery – Elservier, via EurekAlert (free)
Advances in critical care management of patients undergoing cardiac surgery – Intensive Care Medicine (free for a limited period)
Source: Critical Care Reviews Newsletter
Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery – New England Journal of Medicine (free for a limited period)
Commentaries: More Data Show Benefits of Multiple Arterial Over Saphenous-Vein Grafting in CABG: Meta-analysis – TCTMD (free) AND Radial Artery or Saphenous Vein Grafts in CABG – American College of Cardiology (free)
Effect of Ticagrelor Plus Aspirin, Ticagrelor Alone, or Aspirin Alone on Saphenous Vein Graft Patency 1 Year After Coronary Artery Bypass Grafting: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary: Ticagrelor + Aspirin, Ticagrelor Alone, or Aspirin Alone on SVG Patency – American College of Cardiology, Latest in Cardiology (free)
““The major limitation of the DACAB trial is the selection of vein graft patency as the primary outcome”. Agree:we’re starting to understand CAD is a bit more complicated than an open duct (also for this reason, medical practice requires clinical outcomes)” (via @camialderighi see Tweet)
Review: Management of Left Main Coronary Artery Disease – Journal of the American Heart Association (free for a limited period)
Long-term Thromboembolic Risk in Patients With Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Surgery and Patients With Nonvalvular Atrial Fibrillation – JAMA Cardiology (free for a limited period)
Commentaries: Postoperative A-fib Not as Bad as Nonsurgical A-fib for Thromboembolism – TCTMD (free) AND Fib after CABG linked to minimal long-term stroke risk – Cardiovascular Business (free)
Commentary with key points to remember: European Position Paper on Spontaneous Coronary Artery Dissection – American College of Cardiology, Latest in Cardiology (free)
Related position statement: Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association – Circulation (free)
Fluoroquinolone use and risk of aortic aneurysm and dissection: nationwide cohort study – The BMJ (free)
Related: Aortic Dissection and Aortic Aneurysms Associated with Fluoroquinolones: A Systematic Review and Meta-Analysis – American Journal of Medicine (free) AND Fluoroquinolones and collagen associated severe adverse events: a longitudinal cohort study – BMJ Open (free) AND Risk of Aortic Dissection and Aortic Aneurysm in Patients Taking Oral Fluoroquinolone – JAMA Internal Medicine (free)
Meta-analysis: Long-Term Outcomes of On- Versus Off-Pump Coronary Artery Bypass Grafting – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentary: Long-Term Outcomes of On- vs. Off-Pump CABG – American College of Cardiology, Latest in Cardiology (free)
“Off pump CABG. probably best used in a limited set of patients…” (via @keaglemd see Tweet)
This meta-analysis of randomized trials showed CABG had a mortality benefit over PCI in patients with multivessel disease, particularly those with diabetes and higher coronary complexity. There was no mortality benefit in patients with left main disease.
Association of Vegetation Size With Embolic Risk in Patients With Infective Endocarditis: A Systematic Review and Meta-analysis – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentaries: Infective Endocarditis Vegetation Size vs. Embolic Risk – American College of Cardiology, Latest in Cardiology (free) AND Larger Endocarditis Vegetations More Likely to Embolize, Kill – MedPage Today (free registration required)
Short-Term Versus Long-Term Dual Antiplatelet Therapy After Drug-Eluting Stent Implantation in Elderly Patients: A Meta-Analysis of Individual Participant Data From 6 Randomized Trials – JACC: Cardiovascular Interventions (link to abstract – $ for full-text)
Commentary: Dual Antiplatelet Therapy Duration in Elderly Patients – American College of Cardiology, Latest in Cardiology (free)
Short-term Dual Antiplatelet Therapy was not associated with increased risk of ischemic events in elderly patients and was associated with a significant reduction in major bleeding.
New-Onset Atrial Fibrillation After PCI or CABG for Left Main Disease: The EXCEL Trial – Journal of the American College of Cardiology (link to abstract – $ for full-text)
Commentaries: One in Five CABG Patients Develop New-Onset Atrial Fibrillation: EXCEL – TCTMD (free) AND Post-operative AFib common in CABG, linked to future stroke, death – Cardiovascular Business (free)
Opinion: Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used – The New York Times (10 articles per month are free)
Transcatheter versus surgical aortic valve replacement in patients at low surgical risk: A meta-analysis of randomized trials and propensity score matched observational studies – Catheterization Cardiovascular Interventions (link to abstract – $ for full-text)
Commentary: Meta-Analysis Raises ‘Red Flag’ on TAVR in Low-Risk Patients – TCTMD (free)
“Data from six studies show that while short-term mortality is similar between TAVR and SAVR, more low-risk TAVR patients die by 2 years” (from TCTMD)
Commentaries: Largest Study to Date Supports Surgical LAA Closure in A-fib Patients – TCTMD (free) AND Thromboembolism Less Likely With LAA Closure Added to Cardiac Surgery – MedPage Today (free registration required)
Randomized trials are needed to confirm these interesting findings.
Percutaneous PFO Closure Tied to Lower Risk for Recurrent Stroke – Physician’s First Watch (free) AND Meta-Analyses Support Stroke Prevention With PFO Closure – MedPage Today (free registration required)
Original article 1: Device Closure Versus Medical Therapy Alone for Patent Foramen Ovale in Patients With Cryptogenic Stroke: A Systematic Review and Meta-analysis – Annals of Internal Medicine (link to abstract – $ for full-text)
Original article 2: Percutaneous Closure Versus Medical Treatment in Stroke Patients With Patent Foramen Ovale: A Systematic Review and Meta-analysis – Annals of Internal Medicine (link to abstract – $ for full-text)
Alternative drug may prevent atrial fibrillation following heart surgery – NIHR Signal (free)
Original article: Colchicine for primary prevention of atrial fibrillation after open-heart surgery: Systematic review and meta-analysis – International Journal of Cardiology (link to abstract – $ for full-text)
Safety of Magnetic Resonance Imaging in Patients with Cardiac Devices – The New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: MRI scan safe for most people with older pacemakers, defibrillators – Reuters (free) AND Even Thoracic MRI Safe for ‘Legacy’ ICDs, Pacemaker Systems: Large Cohort Study – Medscape (free registration required) AND MRIs safe with older pacemakers, study finds – MedicalXpress (free)
Top Ten Things to Know: Defining Quality in Cardiovascular Imaging (free PDF)
Commentary: “Quality” in Cardiovascular Imaging – Getting to the Heart of the Meaning (free)
“PCI is associated with a reduction in the risk of major cardiovascular outcomes at short-term follow-up in patients with LMCA stenosis; but at long term, MACCE rate is increased for PCI”
Commentaries: Newborn Screening Policies For CHD Associated With Lower Infant Deaths – American College of Cardiology, Latest in Cardiology (free) AND Infant CCHD deaths cut by 33% after mandatory pulse oximetry testing – Cardiovascular Business (free) AND Screening for Critical Congenital Heart Disease at Birth Saves Lives – CDC (free)
Related guideline: Canadian Cardiovascular Society/Canadian Pediatric Cardiology Association Position Statement on Pulse Oximetry Screening in Newborns to Enhance Detection of Critical Congenital Heart Disease (free)
“The European Atlas of Cardiology brings together data from 56 countries to demonstrate the prevalence and cost of cardiovascular disease, and the need to utilise resources more effectively” (RT @OUPMedicine see Tweet)
Commentaries: Neither Sodium Bicarbonate nor Oral Acetylcysteine Prevents Contrast-Induced Kidney Injury – Physician’s First Watch (free) AND PRESERVE: No Benefit from Sodium Bicarbonate, Acetylcysteine After Angiography – Medscape (free registration required)
Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery – New England Journal of Medicine (free)
Commentaries: TRICS III: Restrictive Red-Cell Transfusion Noninferior to Liberal Use in Cardiac Surgery – TCTMD (free) AHA: Restrictive Blood Transfusion OK for Select Patients – MedPage Today (free registration required)
Related article: Transfusion Requirements After Cardiac Surgery: The TRACS Randomized Controlled Trial – JAMA (free)
Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: Mechanical heart valve often the safest choice – Stanford Medicine (free) AND Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement? – NEJM 360 Resident (free) AND Mechanical or Tissue Valve for AVR and MVR – American College of Cardiology, Latest in Cardiology (free) AND Mechanical Valves Show Mortality Benefit Over Biologic Valves – Medscape (free registration required) AND Heart valve replacement success may depend on age, valve type – Reuters (free)
European guidelines on perioperative venous thromboembolism prophylaxis (free PDF articles):
– Patients with preexisting coagulation disorders and after severe perioperative bleeding
– Cardiovascular and thoracic surgery
– Surgery in the obese patient
– Surgery during pregnancy and the immediate postpartum period
– Day surgery and fast-track surgery
– Chronic treatments with antiplatelet agents
– Aspirin
Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
Commentaries: Small Trial Raises Big Concerns That PCI In Stable Angina Is Just A Placebo – Cardiobrief (free) AND Diving Deep Into The ORBITA Trial – Cardiobrief (free) AND ‘Unbelievable’: Heart Stents Fail to Ease Chest Pain – The New York Times (10 articles per month are free) AND ORBITA: PCI Offers No Symptom Improvement Over Sham Procedure – TCTMD (free)
Editorial: Back to the Future in Cardiogenic Shock — Initial PCI of the Culprit Lesion Only (free)
Commentaries: CULPRIT-SHOCK Disputes Benefit of Immediate Multivessel PCI in Patients With Cardiogenic Shock – TCTMD (free) AND CULPRIT-SHOCK: Culprit Lesion Only PCI Vs. Immediate Multivessel PCI in Cardiogenic Shock – American College of Cardiology, Latest in Cardiology (free)
Daytime variation of perioperative myocardial injury in cardiac surgery and its prevention by Rev-Erbα antagonism: a single-centre propensity-matched cohort study and a randomised study – The Lancet (link to abstract – $ for full-text)
Commentaries: Why Heart Surgery May be Better in the Afternoon – Scientific American (free) AND Afternoon heart surgery has lower risk of complications, study suggests – The Guardian (free) AND Aortic Valve Replacement: Afternoon Surgery Linked to Fewer Adverse Events – Physician’s First Watch (free)
Commentaries: Expert Consensus Decision Pathway for Management of Mitral Regurgitation – American College of Cardiology, Latest in Cardiology (free) AND ACC Recommends ‘Structured Approach’ to Mitral Regurgitation – MedPage Today (free registration required)
2017 Appropriate Use Criteria for the Treatment of Patients With Severe Aortic Stenosis (free)
Commentaries: 2017 AUC for Management of Severe Aortic Stenosis – American College of Cardiology, Latest in Cardiology (free) AND First Appropriate Use Criteria Issued for Severe Aortic Stenosis – Medpage Today (free registration required)
Older people with acute coronary syndromes may benefit from routine invasive therapy – NIHR Signal (free)
Original article: Revascularisation compared with initial medical therapy for non-ST-elevation acute coronary syndromes in the elderly: a meta-analysis – Heart (link to abstract – $ for full-text)
Commentaries: Study: Triple-Vessel CABG Strategy Matters in the Long Run – MedPage Today (free registration required)
In patients with multivessel disease who are undergoing coronary artery bypass grafting, multiple arterial grafting (MAG) is associated with reduced mortality, repeated revascularization, myocardial infarction, and heart failure when compared with left internal thoracic artery (LITA) supplemented by saphenous vein grafts (LITA+SVG).
News release: Looking beyond the heart in adults with congenital heart disease (free)
Commentary: Think Outside the Heart: Noncardiac Complications and Considerations in the Adult Congenital Patient (free)
Top Ten Things to Know: Diagnosis and Management of Noncardiac Complications in Adults with Congenital Heart Disease (free PDF)
Predicting 30-Day Mortality for Patients With Acute Heart Failure in the Emergency Department: A Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries: Tool may help accurately predict 30-day mortality for emergency department patients with acute heart failure – 2 Minute Medicine (free) AND Simple tool accurately predicts 30-day mortality for patients with acute heart failure in the ER – MedicalXpress (free)
See Calculator: MEESSI-AHF RISK MODEL
Invited commentary: Coronary Computed Tomographic Angiography—The First Test for Evaluating Patients With Chest Pain? (free)
Commentary: Coronary CT Angiography vs. Stress Testing: Meta-Analysis Offers Mixed Results – Physician’s First Watch (free)
Coronary Computed Tomografic Angiography (CCTA) was associated with a very small reduction in the incidence of myocardial infarction (0.7% vs 1.1% = 0.4% absolute risk reduction), but without differences in death or cardiac hospitalization. Patients undergoing CCTA were significantly more likely to undergo invasive coronary angiography (11.7% vs 9.1%), revascularization (7.2% vs 4.5%) and were also more likely to receive a diagnosis of new CAD and to have initiated aspirin or statin therapy.
D-dimer to guide the intensity of anticoagulation in Chinese patients after mechanical heart valve replacement: a randomized controlled trial – Journal of Thrombosis and Haemostasis (link to abstract – $ for full-text)
Source: ACP Journal Wise ($)
Interventions for treating tuberculous pericarditis – Cochrane Library (free)
News release: Treatment for tuberculosis infection of the membrane around the heart (free)
“For HIV-negative patients, corticosteroids may reduce death. For HIV-positive patients not on antiretroviral drugs, corticosteroids may reduce constriction. For HIV-positive patients with good antiretroviral drug viral suppression, clinicians may consider the results from HIV-negative patients more relevant”.
Association of Guideline Adherence for Serial Evaluations With Survival and Adverse Clinical Events in Patients With Asymptomatic Severe Aortic Stenosis – JAMA Cardiology (link to abstract – $ for full-text)
Commentaries: Serial Echos Valuable in Patients with Asymptomatic Severe Aortic Stenosis – Physician’s First Watch (free) AND Close Watch on Aortic Stenosis May Improve Outcomes – MedPage Today (free registration required)
Survival and Cardiovascular Outcomes of Patients With Secondary Mitral Regurgitation: A Systematic Review and Meta-analysis – JAMA Cardiology (link to abstract – $ for full-text)
Commentary: Even Mild Secondary Mitral Regurgitation Tied to Reduced Survival – MedPage Today (link to abstract – $ for full-text)
Original articles from the New England Journal of Medicine: Patent Foramen Ovale Closure or Antiplatelet Therapy for Cryptogenic Stroke (link to abstract – $ for full-text) AND Patent Foramen Ovale Closure or Anticoagulation vs. Antiplatelets after Stroke (link to abstract – $ for full-text) AND Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke (link to abstract – $ for full-text)
Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial – Journal of The American College of Cardiology (link to abstract – $ for full-text)
Commentaries: Palliative Care Intervention Improves Quality of Life in Advanced Heart Failure Patients – American College of Cardiology, Latest in Cardiology (free) AND Palliative Care & CHF: PAL-HF trial – Pallimed (free)
Spontaneous Coronary Artery Dissection: Clinical Outcomes and Risk of Recurrence – Journal of The American College or Cardiology (link to abstract – $ for full-text)
Commentaries: Long-Term Outcomes of Spontaneous Coronary Artery Dissection – American College of Cardiology, Latest in Cardiology (free) AND Spontaneous Coronary Dissection Often Followed By MACE Long Term – MedPage Today (free registration required)
Beta-blockers were associated with less recurrence in this observational study.
Improving the Appropriate Use of Transthoracic Echocardiography: The Echo WISELY Trial – Journal of The American College of Cardiology (link to abstract – $ for full-text)
Commentaries: Improving Echo Appropriateness: Audit and Feedback Intervention Works – TCTMD (free) AND Improving Appropriate Use of Transthoracic Echocardiography – American College of Cardiology, Latest in Cardiology (free)
Commentary with highlights from the document: Appropriate Use Criteria Published for Valvular Heart Disease Imaging Tests – American College of Cardiology, Latest in Cardiology (free)
Impact of Obesity on Intensive Care Unit Resource Utilization After Cardiac Operations – The Annals of Thoracic Surgery (link to abstract – $ for full-text)
Commentaries: Obese cardiac patients a drain on ICU resources – Cardiovascular Business (free) AND Obese Cardiac Surgery Patients a Burden on ICU Resources – TCTMD (free) AND Post–Cardiac Surgery ICU Usage Rises With Increasing Obesity – Medscape (free registration required)
Original article: Complete versus culprit-only revascularisation in ST elevation myocardial infarction with multi-vessel disease – Cochrane Library (link to abstract – $ for full-text)
Underweight associated with highest mortality and costs after cardiac catheterization (free) (the results have not been published yet)
Commentaries: Underweight and Overlooked: Low BMI Patients May Be Highest-Risk Post-PCI – TCTMD (free) AND Underweight Patients Fare Worse After Heart Catheterization – Medscape (free registration required) AND ESC 2017: Underweight Is Associated With Highest Mortality and Costs After Cardiac Catheterization – PracticeUpdate (free registration required)
Closure of left atrial appendage during heart surgery protects the brain (LAACS) – ESC Press Releases (free) (the results have not been published yet)
Commentary: LAACS: LAA Closure May Protect Against Long-Term Cerebral Ischemic Events – American College of Cardiology, Latest in Cardiology (free)
The Prognostic Value of Coronary Artery Calcium in the PROMISE Study – Circulation (free PDF)
Editorial: Computed Tomography or Functional Stress Testing for the Prediction of Risk: Can I Have My Cake and Eat It? (free PDF)
Commentary: Prospective Multicenter Imaging Study for Evaluation of Chest Pain – PROMISE – American College of Cardiology, Latest in Cardiology (free)
2017 ESC/EACTS Guidelines for the management of valvular heart disease (free) (RT @rafavidalperez see Tweet)
Commentary: European Societies Issue New Valvular Heart Disease Guidelines, With Important Shifts – TCTMD (free)
See also: #ESCCongress Slides (free PPT file)
2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) (free) (RT @rafavidalperez see Tweet)
Commentary: ESC Updates Guidelines for Treating STEMI Patients – TCTMD (free)
See also: #ESCCongress Slides (free PPT file)
CI Versus CABG in Patients With Type 1 Diabetes and Multivessel Disease – Journal of The American College of Cardiology (link to abstract – $ for full-text)
Commentaries: Patients With Type 1 Diabetes and Multivessel Disease Have Greater Benefit From CABG Than PCI – American College of Cardiology, Latest in Cardiology (free) AND Revascularization in Patients With Type 1 Diabetes – American College of Cardiology, Latest in Cardiology (free)
CABG Appears Superior to PCI for Patients With Type 1 Diabetes, Multivessel Disease – TCTMD (free)
“The observational findings support existing recommendations favoring surgical revascularization in patients with diabetes” (from TCTMD).
Editorial: Rheumatic Heart Disease — An Iceberg in Tropical Waters (free) (RT @NEJM see Tweet with interesting table)
Quick Take Video Summary: What is the Global Burden of Rheumatic Heart Disease? (free)
Commentary: Death rates from rheumatic heart disease falling since 1990 – Institute for Health Metrics and Evaluation (free)
Five-Year Outcomes after On-Pump and Off-Pump Coronary-Artery Bypass – New England Journal of Medicine (link to abstract – $ for full-text)
Commentaries: Off-Pump CABG Raises Long-Term Mortality Risk – Cardiobrief (free) AND Newer method of open-heart surgery carries more risks, study finds – STAT (free)
The 10-Year Prognostic Value of Zero and Minimal CAC – Journal of The American College of Cardiology (no abstract – $ for full text)
Commentary: Calcium in Arteries Influences Heart Attack Risk – UT Southwestern Medical Center, via NewsWise (free) AND Study: Calcium in arteries influences heart attack risk – UPI (free)
“Half of the participants had no calcium deposits in their arteries or a zero coronary artery calcium, or CAC, score, and had less than a 3 percent chance of a cardiovascular event over a 10-year period despite having other risk factors for heart disease and stroke such as type 2 diabetes, high blood pressure and high bad cholesterol levels” (from UPI)
Increasing Prevalence of Atrial Fibrillation and Permanent Atrial Arrhythmias in Congenital Heart Disease – Journal of The American College of Cardiology (link to abstract and infographic – $ for full-text)
Commentary: Atrial Fibrillation in Congenital Heart Disease – American College of Cardiology, Latest in Cardiology (free)
Review: The Future of Cardiovascular Magnetic Resonance Imaging – European Heart Journal (free)
Source: Medscape
Eliminating Creatine Kinase–Myocardial Band Testing in Suspected Acute Coronary Syndrome: A Value-Based Quality Improvement – JAMA Internal Medicine (free) (RT @EricTopol see Tweet)
Author interview: Eliminating Creatine Kinase–Myocardial Band Testing in Suspected ACS (free)
Commentaries: Eliminating CK-MB Testing in Suspected ACS – American College of Cardiology, Latest in Cardiology (free) AND Research review recommends eliminating widely ordered blood test for diagnosing heart attacks – Johns Hopkins Medicine, via Science Daily (free)
“Review is first publication from national consortium of academic medical centers working to eliminate unnecessary medical tests, treatments and procedures” (from Science Daily)
Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta-analysis of randomised trials – The Lancet (link to abstract – $ for full-text)
Commentary: Optimal Timing of an Invasive Strategy in NSTE-ACS Patients – American College of Cardiology, Latest in Cardiology (free)
An early invasive strategy does not reduce mortality compared with a delayed invasive strategy in most patients with NSTE-ACS, but seems to reduce mortality in high-risk patients.
Summary with 10 key points to remember: Perioperative Myocardial Injury and Infarction After CABG – American College of Cardiology, Latest in Cardiology (free)
This meta-analysis, mainly from observational studies and including 1276 patients, suggests a positive effect of REBOA on mortality among non-compressible torso hemorrhage patients.
Prosthetic Valve Endocarditis After Surgical Aortic Valve Replacement – Circulation (free)
Commentary: Fewer infections in mechanical heart valves – Karolinska Institutet (free)
In this large cohort with follow-up time of up to 18 years, the risk of endocarditis was about 50 per cent higher with a biological prosthesis than with a mechanical prosthesis.
Commentaries: Surgery vs. Stents With Complete Revascularization – American College of Cardiology, Latest in Cardiology (free) AND PCI Matches Surgery for Multivessel Disease: But technical success with percutaneous procedure is critical – MedPage Today (free registration required)
Related study: Long-Term Mortality After Coronary Revascularization in Nondiabetic Patients With Multivessel Disease – Journal of The American College of Cardiology (free)
Results are comparable as long as complete revascularization has been achieved, additional randomized trials testing this hypothesis needed.
Summary with 10 key points to remember: Acute Aortic Syndromes: Diagnosis and Management – American College of Cardiology, Latest in Cardiology (free)
Original Article: Acute aortic syndromes: diagnosis and management, an update – European Heart Journal (link to abstract – $ for full-text)
Viewpoint: The Evolving Story of Overlapping Surgery – JAMA (free) (RT @pash22 see Tweet)
Commentary: 3 steps to restore patient trust in overlapping surgeries – FierceHealthcare (free)
This interesting viewpoint discusses the practice of scheduling overlapping surgeries, in which a qualified practitioner finishes noncritical parts of the first operation while the primary surgeon moves to the next surgery.
Pericarditis as a Marker of Occult Cancer and a Prognostic Factor for Cancer Mortality – Circulation (link to abstract – $ for full-text)
Commentary: Pericarditis as a Marker of Occult Cancer – American College of Cardiology, Latest in Cardiology (free)
Commentary: Patients whose emergency surgery is delayed are at higher risk of death – Canadian Medical Association Journal, via EurekAlert (free)
Source: STAT News Newsletter
“Delayed operating room access for emergency surgery was associated with increased risk of inhospital mortality, longer length of stay and higher costs”.
Prognostic Value of Noninvasive Cardiovascular Testing in Patients With Stable Chest Pain – Circulation (link to abstract – $ for full-text)
Commentary: CT angiography appears better at predicting future risk for patients with chest pain – Massachusetts General Hospital, via ScienceDaily (free)
Source: EvidenceAlerts (free resource to find articles of interest)
“The most important result indicated that the ability of coronary CTA to identify nonobstructive coronary artery disease – a less-than-70-percent narrowing of a coronary artery – identifies an at-risk group of patients not found by functional testing” (from ScienceDaily)
Comparison of Outcome of Coronary Artery Bypass Grafting Versus Drug-Eluting Stent Implantation for Non–ST-Elevation Acute Coronary Syndrome – The American Journal of Cardiology (link to abstract – $ for full-text)
Source: EvidenceAlerts
In patients with Non–ST-Elevation Acute Coronary Syndrome and left main or multivessel CAD, CABG significantly reduced the risk of death from any causes, myocardial infarction, or stroke compared with PCI with drug-eluting stents
A Meta-analysis of the Impact of Aspirin, Clopidogrel, and Dual Antiplatelet Therapy on Bleeding Complications in Noncardiac Surgery – Annals of Surgery (link to abstract – $ for full-text)
Source: EvidenceAlerts (free resource to find articles of interest)
“Antiplatelet therapy at the time of noncardiac surgery confers minimal bleeding risk with no difference in thrombotic complications. In many cases, it is safe to continue antiplatelet therapy in patients with important indications for their use”
The JAMA Network – For the Media: Study Examines Use, Outcomes of Valve Replacement Procedure Performed for Off-Label Indications
Commentary: Outcomes of Off-Label Use of TAVR – American College of Cardiology, Latest in Cardiology (free)
“A randomized controlled trial directly comparing TAVR with surgery among specific subsets of off-label populations is needed to provide convincing evidence, and significant ‘off-label’ use captured in registries such as this should motivate such prospective randomized studies” (from Latest in Cardiology).
Original article: 2016 The American Association for Thoracic Surgery (AATS) consensus guidelines: Surgical treatment of infective endocarditis: Executive summary (link to abstract – $ for full-text)
Inspired by War Zones, Balloon Device May Save Civilians From Fatal Blood Loss – The New York Times (10 articles per month are free)
Thirty-Year Mortality After Coronary Artery Bypass Graft Surgery: A Danish Nationwide Population-Based Cohort Study – Circulation: Cardiovascular Quality and Outcomes (link to abstract – $ for full-text)
Commentary: Many good years after heart bypass surgery, but something happens after ten years – Aarhus University, via Science Daily (free)
“For patients who make it through the first month after the operation is close to that of the population in general. But 8-10 years after a heart bypass operation, mortality increases by 60-80 per cent” (from Science Daily)
See also: News release (free) AND Top Ten Things to Know (free PDF)
Related: Cardiopulmonary Resuscitation in Adults and Children With Mechanical Circulatory Support: A Scientific Statement From the American Heart Association (free PDF) AND CPR in Patients With Mechanical Circulatory Support – American College of Cardiology, Latest in Cardiology(free)
A New Renaissance in Pericardial Diseases – Progress in Cardiovascular Diseases (special issue with series of review articles on the management of pericardial disease).
Source: Hospital Medicine Virtual Journal Club
1 – Introduction: A New Renaissance in Pericardial Diseases (free)
2 – Structure and Anatomy of the Human Pericardium (free)
3 – Pathophysiology of the Pericardium (free)
4 – Acute Pericarditis (free)
5 – Recurrent Pericarditis (free)
6 – Constrictive Pericarditis: A Practical Clinical Approach (free)
7 – Pericardial Effusions: Causes, Diagnosis, and Management (free)
8 – Pericardial Masses, Cysts and Diverticula: A Comprehensive Review Using Multimodality Imaging (free)
9 – Congenital Absence of the Pericardium (free)
10 – Surgical Management of Pericardial Diseases (free)
Complete versus culprit-only revascularisation in ST elevation myocardial infarction with multi-vessel disease – Cochrane Library (link to abstract – $ for full-text) (RT @Gas_Craic see Tweet)
“Compared with culprit-only intervention, the complete revascularisation strategy may be superior due to lower proportions of long-term cardiovascular mortality, long-term revascularisation, and long-term non-fatal myocardial infarction, but these findings are based on evidence of very low quality”
Finally, Success Reducing Recurrent Stroke With PFO Closure – Medscape (free registration required)
Two randomized trials presented at the 3rd European Stroke Organization Conference (ESOC) 2017 showed that in carefully selected stroke patients in whom Patent Foramen Oval (PFO) was suspected to be a cause of their strokes, a reduction in recurrent stroke was observed with PFO closure.
Meta-Analysis of Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Unprotected Left Main Coronary Narrowing – Journal of The American College of Cardiology (link to abstract – $ for full-text) (source: EvidenceAlerts)
Related recent meta-analysis: Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Trials – Circulation: Cardiovascular Interventions (free) AND Percutaneous intervention versus coronary artery bypass graft surgery in left main coronary artery stenosis: a systematic review and meta-analysis – BMC Medicine (free)
PCI with drug-eluding stents seems to be a safe alternative to CABG in Unprotected Left Main Coronary Artery Stenosis, but it is associated with higher rates of repeat revascularization.
Source: Management of Pulmonary Nodules Found Incidentally on Computed Tomography Scans – Journal Watch (free)
Incidental pulmonary nodules discovered outside the context of screening or cancer follow-up are increasingly common in clinical practice. The purpose of these updated recommendations is to reduce the number of unnecessary follow-up examinations while providing practical guidance on follow-up intervals for selected larger nodules.
Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017 – JAMA Surgery (free) (RT @jankluytmans and @CIDRAP_ASP see Tweet)
Invited commentary: Surgical Site Infection Prevention – What We Know and What We Do Not Know – JAMA Surgery (free)
Commentary: ‘Long-Awaited’ CDC Guidelines on SSI Prevention Released – Medscape (free registration required)
Related: Global guidelines on the prevention of surgical site infection 2016 – World Health Organization (free)
Surgical or Transcatheter Aortic-Valve Replacement in Intermediate-Risk Patients – New England Journal of Medicine (link to abstract – $ required for full text)
Quick Take Video Summary: SURTAVI Study: TAVR versus Open Surgery (free)
See this and other highlights from the American College of Cardiology’s 66th Annual Scientific Session (some articles are no longer free)
This innovative technology seems to be useful for patients with aortic stenosis at high risk for surgery. In this new study, it was noninferior to surgery at 2 years of follow-up in old patients (averaged nearly 80 years) at intermediate risk. Longer follow up data will be important to see if it is a suitable alternative for younger patients.
ACR Appropriateness Criteria Adds Topics, Covers More Clinical Variants Than Ever Before (free)
Browse Appropriateness Criteria Topics (free)
Source: Newswise
This comprehensive guide from American College of Radiology (ACR) covers 230 topics with more than 1,100 clinical indications and has just been updated. It is a very useful resource for doctors in all specialties to guide which exam is most appropriate in each clinical situation.