Heart Failure

FDA approval of the left atrial appendage closure device after a long review process provides a potentially useful alternative to warfarin.

In this edition of Clinical Forum, we asked three Cardiology Review editorial board members to comment on multivessel versus culprit-vessel-only PCI in patients with acute myocardial infarction, considering perspectives from the PRAMI and CvLPRIT trials.

It is well established that among patients with the clinical syndrome of heart failure, approximately half have preserved systolic function, known commonly as heart failure with preserved ejection fraction (HFpEF). Although originally considered to be a syndrome that pathophysiologically involves diastolic dysfunction, ongoing investigation suggests that although diastolic abnormalities may be present in many patients, other aspects of pathophysiology likely also contribute to symptoms. This study examined the association of beta-blockers with mortality in patients with HFpEF.

Physicians may think patients over 80 are too old to benefit from agressive care to treat unstable angina or clogged arteries that caused a heart attack. Think again, a Norwegian researcher said at the American College of Cardiology meeting in San Diego, CA. These patients were 47% more likely to survive and healthier after invasive procedures than a group that got non-invasive care.

AstraZeneca researchers report that a new drug call MED12452 is being developed as an antidote for patients who need to reverse the effects of ticagrelor (Brilinta/AstraZeneca) on an emergency basis. That could be important for patients taking ticagrelor who need emergency surgery or are bleeding from an accident.

Worsening renal function over time is associated with poorer outcomes in patients with acute and chronic HF. Although this association is established in patients with reduced ejection fraction, there are no data about the relationship between WRF and outcomes in HF patients with preserved ejection fraction.

A 75 year-old man with a history of paroxysmal atrial fibrillation and a single-chamber pacemaker placed for bradycardia 5 years prior presents with dizziness and nausea to clinic. He notes that he has also been feeling short of breath with normal activities of daily living.

Could hospitals be a bad place to have heart attacks? That's the finding of a North Carolina research team that looked at data from 303 California hospitals. Patients who had heart attacks while hospitalized for a non-cardiac ailment had a more than 3-fold greater in-hospital mortality than patients taken to a hospital.

Anil Asgaonkar, MD, provides an overview of the signs, symptoms, and causes that are frequently associated with hyponatremia, and outlines several standard treatment approaches.

Is one beta blocker better than another for patients born with long QT syndrome? In a report published in The Journal of the American College of Cardiology, Abeer Abu-Zeitone, PhD, and colleagues found that in their study group, nadolol worked best at preventing a recurrent serious cardiac event and that propranolol, the oldest beta-blocker available, did the worst.

Preliminary research suggests that optogenetics could eventually replace electric shocks in the treatment of atrial fibrillation.

Left untreated or inadequately treated, syphilis may cause tertiary cardiovascular disease, one form of which is syphilitic aortitis.

Researchers at Wake Forest Baptist Medical Center have released a study showing the potential of a dangerous interaction between a common supplement and prescription medication.

A retrospective cohort study of Medicare beneficiaries hospitalized for heart failure with a left ventricular ejection fraction between 30-35% found improved 3-year survival rates among those who received a prophylactic implantable cardioverter-defibrillators compared to those with no ICD.

A study published in BMJ explains the long-term risks of opioid treatment in the postoperative setting.

The FDA's Cardiovascular and Renal Drugs Advisory Committee convenes today to discuss serelaxin after reviewers recommended against the approval of the heart failure drug.

Stressing the significant effect heart failure has on quality of life, a study published in Heart found that patients' and their families' lack of knowledge on their condition causes delays in seeking medical attention and an absence of a long-term care plan.

Hyponatremia must be managed with care, especially in patients with chronic severe illness, due to the unpredictable nature of tolvaptan to raise serum sodium levels.

Do mandatory follow-up visits after discharging heart failure patients decrease rehospitalizations?

Although there appears to be no difference in blood pressure reduction in patients who take aspirin at bedtime compared to those who take it when they awake in the morning, bedtime aspirin may be associated with reduced morning platelet reactivity.