April 2015

Click here to review the Cardiology Review editorial advisory board.

More than 13,000 physicians and cardiovascular team members attended the ACC 2015 meeting in San Diego on March 14-16, 2015. In this issue of Cardiology Review, we focus on 6 important studies presented at ACC 2015: LEGACY, OSLER, PEGASUS, EMBRACE-STEMI, MATRIX, and CoreValve.

Mortality in patients with type 1 diabetes mellitus (T1DM) is higher than in the general population, and whether mortality improves or alters with glycemic control is unknown.

Refractory angina is a loosely defined term generally referring to the persistence of life-impacting angina despite maximal antianginal medications and, when possible, coronary revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]). Numerous novel pharmacotherapies and mechanical interventions have been proposed, and studies conducted, to treat patients with refractory angina.

Atrial fibrillation (AF) and heart failure (HF) often coexist. The use of beta-blockers in HF patients has a class 1A recommendation in both the European and American guidelines. In current guidelines for heart failure therapy, the recommendation for beta-blockers is not restricted to patients with sinus rhythm, and includes all HF patients.

In the era of progressive technology, the diagnostic modalities for stable coronary artery disease are various. The original cardiac stress test has been used in the past for many purposes, including diagnosis of obstructive coronary artery disease in a patient with chest pain as well as risk stratification for ischemia. More recently, coronary computed tomographic angiography (CCTA) has emerged as a great tool to diagnose anatomically obstructive coronary lesions. However, for the past few years, obtaining functional and physiologic data such as comparative fractional flow reserve (FFR) has become the gold standard for evidence of ischemia on CCTA similar to invasive angiography.

The primary objectives of treating acute ischemic stroke are to prevent death and limit functional disability. Similar to acute myocardial infarction (AMI), timely reperfusion using systemic thrombolysis has been shown to improve outcome of acute stroke, namely functional neurologic recovery, but not mortality. But unlike AMI, the role of intra-arterial or endovascular therapy in acute stroke has not been clearly established.