Tag: Circulation


Recently Diagnosed Heart Failure vs Chronic, Worsening Heart Failure Associated with Better Outcomes: ASCEND-HF Substudy

Key Takeaways

  • Investigators analyzed data from the ASCEND-HF (Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure) trial to determine clinical outcomes differences among those with a recent heart failure diagnosis vs those with chronic or worsening heart failure.
  • Authors concluded that recently diagnosed heart failure patients represent a lower risk phenotype of acute heart failure compared with patients with acute forms of chronic disease.
Reference: Greene SJ et al. JACC. 2017;69(25):3029-3039.Hospitalization for heart failure is associated with a high risk of repeat hospitalization, with a 30% risk for mortality at 1 year.1,2 Appropriate and effective management of heart failure in its early stages is imperative for improving survival,3 compared with efforts to improve outcomes during progressive chronic disease. Medical therapy of acute decompensated heart failure has been largely unsuccessful in achieving a meaningful reduction in hospital readmission and mortality. Currently, there are few trials investigating the impact heart failure diagnosis duration has on patient outcomes. Continue readingRecently Diagnosed Heart Failure vs Chronic, Worsening Heart Failure Associated with Better Outcomes: ASCEND-HF Substudy

Use of Impella® Devices During High-Risk PCI is Associated with Reduced Occurrence of Acute Kidney Injury

Patients undergoing complex coronary revascularization are at risk for periprocedural and postprocedural acute kidney injury (AKI), a complication which correlates with an increased risk of death, major bleeding, and myocardial infarction (MI).1 A reduction in cardiac output and renal hypoperfusion, which in turn leads to a decrease in glomerular filtration rate, may partly explain the increased risk for AKI during high-risk percutaneous coronary intervention (HRPCI).1Currently, there are few published studies which examine the impact of micro-axial percutaneous left ventricular assist devices on AKI in patients undergoing HRPCI. Continue readingUse of Impella® Devices During High-Risk PCI is Associated with Reduced Occurrence of Acute Kidney Injury

Optimizing Cardiovascular Care in Accordance with the Body’s Internal “Clock”

Key Takeaways

  • Timing medical therapy to the body’s circadian rhythms may play a key role in improving treatment outcomes among patients with heart failure, myocardial infarction, and hypertension.
The study of circadian rhythms as it relates to human health has expanded in recent years, with a large focus devoted to utilizing knowledge regarding the body’s “internal clock” for improving the treatment of cardiovascular-related therapies. The circadian rhythms are regulated by the suprachiasmatic nucleus, a “master clock” in the hypothalamus that responds to light and manages the expression of genes that are active at varying times throughout the day and night. Exposure to artificial light during the evenings, such as during shift work or sleep deprivation, can disrupt circadian rhythms and lead to the desynchronization of gene expression. This has been consistently linked to cardiovascular disease.1,2Continue readingOptimizing Cardiovascular Care in Accordance with the Body’s Internal “Clock”

PCI with Everolimus Eluting Stents vs CABG for Left Main Coronary Artery Disease: The EXCEL Trial

Key Takeaways

  • Coronary-artery bypass is a standard treatment of choice for left main coronary artery disease patients, but some trials suggest PCI with stenting could be a good alternative therapeutic option.
  • The EXCEL randomized trial found that complete revascularization via PCI with everolimus-eluting stents is noninferior to CABG for left-main CAD with respect to the study’s primary and secondary endpoints.
Patients with left main coronary artery disease (CAD) are at a significantly high risk for cardiovascular events due to vessel occlusion that compromises flow in up to three-fourths of the left ventricle. Bypass surgery had been the standard treatment of choice for left main CAD in the past, yet innovations and advancements in cardiology has led to the use of more refined and less invasive therapies. Continue readingPCI with Everolimus Eluting Stents vs CABG for Left Main Coronary Artery Disease: The EXCEL Trial

CABG Beneficial for Older Patients with Heart Failure and Left Ventricular Systolic Dysfunction

Ten-Year Follow-Up Analysis of STICH Trial Key Takeaways CABG lowered cardiovascular-related mortality for heart failure patients in the STICH trial. Increasing age tends to diminish benefits received from surgical revascularization. Cardiovascular death was higher among younger patients enrolled in STICH at 10 years’ follow-up. While mortality increases with advancing age, CABG plus guideline-directed medical therapy … Continue reading “CABG Beneficial for Older Patients with Heart Failure and Left Ventricular Systolic Dysfunction”