Mon.Dec 18, 2023

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Early insulin resistance in normoglycemic low-risk individuals is associated with subclinical atherosclerosis

Cardiovascular Diabetology

Elevated glycated hemoglobin (HbA1c) is associated with a higher burden of subclinical atherosclerosis (SA). However, the association with SA of earlier insulin resistance markers is poorly understood. The stu.

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AFL WITH 2:1 CONDUCTION IN A PATIENT WITH PREEXISTING RBBB + LAFB

ECG Guru

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

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Breaking Down Barriers: Why Biosimilars Face Resistance in the US Market

HCPLive

Despite a boom of new, cost-efficient options for chronic conditions, prescriber and patient concern over clinical benefit persists.

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Is Your Patient Married? Check Their Spouse's Blood Pressure, Too

Med Page Today

(MedPage Today) -- Hypertension, the leading cause of death from heart disease and stroke both in the U.S. and worldwide, presents significant public health challenges. Globally, many health systems are individual-focused. This means that health.

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New Artificial Intelligence Tool Predicts Mortality After Heart Surgeries

DAIC

Getty Images milla1cf Mon, 12/18/2023 - 15:56 December 18, 2023 — An artificial intelligence (AI) tool developed by investigators at the Smidt Heart Institute at Cedars-Sinai and colleagues at two other institutions accurately predicted how patients would fare after cardiac surgeries and procedures. The results, published in The Lancet Digital Health , include data from patients from three healthcare systems: Cedars-Sinai, Stanford University and Columbia University.

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The future of heart health: Researchers develop vaccine to lower cholesterol

Medical Xpress - Cardiology

Nearly two in five U.S. adults have high cholesterol, according to the Centers for Disease Control and Prevention (CDC). Untreated, high cholesterol can lead to heart disease and stroke, which are two of the top causes of death in the U.S. Worldwide; cardiovascular diseases claim nearly 18 million lives every year, according to the World Health Organization.

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Cardiovascular Surgery at the Mount Sinai Hospital Wins Highest Quality National Ratings from Society of Thoracic Surgeons

DAIC

milla1cf Mon, 12/18/2023 - 15:43 December 18, 2023 — The Department of Cardiovascular Surgery at The Mount Sinai Hospital has received the highest possible three-star recognition in all of the cardiac surgery categories in the 2020-2023 Society of Thoracic Surgeons (STS) report. The STS Adult Cardiac Surgery Database is the current national benchmark to assess excellence in cardiovascular surgery outcomes.

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Prediabetes increases the risk of major limb and cardiovascular events

Cardiovascular Diabetology

Prediabetes, an intermediate stage between normal blood sugar levels and a diabetes mellitus diagnosis, is increasing in prevalence. Severe prediabetes is associated with a similar risk of complications as dia.

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AI may predict survival after heart surgery

Medical Xpress - ECG

A technology from the 19th century meets one from the 21st to better help doctors predict who'll survive a heart surgery.

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Consensus document on palliative care in cardiorenal patients

Frontiers in Cardiovascular Medicine

There is an unmet need to create consensus documents on the management of cardiorenal patients since, due to the aging of the population and the rise of both pathologies, these patients are becoming more prevalent in daily clinical practice. Chronic kidney disease coexists in up to 40%–50% of patients with chronic heart failure cases. There have yet to be consensus documents on how to approach palliative care in cardiorenal patients.

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New discovery could aid regenerative heart therapies

Science Daily - Heart Disease

Researchers identify RBFox1 as a key intrinsic regulator of heart muscle cell maturation, overcoming a major limitation in cardiac regenerative therapy and disease modelling and demonstrating for the first time that RNA splicing control can significantly impact this process.

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Circulating microRNAs as biomarkers of Chagas cardiomyopathy

Frontiers in Cardiovascular Medicine

Background Chagas cardiomyopathy (CHCM) is the most important clinical manifestation of Chagas disease. The analysis of cardiac miRNAs may contribute to predicting the progression to CHCM in Chagas indeterminate phase and/or to the differential diagnosis for cardiomyopathy. Methods We carried out a case-control study to identify circulating miRNAs associated with CHCM.

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2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care

Circulation

Circulation, Ahead of Print. Cardiac arrest is common and deadly, affecting up to 700 000 people in the United States annually. Advanced cardiac life support measures are commonly used to improve outcomes. This “2023 American Heart Association Focused Update on Adult Advanced Cardiovascular Life Support” summarizes the most recent published evidence for and recommendations on the use of medications, temperature management, percutaneous coronary angiography, extracorporeal cardiopulmonary resusci

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New survey: 79% of respondents overlook their health needs during the holidays

Medical Xpress - Cardiology

According to new survey from the American Heart Association, the holidays are more stressful than taxes, causing people to overlook their own health during "the most wonderful time of the year." The survey suggests that adults of all ages have trouble prioritizing their mental and physical health at this time of year.

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Atrial Flutter With Right Bundle Branch Block and Left Anterior Fascicular Block In a Patient With Preexisting RBBB + LAFB

ECG Guru

If a wide complex tachycardia occurs, the probability is very high that it is a ventricular tachycardia (approx. 80%, in patients with a previous myocardial infarction (.) approx. 90%). Here we see a broad complex tachycardia that looks like an RBBB + LAFB, which is regular. In this constellation, 3 causes must be considered: 1. fascicular tachycardia from the left posterior fascicle of the left tawara fascicle (QRS width usually only around 130 ms, but sometimes significantly longer). 2.

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Intravenous Thrombolysis for Acute Ischemic Stroke in Patients With Recent Direct Oral Anticoagulant Use: A Systematic Review and Meta?Analysis

Journal of the American Heart Association

Journal of the American Heart Association, Ahead of Print. BackgroundIntravenous thrombolysis (IVT) is an effective stroke therapy that remains underused. Currently, the use of IVT in patients with recent direct oral anticoagulant (DOAC) intake is not recommended. In this study we aim to investigate the safety and efficacy of IVT in patients with acute ischemic stroke and recent DOAC use.Methods and ResultsA systematic review and meta‐analysis of proportions evaluating IVT with recent DOAC use w

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2023 Top Journal Scans and Clinical Trials

American College of Cardiology

In 2023, we continued to see advances in global health technology. These technologies provide a means to prevent, diagnose and treat cardiovascular disease and may also hold the keys to addressing health equity and improving clinician well-being.

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Study shows postoperative atrial fibrillation tied to worse outcomes after valve surgery

Medical Xpress - Cardiology

Postoperative atrial fibrillation (POAF) is associated with an increased rate of neurologic events and worse long-term survival, according to a study published online Sept. 11 in the Journal of Thoracic and Cardiovascular Surgery.

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Nonsense Variant PRDM16-Q187X Causes Impaired Myocardial Development and TGF-? Signaling Resulting in Noncompaction Cardiomyopathy in Humans and Mice

Circulation: Heart Failure

Circulation: Heart Failure, Volume 16, Issue 12 , Page e010351, December 1, 2023. BACKGROUND:PRDM16 plays a role in myocardial development through TGF-β (transforming growth factor-beta) signaling. Recent evidence suggests that loss of PRDM16 expression is associated with cardiomyopathy development in mice, although its role in human cardiomyopathy development is unclear.

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Heart vest could help predict sudden cardiac death risk

Medical Xpress - Cardiology

A reusable vest that can map the electrical activity of the heart in fine detail could potentially be used to better identify people at high risk of sudden cardiac death, suggests a new study led by UCL researchers.

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Top Clinical Content for 2023

American College of Cardiology

The most popular clinical content items of 2023, developed by the ACC.org Editorial Board, including the ACC Member Section Editorial Teams and the E-Learning Team.

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Cardiac follow-up should be common practice after MIS-C diagnosis, say researchers

Medical Xpress - Cardiology

Following multisystem inflammatory disease in children (MIS-C), cardiac abnormalities are common, regardless of myocardial injury during acute disease, according to a study published online Nov. 15 in Pediatrics.

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Case Report: Four cases of cardiac sarcoidosis in patients with inherited cardiomyopathy—a phenotypic overlap, co-existence of two rare cardiomyopathies or a second-hit disease

Frontiers in Cardiovascular Medicine

Cardiac sarcoidosis (CS), a rare condition characterized by non-caseating granulomas, can manifest with symptoms such as atrioventricular block and ventricular tachycardia (VT), as well as mimic inherited cardiomyopathies. A 48-year-old male presented with recurrent VT. The initial 18 F-fluorodeoxyglucose positron emission tomography ( 18 FDG-PET) scan showed uptake of the mediastinal lymph node.

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Multi-site study reveals addressable socioeconomic barriers to prenatal diagnosis of congenital heart defects

Medical Xpress - Cardiology

Prenatal diagnosis of congenital heart defects—the most common birth defects in the United States—is associated with improved outcomes. Despite its importance, however, overall prevalence of prenatal diagnosis is low (12–50%).

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Diabetes Dialogue: Diabetes Technology Updates and Standards of Care—2024

HCPLive

This episode features a discussion on a pair of AID system integrations with the Dexcom G7 CGM system as well as important updates in the diabetes technology portion from the ADA's Standards of Care—2024.

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Subclinical Primary Aldosteronism and Cardiovascular Health

American College of Cardiology

Does mild or subclinical renin-independent (“primary”) aldosteronism increase the chance of cardiovascular (CV) disease?

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Sinus arrest in a p.Arg160X-DSP-positive patient without evidence of desmoplakin-mediated cardiomyopathy: a case report

Frontiers in Cardiovascular Medicine

Background Pathogenic/Likely pathogenic variants in DSP -encoded desmoplakin are strongly associated with arrhythmogenic cardiomyopathy (ACM). However, their contribution towards sinus node dysfunction has not been well-delineated. Case summary A 74-year-old man with a pathogenic variant of DSP -encoded desmoplakin (c.478C >T; p.Arg160X) but no evidence of ACM presented with one episode of syncope in the setting of a gastrointestinal illness.

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Updated Guidelines Announced for Clinicians Treating Atopic Dermatitis, Anaphylaxis

HCPLive

These newly-updated parameters were a response by the ACAAI and the AAAAI to recent evidence that had become visible.

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Anthracycline-induced cardiotoxicity: mechanisms, monitoring, and prevention

Frontiers in Cardiovascular Medicine

Anthracyclines are the most fundamental and important treatment of several cancers especially for lymphoma and breast cancer. However, their use is limited by a dose-dependent cardiotoxicity which may emerge early at the initiation of anthracycline administration or several years after termination of the therapy. A full comprehending of the mechanisms of anthracycline-induced cardiotoxicity, which has not been achieved and is currently under the efforts, is critical to the advance of developing

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Toothbrushing by Hospitalized Patients Linked to Lower Rates of Pneumonia, ICU Mortality

HCPLive

The data from these meta-analyses highlight the value of developing systems to promote daily toothbrushing among those who have been hospitalized and, particularly, those on mechanical ventilation.

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Comparative treatment outcomes of a single long stent vs. overlapped short stents in acute myocardial infarction

Frontiers in Cardiovascular Medicine

Objectives There is no consensus regarding the optimal choice between single long stent (SLS) and overlapped double short stents (DSS) in patients with acute myocardial infarction (AMI). Therefore, we aimed to compare treatment outcomes among patients with AMI treated with these two different stenting methods. Methods In total, 537 patients with AMI from a single tertiary center were categorized into two groups: (1) those who received an SLS (stent length ≥38 mm) ( n  = 254; 47.3%) and (2) those

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Bone marrow adipocytes support fatty acid metabolism during MI-mediated emergency haematopoiesis

Nature Reviews - Cardiology

Nature Reviews Cardiology, Published online: 19 December 2023; doi:10.1038/s41569-023-00987-8 During myocardial infarction, haematopoietic stem and progenitor cells increase fatty acid oxidation, and bone marrow adipocytes can act as a local energy resource for these cells.

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Hybrid model of CT-fractional flow reserve, pericoronary fat attenuation index and radiomics for predicting the progression of WMH: a dual-center pilot study

Frontiers in Cardiovascular Medicine

Objective To develop and validate a hybrid model incorporating CT-fractional flow reserve (CT-FFR), pericoronary fat attenuation index (pFAI), and radiomics signatures for predicting progression of white matter hyperintensity (WMH). Methods A total of 226 patients who received coronary computer tomography angiography (CCTA) and brain magnetic resonance imaging from two hospitals were divided into a training set ( n  = 116), an internal validation set ( n  = 30), and an external validation set (

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Dapagliflozin Shows Appropriate Safety in Real-World Type 1 Diabetes Study

HCPLive

In the Dapa-ON trial, the careful selection of people with T1D and the implementation of strategies to reduce the risk of DKA were associated with dapagliflozin's appropriate safety profile.

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Cryoballoon vs. laser balloon ablation for atrial fibrillation: a meta-analysis

Frontiers in Cardiovascular Medicine

Background Cryoballoon ablation (CBA) and laser balloon ablation (LBA) are two innovative ways for the treatment of atrial fibrillation (AF). This study aimed to evaluate the efficacy and safety of cryoballoon ablation and laser balloon ablation in patients with AF. Methods We searched Pubmed, Embase, Ovid, Web of Science and other databases for comparative trials comparing CB and LB ablation in the treatment of AF, from establishment of database to August, 2023.

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Smidt expands virtual second-opinion program to heart disease

Becker's Hospital Review - Cardiology

Los Angeles-based Smidt Heart Institute at Cedars-Sinai expanded its Virtual Second Opinion Program to women with heart disease.

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Residual Leaks Following Percutaneous LAAO and Outcomes

American College of Cardiology

What is the impact of residual leaks after left atrial appendage occlusion (LAAO) in patients with atrial fibrillation (AF)?