MDedge Cardiocast

This week in cardiology:

1. PCSK9 inhibition cuts events in very-high-risk groups ODYSSEY OUTCOMES analyses peg prior CABG and polyvascular disease as targets for alirocumab.
2. Cardiovascular cost of smoking may last up to 25 years Past smokers face an elevated cardiovascular risk for up to 25 years after they quit.
3. Impact of climate change on mortality underlined by global study This may be the largest study ever to assess the effects of inhalable particulate matter around the world.
4. HCV coinfection adds to the cardiovascular risk in HIV-infected patients Hepatitis C virus and other injections were independently linked to the risk of having a cardiovascular event in HIV-infected patients.

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1. TAVR valves now FDA approved for low-risk patients The FDA's decision will expand TAVR access to younger, healthier patients.
2. FDA approves baroreflex activation for advanced HF A phase 4 trial will investigate impact on hospitalizations and mortality.
3. Top line results: Dapagliflozin meets primary endpiont in DAPA-HF AstraZeneca announces preliminary results in first heart failure trial in an SGLT2 inhibitor.
4. Cardiovascular cost of smoking may last up to 25 years Past smokers face an elevated cardiovascular risk for up to 25 years.

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1. Midlife hypertension linked to dementia risk

Elevated blood pressure in midlife is associated with risk of subsequent dementia, but whether the risk is treatable is unclear.

1. Ambulatory BP slightly better than in-office measures for predicting cardiovascular outcomes

It's probably best to save these techniques for specific patients.

1. NSAIDs a significant mediator of cardiovascular risk in osteoarthritis

NSAID use could be responsible for a significant proportion of the increased risk of cardiovascular disease associated with osteoarthritis.

1. Burnout gets personal for 68% of physicians

Burden hits primary care more than specialties, younger more than older.

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The top stories in cardiology:

1. Artificial intelligence technology meets AFib detection An AI-enabled ECG model suggests clinical implications for early identification of atrial fibrillation.
2. Older patients who stop statins may be increasing their cardiovascular risk Discontinuation of statins was associated with an increased risk of hospital admission for a cardiovascular event.
3. Psoriasis patients on biologics show improved heart health Novel imaging biomarker identifies reduced coronary inflammation in psoriasis patients on biologics.
4. Acupuncture cuts attacks in chronic angina Chronic stable angina patients showed significant improvement with acupuncture over patients given shame or no acupuncture.

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The top news in cardiology:

1. Meeting just 2 of 7 'simple' goals lowers HF risk American Heart Association recommendations seem to lower risk even if only a couple of the 'Simple 7' are mastered.

2. Increased cardiovascular risk seen early on with testosterone replacement therapy Testosterone replacement therapy for low testosterone is linked to an early increase in the risk of cardiovascular and cerebrovascular events.
3. No increase in UTI risk with SGLT-2 inhibitors SGLT-2 inhibitors are not associated with an increased risk of severe urinary tract infections.
4. As patients, physicians fare nearly the same as everybody else Physicians do only slightly better than nonphysicians in adhering to guidelines "but not by much and not always."

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1. Statins crush early seizure risk poststroke Statin initiation upon hospitalization for acute ischemic stroke was linked to a major antiseizure benefit in a Japanese study.
2. Atherosclerotic disease risk persists after smoking cessation Clinicians should reinforce smoking cessation with awareness that risk for several atherosclerotic diseases remains significant for decades.
3. Air pollution levels correlated with cardiorespiratory mortality; reduced life expectancy Fine particulate matter pollution is associated with increased cardiorespiratory mortality, particularly in lower-income areas.
4. Exercise counters astronauts' dizziness after space flight Two hours of daily activity during space flight eliminated hypotension after landing.

You can contact the MDedge Cardiocast by emailing us at [email protected] or following us on Twitter @MDedgeCardio

This week in cardiology:

1. Systolic, diastolic BP each tied to adverse CV outcomes Diastolic hypertension can't be ignored, though systolic ultimately has a larger impact.
2. Almost half of sudden cardiac deaths linked to prior silent MI Prior silent MIs were detected in nearly half of sudden cardiac deaths in people with no coronary artery disease.
3. How does uncontrolled hypertension play into dementia? Findings from a French cohort suggest that a vascular pathway, independent of amyloid, bears on cognitive decline.
4. Vaping device marketers take aim at youth through social media More than a third of JUUL-related posts contained promotional content that highlighted ways to obtain products at reduced cost.

You can contact the Cardiocast by emailing us at [email protected] or interacting with us on Twitter @MDedgeCardio.

The top stories in cardiology:

1. New findings cast more doubt on fat-but-fit theory Patients who are obese and metabolically healthy face higher cardiac risk
2. Higher omega-3 fatty acid levels cut heart failure risk A large multi-ethnic cohort study shows significantly higher levels of EPA in adults without heart failure.
3. Microvascular disease: An independent and exacerbating risk factor for amputation The presence of microvascular disease plus peripheral artery disease resulted in a more than 20-fold increased risk of amputation that MVD or PAD.
4. Court halts rule requiring drug list pricing in advertising Judge noted that the court understands what HHS wanted to do - but that it's up to Congress to enact such a requirement.

You can contact the MDedge Cardiocast by emailing us at [email protected] or following us on Twitter @MDedgeCardio

This week's top stories in cardiology:

1. Lipoprotein(a) levels, genes boost ischemic stroke risk
2. Could some elderly skip statins based on negative risk markers?
3. Cardiac events jump after COPD exacerbation
4. CAROLINA findings reaffirm linagliptin's safety, free glimepiride of CV-risk stigma

You can contact the MDedge Cardiocast by emailing us at [email protected] or following us on Twitter at @MDedgeTweets.

This week's top stories in cardiology:

1. FDA Panel: Continue using paclitaxel-eluting PAD Devices, with caveats. Although the benefits of the devices were clear, the panel felt there should be a label change to warn of the late mortality signal seen in a key meta-analysis.

2. Many cardiac cath, electrophysiology lab directors receive big industry payments

   These payments were substantially higher than those made to local interventional cardiologists and electrophysiologist.

3. Two trials support shorter DAPT

   DAPT with a twist: Continuing the P2Y12 inhibitor instead of aspirin.

4. Do black patients with type 2 diabetes gain cardiac benefit from the SGLT2 and GLP-1 drugs?

   New findings suggest there is no effect on cardiovascular outcomes, although the analysis has limitations