Cardiology News / Recent Literature Review / First Quarter 2019
Keywords:
Cardiology, news, literature reviewAbstract
HRS Meeting: San Francisco, CA, USA, 8-11/5/2019
EuroPCR: Paris, 21-24/5/2019
ESC Meeting: Paris, 31/8-4/9/2019
TCT Meeting: San Francisco, 25-28/9/2019
HCS 40th Congress: Ioannina, 17-19/10/2019
AHA Meeting: Philadelphia, PA, USA, 16-18/11/2019
ACC Meeting: Chicago, IL, USA, 28-30/3/2020
EHRA Meeting: Vienna, 29-31/3/2020
SWEDEHEART Registry: Troponinemia is not Innocent and Demands Careful Workup
Among 48,872 patients, a cardiac troponin (cTn) level >99th percentile was found in 9,800 (20.1%) patients. The prevalence of cardiovascular (CV) risk factors as well as CV and nonCV comorbidities increased across higher cTn strata. In total, 7,529 (15.4%) patients had a major adverse event (MAE), defined as the composite of all-cause mortality, MI, readmission for heart failure, or stroke over a median of 4.9 years). MAE risk was associated with higher cTn strata (hazard ratio–HR for highest assay-specific cTn tertile: 2.59; HR 3.57 in patients without CV comorbidities, renal dysfunction, LV dysfunction, or significant coronary stenosis) (Eggers KM et al, J Am Coll Cardiol 2019;73: 1–9).
French SCAD Study: the rs9349379 Allele of the PHACTR1/EDN1 Genetic Locus Lying on Chromosome 6q24 is the First Generic Risk Locus for Spontaneous Coronary Artery Dissection
The previously reported risk allele for fibromuscular dysplasia (FMD) (rs9349379-A) was associated with a higher risk of SCAD in all studies. In a meta-analysis of 1,055 SCAD patients and 7,190 controls, the odds ratio (OR) was 1.67 per copy of rs9349379-A. In a subset of 491 SCAD patients, the OR estimate was higher for the association with SCAD in patients without FMD (OR: 1.89) than in SCAD cases with FMD (OR: 1.60). There was no effect of genotype on age at first event, pregnancy associated SCAD, or recurrence (Adlam D et al, J Am Coll Cardiol 2019;73:58-66).
COMPASS-CABG Study: Compared With Aspirin or Rivaroxaban Alone, the Combination of Rivaroxaban and Aspirin Did Not Prevent Early Failure of CABGs but Reduced MACE, Consistent With Outcomes in the Overall COMPASS Trial
Among 1,448 COMPASS trial patients randomized 4-14 days after CABG surgery to receive the combination of rivaroxaban plus aspirin, rivaroxaban alone, or aspirin alone, the combination of rivaroxaban and aspirin and the regimen of rivaroxaban alone did not reduce the graft failure rates compared with aspirin alone (combination vs. aspirin: 9.1% vs 8% failed grafts; odds ratio - OR: 1.13; p=0.45; rivaroxaban alone vs aspirin: 7.8% vs 8% failed grafts; OR: 0.95; p=0.75). Compared with aspirin, the combination was associated with fewer MACE (2.4% vs. 3.5%; hazard ratio-HR: 0.69; p=0.34), whereas rivaroxaban alone was not (3.3% vs 3.5%; HR: 0.99; p=0.98). There was no fatal bleeding or tamponade within 30 days of randomization (Lamy A et al, J Am Coll Cardiol 2019;73:121-30)... (excerpt)
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