Clinical cardiology
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Clinical cardiology · Oct 2020
Multicenter Study Comparative StudyBioprosthetic vs mechanical mitral valve replacement for infective endocarditis in patients aged 50 to 69 years.
The optimal choice of the valve prosthesis in mitral valve replacement (MVR) for infective endocarditis (IE) is controversial and challenging, particularly for younger patients. ⋯ Mechanical valve prostheses were associated with better survival, lower rates of reoperation compared with bioprostheses within 15 years after MVR in IE patients aged 50 to 69. These findings suggest mechanical valve prostheses may be a more reasonable alternative to bioprostheses in this patient group.
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Clinical cardiology · Oct 2020
Canakinumab to reduce deterioration of cardiac and respiratory function in SARS-CoV-2 associated myocardial injury with heightened inflammation (canakinumab in Covid-19 cardiac injury: The three C study).
In patients with Covid-19, myocardial injury and increased inflammation are associated with morbidity and mortality. We designed a proof-of-concept randomized controlled trial to evaluate whether treatment with canakinumab prevents progressive respiratory failure and worsening cardiac dysfunction in patients with SARS-CoV2 infection, myocardial injury, and high levels of inflammation. ⋯ The three C study will provide insights regarding whether IL-1β inhibition may improve outcomes in patients with SARS-CoV2 associated myocardial injury and increased inflammation.
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Clinical cardiology · Oct 2020
Multicenter Study Observational Study"Missing" acute coronary syndrome hospitalizations during the COVID-19 era in Greece: Medical care avoidance combined with a true reduction in incidence?
Reports from countries severely hit by the COVID-19 pandemic suggest a decline in acute coronary syndrome (ACS)-related hospitalizations. The generalizability of this observation on ACS admissions and possible related causes in countries with low COVID-19 incidence are not known. ⋯ We observed a reduction in ACS hospitalizations during the COVID-19 outbreak in a country with strict social measures, low community transmission, and no excess in mortality. Medical care avoidance behavior is an important factor for these observations, while a true reduction of the ACS incidence due to self-isolation/quarantining may have also played a role.
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Clinical cardiology · Sep 2020
ACC.20: Impact of social media at the virtual scientific sessions during the COVID-19 pandemic.
The COVID-19 pandemic led to the American College of Cardiology (ACC) Annual Scientific Session 2020 (ACC.20) being held as a virtual event. ⋯ Comparing the 2019 and 2020 Scientific Sessions, the global cardiology community continued to communicate despite COVID-19, but with reduced social media activity potentially due to the briefer format, no physical interaction and private virtual chatroom during live sessions, reducing visibility of new cardiology research findings.
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Hyperkalemia is a frequent and sometimes life-threatening condition that may be associated with arrhythmia and cardiac dysfunction in patients with heart failure (HF). High potassium levels in HF represent both a direct risk for cardiovascular complication and an indirect biomarker of the severity of the underlying disease, reflecting neurohormonal activation and renal dysfunction. Evaluating the prevalence and significance of hyperkalemia in HF patients is essential for optimizing the use of potassium sparing agents, such the renin-angiotensin-aldosterone system inhibitors (RAASi) or angiotensin receptor-neprilysin inhibitors and mineralocorticoid receptor antagonists, which represent a well-established cornerstone and life-saving therapy. ⋯ Although older potassium-binding agents are associated with serious adverse events, novel potassium-binding drugs are effective in lowering potassium levels and are generally well tolerated. Novel potassium-binding drugs, such as patiromer and sodium zirconium cyclosilicate, may help to optimize therapy in HF and achieve guideline-recommended doses. Hyperkalemia is common in HF patients and is associated with a poorer prognosis and an increased risk of cardiovascular complications: Contrariwise, "moderate" potassium levels go with a better prognosis, while the emergence of new drugs, potassium binders, could allow target doses of RAASi to be achieved.