Annals of internal medicine
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Although cardiovascular mortality has increased among middle-aged U.S. adults since 2011, how the burden of cardiovascular risk factors has changed for this population by income level over the past 2 decades is unknown. ⋯ National Institutes of Health.
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Editorial Comment
Rebound of COVID-19 With Nirmatrelvir-Ritonavir Antiviral Therapy.
In their article, Edelstein and colleagues provide the results of an observational study of virologic response in patients who received treatment with nirmatrelvir–ritonavir (N-R) versus those who received no COVID-19 therapy. The editorialists discuss the findings and emphasize the need for further consideration of the dosage, timing, and duration of treatment to inform optimal use of N-R.
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The proportion of patients with new-onset heart failure who have preserved rather than reduced left ventricular ejection fraction (HFpEF and HFrEF) has been increasing over recent decades. In fact, HFpEF now outweighs HFrEF as the predominant heart failure subtype and likely remains underdiagnosed in the community. This is due in part to an aging population and a rise in other risk factors for HFpEF, including obesity and associated cardiometabolic disease. ⋯ New recommendations included broader use of sodium-glucose cotransporter-2 inhibitors (SGLT2i, class 2a), and angiotensin receptor-neprilysin inhibitors (class 2b). In 2023, the American College of Cardiology published an expert consensus decision pathway for the management of HFpEF that suggests treatment strategies based on sex assigned at birth, ejection fraction, clinical evidence of congestion, and candidacy for SGLT2i therapy. Here, 2 experts, a cardiologist and a geriatrician, discuss their approach to the diagnosis and management of HFpEF and how they would apply guidelines to an individual patient.
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Kim DH, Lee SB, Park CM, et al. Comparative safety analysis of oral antipsychotics for in-hospital adverse clinical events in older adults after major surgery: a nationwide cohort study. Ann Intern Med. 2023;176:1153-1162. 37665998.