Future cardiology最新文献

Aim: To compare the efficacy of polymer-free drug-eluting stents (PF-DES) versus other stents in diabetic patients with coronary artery disease undergoing percutaneous coronary interventions.Materials & methods: A systematic review and meta-analysis were performed to identify pertinent randomized controlled trials. The primary end point was the occurrence of target lesion failure.Results: Eight randomized controlled trials were included for a total of 4854 subjects. The PF-DES group experienced a trend in favor of a lower rate of target lesion failure (Incidence rate ratio = 0.91; p = 0.11) and a significantly lower rate of cardiac mortality, as compared with the control group (Incidence rate ratio = 0.82; p = 0.04). However, statistical significance was lost if bare-metal stent patients were excluded and a trend in favor of the PF-DES strategy was reported only for cardiac mortality.Conclusion: PF-DES could be a valuable strategy in diabetic patients with coronary artery disease undergoing percutaneous coronary interventions.

Cardiovascular disease is the leading cause of death worldwide. Dual antiplatelet therapy (DAPT), with aspirin plus a P2Y12 inhibitor, is currently recommended as a default for patients after acute coronary syndrome (ACS) and following percutaneous coronary intervention (PCI). However, controversies arise over the role of aspirin, the optimal duration of DAPT after drug-eluting stent (DES) implantation, the choice of P2Y12 inhibitor and the variability in individual responses to antiplatelet agents. Recent data indicate that monotherapy with a P2Y12 inhibitor may have adequate anti-ischemic effects with lower bleeding risk. Additionally, discrepancies in DAPT duration recommendations and the optimal P2Y12 inhibitor, provides more uncertainty. We ask the question "does one size really fits all?" or should a more personalized strategy should be implemented.

Tweetable abstract Cardiology's digital revolution: AI diagnoses, ChatGPT consults, Metaverse educates. Challenges & promises explored. #CardiologyTech #DigitalHealth.

Lipoma is a common benign soft tissue tumor, but its size and location can lead to serious issues. We report a case of a 48 year-old male patient who experienced sudden cardiac arrest outside the hospital. After resuscitation and examination, we determined that this was due to a massive mediastinal lipoma compressing the lungs, leading to respiratory failure and pulmonary encephalopathy, ultimately resulting in cardiac arrest. This case serves as a reminder to promptly identify and manage chest lipomas to avoid compression and functional impairment of the respiratory system. Early evaluation and treatment of massive lipomas are crucial for preventing complications.

Aim: We compared inpatient outcome data of open (OC) versus laparoscopic cholecystectomy (LC). Patients & methods: We used the National Inpatient Samples database from 2010-2014. Results: LC was done in 340,999 and OC in 68,529 OC patients. In 2010, ST-elevation myocardial infarction (STEMI) prevalence was 0.2 versus 0% (OR: 3.1, CI: 1.7-5.5; p < 0.001), non-STEMI 1 versus 0.4% (OR: 2.5 CI: 2.0-3.0; p < 0001), mortality 3.4 versus 0.4% (OR: 9.2, CI: 7.9-10.6; p < 0001). After multivariate adjustment, OC remained independently associated with STEMI, non-STEMI and all-cause inpatient mortality (mortality multivariate OR: 6.4, CI: 5.5-7.4; p < 0001, STEMI OR: 2.2. CI: 1.2-3.9; p = 0.007, non-STEMI OR: 1.5, CI: 1.3-1.9; p < 0001). Conclusion: OC is independently associated with STEMI, non-STEMI and all-cause inpatient mortality compared with LC.

Leadless permanent pacemakers represent an important innovation in cardiac device developments. Although transvenous permanent pacemakers have become indispensable in managing bradyarrhythmia and saving numerous lives, the use of transvenous systems comes with notable risks tied to intravascular leads and subcutaneous pockets. This drawback has spurred the creation of leadless cardiac pacemakers. Within this analysis, we compile existing clinical literature and proceed to evaluate the efficacy and safety of the Micra Transcatheter Pacing System. We also delve into the protocols for addressing a malfunctioning or end-of-life Micra as well as device extraction. Lastly, we explore prospects in this domain, such as the emergence of entirely leadless cardiac resynchronization therapy-defibrillator devices.

What is this study about?: The EMPEROR-Preserved study looked at the effects of empagliflozin in participants with heart failure with a preserved ejection fraction (HFpEF). This is when the lower left part of the heart (left ventricle) squeezes normally or near normally but does not fill with enough blood between heartbeats. Therefore, not enough blood is pumped around the body. For this study, HFpEF was defined as a condition in which more than 40% of blood in the left ventricle was pumped around the body. When researchers started the EMPEROR-Preserved study, there was no treatment for HFpEF. Also, researchers did not know if empagliflozin was more or less effective in people with and without diabetes, a condition where there are high levels of sugar (glucose) in the blood. This study included participants with HFpEF with and without diabetes to see if empagliflozin had a positive effect on the heart compared with a placebo (a pill that looked like empagliflozin but did not contain any active medication). Nearly 50% of participants had diabetes. The researchers looked at: How many people needed to be hospitalized for heart failure (HF) or died from conditions that affect the heart and blood vessels (cardiovascular disease) If peoples' kidneys worked less over time (the decline in kidney function) The side effects of empagliflozin.

What were the study results?: Empagliflozin reduced the risk of either being hospitalized for HF or dying from cardiovascular disease. The decrease in this risk was due to fewer hospitalizations for HF. This was true regardless of whether or not participants had diabetes. Empagliflozin also slowed the decline in kidney function, regardless of whether the participant had diabetes, but the effect was larger in participants with diabetes. There were no differences in side effects in participants taking empagliflozin or placebo, and the results were similar regardless of whether or not participants had diabetes.

What do these study results mean?: The results showed that treatment with empagliflozin reduced the risk of hospitalization for HF and there were no major side effects in participants with HFpEF, regardless of whether or not they had diabetes.

Aim: Limited knowledge exists on the pathophysiological cascade beyond serum lactate's association with myocardial injury. Method: Assessed the prognostic value of lactate index on periprocedural variables and its impact on 30-day major adverse cardiovascular events (MACE) in 300 prospective ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Results: Significant correlations were observed between admission lactate and Killip class, periprocedural time intervals, postprocedure thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG; p < 0.01). Lactate levels correlated with diminished ST-deviation resolution, cardiac enzymes (CK-MB, troponin; p < 0.001; 0.004), and lower ejection fraction (p < 0.001). This relationship impacted 30-day MACE (p < 0.001). Conclusion: Hyperlactatemia in STEMI patients undergoing pPCI is associated with worse Killip class, unsatisfactory TIMI flow, MBG, larger infarct size and higher 30-day MACE. Serum lactate aids risk stratification in pPCI for STEMI patients.

Infective endocarditis (IE) is a relatively rare but life-threatening condition with potential complications such as valve dysfunction, abscess formation, development of penetrating lesions and embolization of septic material. In this case report, we describe the case of a 56-year-old with IE involving the tricuspid valve and resulting in near total occlusion of the right pulmonary artery due to embolization of a massive piece of septic material. While embolization of septic material is well documented, associated occlusion of the right pulmonary artery is rare.