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Cardiology
Top Medical News
Patients who received direct oral anticoagulants (DOACs) following transcatheter mitral valve replacement (TMVR) seem to have a lower risk of bleeding complications and shorter length of hospital stay, with no significant increase in the risk of thrombotic events, than those treated with vitamin K antagonists (VKAs), a study has shown.
Multiple factors contribute to the low uptake of evidence-based medical therapy (EBMT) in the management of peripheral artery disease (PAD), reports a Singapore study.
Maintaining good cardiovascular health (CVH) can help avert incident adult-onset asthma (AOA) regardless of a person’s asthma genetic risks, according to a study.
Semaglutide is associated with a 49─73 percent lower risk of suicidal ideation vs other agents for treatment of obesity and type 2 diabetes mellitus (T2DM), a National Institutes of Health (NIH)─funded study has shown.
Proton pump inhibitor (PPI) co-therapy appears to lower the risk of hospitalization for upper gastrointestinal bleeding (UGIB) in atrial fibrillation (AF) patients receiving direct oral anticoagulant (DOAC) treatment, according to a study from Korea.
Statin therapy appears to mitigate the risk of venous thromboembolism associated with exogenous hormones, according to a study.
A systematic review and meta-analysis of prospective studies demonstrate that switching from animal-based (AB) to plant-based (PB) foods conferred cardiometabolic improvements.
Special Reports
Growing evidence supports early initiation of guidelinedirected medical therapy (GDMT), including sodium-glucose cotransporter 2 (SGLT2) inhibitors, in patients with heart failure (HF). At a Boehringer Ingelheim–sponsored symposium in Hong Kong, Professor Piotr Ponikowski of the Medical University, Wrocław, Poland, discussed how this approach may improve patients’ prognosis, highlighting randomized controlled trial (RCT) evidence supporting in-hospital initiation of empagliflozin in acute HF and sharing a case study to illustrate practical aspects of this approach.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiorenal benefits in patients with type 2 diabetes mellitus (T2DM) and those with heart failure (HF) or chronic kidney disease (CKD) with or without diabetes. However, misconceptions may lead to inertia in treatment initiation in elderly patients. At a Boehringer Ingelheim–sponsored symposium organized by the Hong Kong Geriatrics Society, Professor Silvio Inzucchi of Yale School of Medicine, New Haven, Connecticut, US, and Professor Michael Böhm of Saarland University, Saarbrücken, Saarland, Germany, presented pivotal trial and real-world data demonstrating empagliflozin’s cardiorenal benefits and safety in elderly patients with these closely interrelated cardio-renalmetabolic (CRM) conditions.
Hyperkalaemia or concerns regarding potential hyperkalaemia may contribute to dose reduction or discontinuation of reninangiotensin system inhibitors (RASIs). At a recent diabetic kidney disease (DKD) expert meeting chaired by Professor Juliana Chan of the Department of Medicine and Therapeutics, the Chinese University of Hong Kong (CUHK), and Professor Sydney Tang of the Department of Medicine, the University of Hong Kong (HKU), a panel of clinical pharmacologists, endocrinologists and nephrologists shared insights into personalized potassium management and provided practical guidance on RASI optimization.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been dubbed “surprise blockbusters” because of their paradigm-shifting cardiorenal benefits in chronic kidney disease (CKD). At an industry-sponsored symposium during the 18th Congress of Asian Society of Transplantation (CAST 2023), Professor Kai-Uwe Eckardt of the Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Germany, reviewed findings from randomized controlled trials (RCTs) and a recent meta-analysis showing reductions in risk of kidney disease progression and acute kidney injury (AKI) associated with these agents. He also discussed how these effects potentially delay the need for dialysis and kidney transplantation.
A 77-year-old male presented with an incidental finding of lymphocytosis (absolute lymphocyte count [ALc], 9 x 109/L) in November 2018.
Major bleeding secondary to intake of direct oral anticoagulants (DOACs) and hyperkalaemia are two potentially fatal conditions encountered in the Accident and Emergency (A&E) department. At an industry-sponsored meeting organized by the Hong Kong College of Emergency Medicine, Professor Adam J Singer of the Stony Brook University Hospital in Stony Brook, New York, US, shared updates on management of these conditions, focusing on the role of andexanet alfa in reversing the effects of factor Xa (FXa) inhibitors, and discussed the emergence of sodium zirconium cyclosilicate (SZC) as the preferred potassium binder to treat life-threatening hyperkalaemia.
Patients with coronary artery disease (CAD) who have undergone percutaneous coronary intervention (PCI) and completed dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor typically receive aspirin as lifelong single antiplatelet therapy (SAPT). However, a growing body of evidence suggests that East Asian patients are prone to excess bleeding from antithrombotic therapy compared with their Western counterparts, and thus may require a different antithrombotic strategy. At a scientific symposium organized by the Hong Kong Society of Congenital and Structural Heart Disease (HKCASH), Professor Hyo-Soo Kim of the Cardiovascular Center, Seoul National University Hospital, Seoul, Korea, discussed emerging clinical data supporting use of clopidogrel as optimal maintenance therapy after PCI in East Asian patients.
Conference Reports
Add-on PCSK9 inhibitor cuts LDL-C by half, allows infrequent dosing in patients maxed out on statins
Injection with the novel, long-acting PCSK9 inhibitor recaticimab once every 3 months reduces LDL-cholesterol (LDL-C) levels by >50 percent compared with placebo in patients already maxed out on statins in the phase III REMAIN-2 trial.
A screening programme that incorporates artificial intelligence (AI)-guided digital stethoscope improves clinicians’ ability to detect peripartum cardiomyopathy in the Nigerian SPEC-AI trial.
In the phase III REMAIN-2 trial, add-on recaticimab – a novel, long-acting anti-PCSK9 monoclonal antibody (mAb) – led to reductions in bad cholesterol and other lipids in patients with non-familial hypercholesterolaemia (non-FH) and mixed hyperlipidaemia inadequately controlled on background statin therapy.
Adopting a liberal blood transfusion strategy in patients with acute myocardial infarction (AMI) and anaemia does not appear to do much in terms of reducing the risk of AMI recurrence or death compared with a restrictive transfusion strategy, although there appears to be a hint of benefit, as shown in the results of the phase III MINT trial.
Empowering mums to self-monitor their blood pressure (BP) with a physician-guided titration of antihypertensive medications helps lower postpartum BP level after a pregnancy complicated by hypertension, as shown in the POP-HT trial.
An ultrathin stent performed just as well as the conventional thin-strut stent in patients at high risk of bleeding in the first head-to-head COMPARE 60/80 trial, providing a new and effective drug-eluting stent (DES) option.
Among Chinese patients with hypertension, a 48-month intensive blood pressure (BP) intervention programme significantly reduces the risk of developing dementia than usual care, according to a study presented at AHA 2023.
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