Physicians' Academy for Cardiovascular Education

Stroke

LDL-c target of <70 vs. 100 mg/mL after stroke lowers risk of CV events

News - Nov. 25, 2019

AHA 2019 The Treat Stroke to Target (TST) trial randomized patients with ischemic stroke or TIA with evidence of atherosclerosis to one of two LDL-c targets and found a benefit of the lower target.

Optimism associated with reduced risk of CV events and all-cause mortality

Literature - Oct. 10, 2019 - Rozanski A, et al. - JAMA Network Open

A meta-analysis of 15 studies with more than 220,000 individuals showed that a mindset of optimism was associated with reduced risk of CV events and all-cause mortality.

Long-term treatment with dual antiplatelet therapy in patients with diabetes and stable CAD

3' education - Sep. 9, 2019 - Prof. Ph. Gabriel Steg
The THEMIS study evaluated the effect of ticagrelor vs. placebo on top of aspirin in diabetes patients with stable coronary artery disease. Netto clinical benefit depended on having a history of PCI or not.

ESC 2019 The THEMIS study evaluated the effect of ticagrelor vs. placebo on top of aspirin in diabetes patients with stable coronary artery disease. Netto clinical benefit depended on having a history of PCI or not.

Systolic and diastolic hypertension independently associated with CV outcomes

Literature - July 22, 2019 - Flint AC et al. - N Engl J Med 2019
In a large cohort of 1.3 million participants, both systolic and diastolic hypertension were associated with composite of MI, ischemic stroke and hemorrhagic stroke, independent of thresholds defining hypertension.

In a large cohort study of 1.3 million participants, both systolic and diastolic hypertension were associated with composite of MI, ischemic stroke and hemorrhagic stroke, independent of thresholds defining hypertension.

Vitamin D supplementation not associated with reduced major adverse CV events

Literature - July 1, 2019 - Barbarawi M, et al. - JAMA Cardiol 2019
In a meta-analysis of 21 RCTs including diverse populations, supplementation with vitamin D did not result in a reduction of MACE, MI, stroke/CVA, CV mortality and all-cause mortality compared to placebo.

In a meta-analysis of 21 RCTs including diverse populations, supplementation with vitamin D did not result in a reduction of MACE, MI, stroke/CVA, CV mortality and all-cause mortality compared to placebo.

Higher BMI associated with lower stroke/SEE risk in anticoagulated AF patients

Literature - June 26, 2019 - Boriani G et al., - Eur Heart J. 2019
ENGAGE AF-TIMI 48 data show that BMI was negatively associated with risk of stroke/SEE and positively associated with risk of bleeding, although sex differences were seen.

ENGAGE AF-TIMI 48 data show that BMI was negatively associated with risk of stroke/SEE and positively associated with risk of bleeding, although sex differences were seen.

No reduction of recurrent stroke with DOAC after embolic stroke of undetermined source

Literature - June 12, 2019 - Diener H-C, et al. - N Engl J Med 2019

Dabigatran therapy did not result in a reduction of recurrent strokes compared to aspirin use after embolic stroke of undetermined source, whereas risk of nonmajor bleeding was higher with dabigatran.

High residual inflammatory risk associated with adverse clinical outcomes in patients undergoing PCI with low LDL-c

Literature - June 7, 2019 - Guedeney P et al. - JACC 2019
A single-center prospective PCI-registry showed an independent association of high residual inflammatory risk and adverse clinical outcomes in patients undergoing PCI with LDL-c ≤70 mg/dL at baseline.

A single-center prospective PCI-registry showed an independent association of high residual inflammatory risk and adverse clinical outcomes in patients undergoing PCI with LDL-c ≤70 mg/dL at baseline.

Uninterrupted treatment with NOAC as alternative to VKA for ablation of AF

Literature - June 5, 2019 - Hohnloser SH et al. - Eur Heart J 2019

The exploratory ELIMINATE-AF study demonstrated that uninterrupted treatment with edoxaban represents an alternative to continuous VKA in patients undergoing catheter ablation of AF.

Factor Xa inhibitor reduces stroke risk in patients with HFrEF, sinus rhythm and CAD

News - May 25, 2019
A subanalysis of the COMMANDER-HF trial demonstrated that low dose rivaroxaban decreased stroke/TIA risk in patients with HFrEF, sinus rhythm and CAD without increase in major bleeding.

ESC HF 2019 A subanalysis of the COMMANDER-HF trial demonstrated that low dose rivaroxaban decreased stroke/TIA risk in patients with HFrEF, sinus rhythm and CAD without increase in major bleeding.

Increase in hs-troponin I associated with higher risk of CVD in individuals without CVD history

Literature - May 14, 2019 - Jia X, et al. - Circulation 2019

In individuals without CVD history in the ARIC study, increase in troponin I, measured by a high sensitivity assay, was associated with ASCVD, global CVD, CHD, stroke, HF hospitalization, and all-cause mortality.

Total antibiotic exposure time in different life-stages associated with higher CVD risk in later life

Literature - May 9, 2019 - Heianza Y et al. - Eur Heart J 2019
In women, longer total exposure to antibiotics in middle- and late adulthood was significantly associated with risk of CVD in later life, and antibiotic use in middle adulthood with risk of CHD but not of stroke.

In women, longer total exposure to antibiotics in middle- and late adulthood was significantly associated with risk of CVD in later life, and antibiotic use in middle adulthood with risk of CHD but not of stroke.