Cardiovascular News – November, 2020

DMS Cardiovascular news is a curated collection of articles, posts & studies related to general & interventional cardiology, cardiovascular & heart health that I found interesting and may be of help or interest to others. All articles are published on reliable and respected sources cited with links to read the original full article. 

Report on latest menopause science looks at heart risks

November 30, 2020 - Heart.org
At a glance:
The years in a woman's life leading to menopause are a critical time for preventing heart disease, according to a new report that summarizes the latest science on this midlife transition and its connection to cardiovascular risks.

The most recent data on the years just before menopause – a time when cardiovascular risks accelerate – includes a look at the timing of hormone replacement therapy, the age when menopause begins and the lifestyle factors that affect a woman's risk during that time.

 

Also discussed are:

  • Importance of health monitoring
  • Life phases from reproductive to non-reproductive phases and related changes
  • Cardiovascular benefits of combination hormone replacement therapies
  • AHA Scientific Statement published in AHA Journal Circulation

Can Coronary Artery Calcium Scores Help to Personalize Risk Assessment and Tailor Treatment in Familial Hypercholesterolemia?

November 30, 2020 - American College of Cardiology
At a glance:

Heterozygous familial hypercholesterolemia (HeFH) is one of the most common genetic conditions associated with premature atherosclerotic cardiovascular disease (ASCVD) and is vastly underdiagnosed and undertreated.

Heterogeneity in ASCVD risk in patients with HeFH suggests an opportunity and need to tailor the treatment strategy using clinical data beyond LDL-C.

CAC testing may be able to further clarify the heterogeneity in ASCVD risk among FH patients and identify those who would derive the largest benefit from non-statin therapies.

 

Also discussed are:

  • Heterogeneity in HeFH
  • Potential for Personalization of FH Care with CAC
Conclusion:
HeFH is a common condition that is underdiagnosed and undertreated. A huge clinical priority is to find these patients, cascade screen their families, and initiate proper guideline-directed care, including lifestyle modification and high-intensity statin therapy. A >50% LDL-C reduction and attainment of LDL-C <100 mg/dL at a minimum is necessary for primary prevention in HeFH patient

The Role of Diet in Regulating Inflammation & Heart Failure

November 30, 2020 - Heart.org
At a glance:
People with heart failure who eat a diet high in foods that cause inflammation are twice as likely to end up in the hospital or die as those who eat foods known to reduce inflammation, new research shows."If people with heart failure can reduce the amount of pro-inflammatory foods that they eat, it might help with their survival," said lead researcher JungHee Kang, a nursing research assistant and PhD student at the University of Kentucky in Lexington.

Also discussed are:

Typical Teen Diet of Ultra Processed Foods Increases Risk of Heart Disease

November 24, 2020 - Heart.org
At a glance:
U.S. adolescents get about two-thirds of their calories from ultra-processed food, and the more they eat, the worse they score on important measures of heart health, a new study says.
The ultra-processed food category includes chips, cookies, candy, soft drinks and ready-to-heat products such as pizza, instant soup, hot dogs and chicken nuggets. In short – a list of wrappers you might find on the floor of a teenager's room.
Also discussed are:

Many Patients With Type 2 MI Don't Get Cardiologist Evaluation

November 23, 2020 - Medscape
At a glance:
Perhaps 40% of hospitalized patients with type 2 myocardial infarction (MI) are not evaluated by a cardiologist at the same admission, suggests a study based on experience over several years at a major medical center.
Such patients may be short-changed on the number and kind of tests they undergo, their discharge prescriptions, and whether they are scheduled for a postdischarge cardiology follow-up, results further show.
Also discussed are:

 

Conclusion:

Conditions that can promote the culprit oxygen demand-supply mismatch can include sepsis, pneumonia, anemia, hypoxia, hypertension, and bleeding, along with cardiac issues such as atrial fibrillation.

So patients with type 2 MI tend to be "a broadly heterogeneous group," and it helps to consider that when trying to arrive at a diagnosis, Newby said. It also means that they may well not be seen as primarily cardiac patients, perhaps making cardiologist involvement less likely.

Combined OCT, Cardiac MRI Unravels Root Cause in Most MINOCA

November 14, 2020 - Medscape
At a glance:

Optical CT (OCT) plus cardiac MRI (CMR) provides a more specific diagnosis in the majority of women presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA).

The multimodal imaging strategy identified the underlying cause of MINOCA in 85% of women in the HARP-MINOCA study. Overall, 64% of women had a true MI and 21% had an alternate nonischemic diagnosis, most commonly myocarditis.

Also discussed are:
  • MINOCA occurs in 15% of patients with MI
  • MINOCA is three times more common in women than men and disproportionately affects Black, Hispanic, Maori, and Pacific ethnicities.
  • As part of the Women's Heart Attack Research (HARP) program, patients underwent OCT, followed by CMR within 1 week of the acute presentation.

 

Conclusion:

When the OCT and CMR results were combined, a cause of MINOCA was identified in 84.5% of women. Three-fourths of the causes were ischemic (64% MI) and one-quarter were nonischemic (15% myocarditis, 3% Takotsubo syndrome, and 3% nonischemic cardiomyopathy). In the remaining 15%, no cause of MINOCA was identified.

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About Jasdeep Dalawari MD

Experienced General and Specialist Physician with a demonstrated history of working in the medical practice industry. Skilled in Interventional, Endovascular, Vascular, and General Cardiovascular Medicine; Emergency Medicine; Healthcare Consulting, including Peer Review, Expert Witness, and Utilization Review; and Medical Education. Strong healthcare services professional with an MS focused in Health Administration from Virginia Commonwealth University.