July 2022 News Roundup

Every month, Section Editor L.A. McKeown curates a roundup of recent news tidbits from journals and medical meetings around the globe.

In a nationwide study of US patients with newly diagnosed severe aortic stenosis, receiving care from a primary care provider instead of a cardiac specialist was associated with lower rates of cardiac specialist follow‐up and referral for AVR. Writing in the Journal of the American Heart Association, the researchers say cardiac specialist follow‐up and AVR were independently associated with lower mortality (P < 0.0001 for both.)

A racial/ethnic diversity analysis finds that Hispanic, Black, and Native American or Alaskan fellows in training (FIT) are among the most underrepresented in the field of cardiology and its subspecialties. The study, published in the Journal of the American College of Cardiology, advocates for more effective systematic changes to ensure equitable opportunities in early education, medical schools, and graduate training programs.

Patients with dementia admitted for heart failure or acute MI have higher rates of in-hospital mortality and longer lengths of stay than patients without dementia, according to a study published in Progress in Cardiovascular Diseases. Data from the National Inpatient Sample database also showed that dementia patients had a lower likelihood of receiving PCI, CABG, or thrombolytics.

In moderate aortic stenosis managed with “watchful waiting,” LV remodeling is different between women and men, with the latter having worse survival, according to a study from the Netherlands and Singapore. “Because male patients not only more often present with LV systolic dysfunction but also seem less able to cope with the same increase in afterload compared to women, questions of optimizing the management of AS in a sex-specific manner are rising. However, whether the timely implementation of AVR will translate into improved outcomes will require prospective evaluation,” the authors write in Structural Heart.

Young Black adults have a higher prevalence of subclinical atherosclerosis on carotid and femoral vascular ultrasound compared with young Hispanic adults, which is not adequately explained by Framingham Risk Score or other traditional risk factors. As TCTMD reports, the data from the FAMILIA trial—which follows the health of preschool children in Harlem, NY, and their parents/caregivers—suggest that emerging or undiscovered CV factors could account for the excess risk, the investigators conclude in the Journal of the American College of Cardiology.

Physical activity may lower mortality risk and CV events in patients with chronic kidney disease (CKD). In a study published in the American Journal of Kidney Diseases, researchers say the “well-established cardioprotective effects of physical activity in the general population also hold true for adults with CKD," which may have implications for clinical practice as well as the design of interventional trials.

Having polycystic ovary syndrome (PCOS) puts pregnant women at increased risk of preeclampsia, eclampsia, peripartum cardiomyopathy, and HF during delivery. In a paper published in the Journal of the American Heart Association, investigators say prepregnancy consultation and optimization for cardiometabolic health is an urgent priority in this population to improve outcomes for both mother and child.

Following routine implantation of a subcutaneous implantable cardioverter-defibrillator (SICD), a 47-year-old patient was found to have a bowel perforation. Reporting in JACC: Case Reports, investigators say the presence of subdiaphragmatic air on a chest X-ray the morning after the procedure led to the finding of the perforation and ultimately to removal of the device. After recovering, the patient was scheduled for implantation of a single-chamber transvenous ICD.

Even among those who are fully vaccinated and boosted against COVID-19, having hypertension doubles the risk of hospitalization, according to a study conducted during the Omicron surge in southern California from December 2021 through April 2022. The report in Hypertension extends observations from early in the pandemic when hypertensive patients hospitalized with COVID-19 were found to have a twofold increased risk of dying compared to those without hypertension.