May 2024 Dispatch for the CV Team

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

Adjustable compression devices filled with a predetermined amounts of air may be more effective in achieving patent hemostasis after transradial procedures when compared with nonadjustable devices, a randomized study of nearly 500 patients suggests. Writing in the Journal of Invasive Cardiology, Italian researchers report that patients who had nonadjustable compression devices had more than threefold greater incidence of radial artery occlusion, with no difference between the groups in compression-related bleeding.

Compared with men, women have higher mortality and poorer outcomes after catheter-directed thrombolysis for pulmonary embolism, according to a contemporary analysis of more than 4,600 patients in the National Inpatient Sample. Presented as an abstract at SCAI 2024, the study also showed that women had longer lengths of stay, higher total hospital charges, greater odds of arrhythmias and shock, and increased pressor requirements.

Healthcare-related spending for patients with heart failure is growing at a faster rate than for any other chronic condition, researchers say in JACC: Heart Failure. The annual per-person expenditure increased from $20,781 in 2008/2009 to $34,180 in 2016/2017, a 64.5% increase, with most of it being driven by inpatient care. Over the same time period, healthcare expenditure increases for MI were 14%, while those for diabetes and cancer grew by 11.6% and 14.3%, respectively.

The Valve Academic Research Consortium for High Bleeding Risk (VARC-HBR) has published a new document that provides a uniform definition of high bleeding risk in patients undergoing TAVI. Published in EuroIntervention, the collaborative effort from research organizations, regulatory authorities, and physician-scientists from Europe, the United States, and Asia “aims at improving the efficiency and validity of investigations in the field of heart valve bleeding risk and ensures that interventions performed on patients undergoing transcatheter interventions are effective, safe, and durable.”

The best time of day to take an antihypertensive medication may depend on personal circadian rhythm, a study published in eClinicalMedicine suggests. People classified as later chronotypes, or night owls, had fewer hospitalizations and nonfatal MIs when taking antihypertensive medications in the evening rather than in the morning, while those classified as early chronotypes, or morning larks, had fewer hospitalizations and nonfatal MIs when taking antihypertensives in the morning. “A simple chronotype questionnaire or asking patients to self-report their chronotype during a consultation, could redirect prescription of antihypertensives to a more individual time to further reduce their MI risk,” the researchers say.

When direct oral anticoagulants (DOACs) were first introduced into clinical practice, Black and Hispanic patients were less likely than white patients to receive them in place of warfarin in the treatment of atrial fibrillation (AF), according to a large study of Medicare beneficiaries published in JAMA Network Open. While more contemporary data show nonsignificant differences in prescribing patterns for DOACs, the study authors say it is important to identify the factors that contributed to these early disparities to ensure “equitable access to novel therapies as they emerge for Black and Hispanic populations.”

Nurse-led interventions for hypertension management have a greater positive impact on lifestyle behaviors, including diet and physical activity, than does usual care, a systematic review and meta-analysis indicates. Across a variety of intervention types both in the clinic and in the patient’s home, nurse-led care was superior in reducing systolic and diastolic blood pressure, with the duration of the intervention tied to the magnitude of the reduction seen, investigators report in the European Journal of Cardiovascular Nursing.

In patients with peripheral artery disease, listening to classical music in the cath lab helps calm procedure-related anxiety, a single-center RCT suggests. Patients randomized to the music group had faster resolution of their self-reported anxiety than the control group, with most stating that they would like to listen to music during potential future interventions, researchers from the MULAN trial conclude in a paper published in Vasa, the European Journal of Vascular Medicine.

Fewer than one in three patients with CV comorbidities or at high risk of developing CVD have full recovery at 1 year after a SARS-CoV-2 hospitalization, according to results from the PHOSP-COVID study published in Open Heart. The investigators say shared “chronic disease risk factors implicated in both severe infections and CVD may account for an accelerated progression of CVD rather than the pathogen itself,” and suggest that targeted interventions to address deconditioning “may help alleviate symptoms in those with delayed recovery following SARS-CoV-2 infection.”

News Highlights From TCTMD:

Patient Decision Aid Improves Shared Decision-making in Aortic Stenosis

CASA-AF: Similar 3-Year Efficacy for Surgical and Catheter Ablation

POLMIDES: Hybrid Revascularization Bests CABG For 10-Year Survival

SWIFT TAVI Algorithm Lowers Wait Times for Highest-Risk Patients

ORBITA-2: Angina Phenotype Strongly Predicts PCI Response