October 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.

If optimal guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) were implemented globally, it could save an estimated 1.19 million lives over the course of 1 year, an analysis suggests. “Significant benefits would be achieved with GDMT optimization in Southeast Asia and the Western Pacific, as well as in Eastern Mediterranean and African countries,” thanks to the high prevalence of HFrEF and the current levels of undertreatment, the researchers write in JAMA Cardiology. 

The age-old question of whether caffeine is good for you is getting another boost from a study of lupus patients that shows those who consume more caffeine have better vascular health. Reporting their findings in Rheumatology, researchers say the small study of lupus patients with no traditional CV risk factors requires further confirmation but may be a step toward clarifying the role of dietary caffeine in controlling the disease process.

The Chest Pain Conception Questionnaire (CPCQ) performs as well in the racially and ethnically diverse real world as it did when first developed in a primarily white population, a paper published in the Journal of Cardiovascular Nursing suggests. The CPCQ was created to assess the lay public's ideas about chest pain symptoms and what they would feel like if the symptoms happened to them.

Episodes of acute decompensated HF can, due to systemic congestion, cause changes in the retinal microvasculature, a study in the European Journal of Heart Failure demonstrates. While gains in certain parameters of the eye were observed after patients recovered, the authors say the changes did not return to normal compared with controls, thus highlighting the need for more study of this cardio-ocular syndrome and its potential long-term consequences. 

New stroke prevention guidelines from the American Heart Association/American Stroke Association provide evidence-based recommendations for supporting brain health throughout the lifespan with the goal of minimizing risk in people with no prior history of stroke. Published in Stroke, the advice addresses risk factors, lifestyle modification, and health equity as well as screening and management strategies specific to sex and gender.

Over the last decade there has been a sizeable shift in the acute ischemic stroke realm toward endovascular therapies such as clot retrieval and rescue stenting, which a review article in the Lancet says has improved understanding of optimal management techniques. Randomized trials using next-generation devices confirmed the benefit of endovascular therapy over best medical treatment in selected patients, the authors say, and have led to improved patient selection as operators rely on evolving RCT evidence.

Black patients are 22% more likely than those who are white to die in the hospital following CABG surgery, data from a large US inpatient database show. The findings, presented at the recent Anesthesiology 2024 meeting, also reveal longer hospital stays for Black patients as well as higher likelihood of cardiac arrest. 

In a recent study of prognostic factors in cardiogenic shock, several patient characteristics emerged as factors linked to increased risk of early mortality: age ≥ 75 years, peripheral arterial disease, chronic kidney disease, and female sex. The systematic review and meta-analysis of over 2.4 million patients, published in NEJM Evidence, also showed that certain procedural and presentation factors may portend increased mortality, including out-of-hospital cardiac arrest, left ventricular ejection fraction < 30%, and need for dialysis or mechanical circulatory support.

As data accumulate suggesting that fasting is unnecessary and unpleasant for patients undergoing cardiac catheterization procedures, an analysis from two hospitals suggests that the risk of aspiration in STEMI patients undergoing emergent or urgent cardiac catheterization with moderate sedation and no enforced fasting is extremely low. Potential aspiration has been long cited as the reason behind fasting requirements. Of 446 patients, 15 had a suspected aspiration event that upon adjudication and chart review resulted in just one likely and one possible aspiration, the researchers report in JSCAI.

News Highlights From TCTMD:

SOUL: Oral Semaglutide Cuts CV Events in Diabetic Patients

Practical Strategies to Foster Diversity in Cardiology Clinical Trials

Can ‘Body Roundness Index’ Replace BMI? That Depends, Say Experts

Standing Alone Will Not Offset Sitting’s CVD Risks, Study Suggests

‘Teleprehabilitation’ Before Cardiac Surgery Improves the Outcomes That Follow