‘... in an undifferentiated population of patients undergoing invasive management during daily practice, an interventional diagnostic procedure empowers cardiologists to make the correct diagnosis with linked therapy’
Coronary angiography is the standard-of-care test for identifying obstructive CAD either by anatomic imaging using noninvasive computed tomographic coronary angiography (CTCA) or invasive coronary angiography
Yet, invasive coronary angiography has a spatial resolution of approximately 0.5 mm, & evaluation is determined by subjective visual interpretation.
The limited spatial resolution of angiography does not allow visualization of the resistance arterioles (20 to 400 μm) that largely govern myocardial blood flow
Patients with undiagnosed chest pain (including those who have undergone cardiac investigations) are at increased risk for cardiovascular events for at least 5 years.
#Women with #angina appear to be particularly burdened by symptoms & morbidity even after reassuringly “normal” findings on invasive coronary angiography.
An increasing proportion of patients who undergo invasive coronary angiography have not undergone functional stress testing, meaning that information on ischemia is often lacking at the time of anatomic testing with either invasive or noninvasive angiography.
This gap presents new challenges for decision making in patients with INOCA.
Coronary vascular function reflects contributions from the epicardial conduit coronary arteries, its intramyocardial branches, and the microcirculation.
The coronary sinus reducer stent (which is being researched) aims to induce a controlled increase in coronary sinus blood pressure, thereby increasing retrograde myocardial perfusion to reduce the propensity to myocardial ischemia. Clinical evidence from RCTs is awaited.
Emerging data from @PHE_uk suggests a synergistic detrimental effect of co-infection with #SARS_CoV_2 & #flu viruses. The preprint (not peer reviewed) article is available here medrxiv.org/content/10.110…
‘The risk of testing positive for #SARS_CoV_2 was 68% lower among #influenza positive cases, suggesting possible pathogenic competition between the two viruses.’
However, ‘Patients with a coinfection had a risk of death of 5.92 (95% CI, 3.21-10.91) times greater than among those with neither influenza nor SARS-CoV-2 suggesting possible synergistic effects in coinfected individuals.’
Advances in #cancer treatment have improved clinical outcomes, leading to an increasing population of cancer survivors. Yet, this success is associated with high rates of short‐ & long‐term #cardiovascular toxicities. The Cancer Patient and Cardiology onlinelibrary.wiley.com/doi/abs/10.100…
The number & variety of #cancer drugs & #cardiovascular toxicity types make long‐term care a complex undertaking.
This requires a multidisciplinary approach including expertise from #oncology, #cardiology, & other related specialties, & has led to the development of the cardio‐oncology subspecialty.
The rise in admissions with #COVID19 does not mean that you shouldn’t attend hospital if you have a medical emergency #heartattack
During the first peak, admissions with #heartatrack declined & was of grave concern : COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England @TheLancetthelancet.com/journals/lance…
Yet, hospitals provided high quality care for those who did attend: Patient response, treatments and mortality for acute myocardial infarction during the COVID-19 pandemic @ESC_Journals#EHJQCCOacademic.oup.com/ehjqcco/advanc…
@TheLancet journals now require all #research papers, irrespective of method, to include a data-sharing statement that details what #data will be shared, whether additional documents will be shared, when data will become available & by what access criteria data will be shared.
All @TheLancet journals will now introduce additional peer-review requirements for papers based on large, real-world datasets.
Patients with mitral annular disjunction present with frequent premature ventricular contractions; in this study, one-third had ventricular arrhythmias & one-tenth had severe arrhythmic events. @JACCJournalsonlinejacc.org/content/72/14/…
A total of 82 (71%) patients reported #palpitations, 47 (41%) patients reported previous pre-syncope, 40 (34%) had ventricular arrhythmia, 15 (13%) had experienced #syncope, & 14 (12%) patients had experienced a severe arrhythmic event prior to inclusion
Mitral valve prolapse was present in 90 (78%) patients