Central arteriovenous anastomosis for the treatment of uncontrolled hypertension

Although renal denervation didn’t go down so well for the management of refractory hypertension, that doesn’t mean the problem has gone away. This new randomised controlled trial is about trying something a little different – and the early results look promising. Check it out at the Lancet, here.

Atrial fibrillation as a risk factor for myocardial infarction

File:A-fib.png

We all know that ischaemic heart disease is a risk factor for AF, through multiple mechanisms, however how about AF as a risk factor for having an MI?

Turns out AF doubles your risk (1.7 after adjustment for major risk factors). This association was stronger in women, and not significant in the older age group.

It’s not just strokes – AF is becoming a serious public health issue, and one we don’t know enough about. Read more at JAMA Internal Medicine.

 

image | Wikimedia Commons

source | JAMA Internal Medicine

 

Atherosclerotic renal artery stenosis – stents or tablets?

The recent AHA meetings have provided a littany of articles to look at, with the most recent coming in an online first form over at the New England Journal of Medicine. This topic however has been looked at before (ASTRAL and STAR), and now this new trial titled CORAL aims to put the argument to bed once and for all.  Continue reading

Transcatheter aortic valve replacement

This one is more for the cardiologists among you, however it is a technique that is becoming increasingly common. Transcatheter aortic valve replacement or implantation is generally indicated for the treatment of severe symptomatic aortic stenosis in patients with inoperable or high risk but operable comorbidities. Here, the results from all US TAVR cases (almost eight thousand cases) are presented.

So, what do you need to know?

  • average age was 84
  • About half are women
  • the STS predicted mortality was 7% – actual in hospital mortality was 5.5%, and 7.6% at 30 days
  • 64% were done from the femoral approach
  • there was a 2% stroke rate
  • 1.9% required dialysis due to renal failure
  • 0.5% of patients required intervention

An interesting read regarding TAVR/TAVI in general, and useful to provide more information to patients. Check it out here.

 

source | Journal of the American Medical Association

image | Heart Hospital of Austin

Mechanical CPR

A few people have been waiting for these trial results for a while – a comparison between mechanical and manual CPR. A few of these devices have been around for a while, with different methods used in each. This article in JAMA covers the LINC trial, looking at 2589 patients with out of hospital cardiac arrests across 5 years.  Continue reading