Top 10 Cardiology articles of the week (30.6.14- 6.7.14)

1. Prospective Randomized Evaluation of the Watchman Left Atrial Appendage Closure Device in Patients With Atrial Fibrillation Versus Long-Term Warfarin Therapy : The PREVAIL Trial.
In this trial, LAA occlusion was noninferior to warfarin for ischemic stroke                                      prevention or systemic embolism >7 days’ post-procedure. Although noninferiority                was not achieved for overall efficacy, event rates were low and numerically                                      comparable in both arms. Procedural safety has significantly improved. This trial provides additional data that LAA occlusion is a reasonable alternative to warfarin therapy for stroke prevention in patients with NVAF who do not have an absolute contraindication to short-term warfarin therapy.
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2.Stent Thrombosis in New-Generation Drug-Eluting Stents in Patients With STEMI Undergoing Primary PCI A Report From SCAAR.

Patients treated with n-DES (new generation DES)  have a lower risk of early/late ST  (stent thrombosis) than patients treated with BMS. The risk of very late ST  is low and comparable between n-DES and BMS up to 3 years of follow-up, whereas o-DES  (older generation DES) treatment is associated with an increased risk of very late ST. The current STEMI guidelines might require an update in light of the results of this and other recent studies.

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3.Clinical Outcomes and Improved Survival in Patients With Protein-Losing Enteropathy After the Fontan Operation.

http://content.onlinejacc.org/article.aspx?articleID=1886825
4.Hypertrophic Cardiomyopathy Present and Future, With Translation Into Contemporary Cardiovascular Medicine
http://content.onlinejacc.org/article.aspx?articleID=1886834

 
5.Dual antiplatelet therapy in patients with stable coronary artery disease in modern practice: Prevalence, correlates and impact on prognosis
(from the CORONOR study)
About one-quarter of patients with stable coronary artery disease (CAD) are prescribed dual antiplatelet therapy (DAPT), probably due to factors such as MI or revascularization within recent years, diffuse atherosclerosis, and DES implantation. Nonetheless, these patients are no more likely to be protected against future ischemic events than those receiving aspirin or clopidogrel alone.

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6.Use of the REG1 anticoagulation system in patients with acute coronary syndromes undergoing percutaneous coronary intervention:results from the phase II RADAR-PCI study.
High-level factor IXa inhibition in ACS patients undergoing PCI, with at least 50% reversal, has a favourable bleeding profile and appears effective at suppressing ischaemic events and thrombotic complications. Larger phase trials in PCI are warranted.
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7.Sitagliptin Use in Patients With Diabetes and Heart Failure: A Population-Based Retrospective Cohort Study.
There is considerable uncertainty about the safety of sitagliptin in patients with T2DM and HF, and current guidelines from the American Diabetes Association suggest caution with the use of antihyperglycemics in patients with HF. This study adds to the mounting evidence that DPP-4 inhibitors may increase the risk of HF, challenging a platform of basic science data that DPP-4 inhibition may actually have a beneficial impact on cardiovascular function.
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8.Lifetime Prevalence of Congenital Heart Disease in the General Population from 2000 to 2010

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9.Insulin pump treatment compared with multiple daily injections for treatment of type 2 diabetes (OpT2mise): a randomised open-label controlled trial

 

 
10.Long-term Survival in Patients Undergoing Percutaneous Interventions With or Without Intracoronary Pressure Wire Guidance or Intracoronary Ultrasonographic Imaging: A Large Cohort Study
In this large observational study, FFR-guided PCI and IVUS-guided PCI were not associated with improved long-term survival compared with standard angiography-guided PCI. The use of FFR was associated with the implantation of fewer stents.
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