December 2022 News Roundup

This month features surgical conscience, 2-year mitral outcomes, sex differences in CTO PCI, and more.

December 2022 News Roundup

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

Hispanic patients with a diagnosis of PAD face more linguistic challenges and barriers to transportation that impact them receiving care than do non-Hispanic patients, data from a survey show. Writing in the Journal of Critical Limb Ischemia, investigators say public health and policy strategies are needed to mitigate these barriers.

CLF1Nurses working in operating rooms and other sterile environments have a “surgical conscience” that, while difficult to define, is crucial to patient care and deserving of further study to empower nurses to exercise it, according to a paper published in the Association of Operative Registered Nurses Journal. One example of such conscience is delaying or halting a procedure that is about to start because the patient has a question regarding informed consent.

Researchers at the University of Waterloo are in the early stages of testing cardiac bypass grafts made with fucoidan, a natural substance found in seaweed. With a structure similar to heparin, fucoidan promotes the growth of vascular cells and prevents clotting, which could potentially improve the performance of synthetic vascular grafts.

Two-year data from the MITRAL trial of balloon-expandable Sapien XT and Sapien 3 transcatheter aortic valves (Edwards Lifesciences) used in the mitral position show sustained reduction in heart failure symptoms, improved functional capacity and quality of life, and prosthesis stability, researchers report in the Journal of the American College of Cardiology.

Compared with men, women have similar mortality and major cardiovascular and cerebrovascular events (MACCE), but higher risk of periprocedural complications when undergoing PCI for chronic total occlusion (CTO). In the analysis of more than 30,000 procedures, published in Cardiovascular Revascularization Medicine, only one in five patients were women. The study authors say this suggests “systematic biases with a significant unmet need, particularly in women with poorly controlled angina despite optimal medical therapy.”

Giving intravenous iron infusions to patients with heart failure and iron deficiency may result in fewer hospital admissions and a lower risk of CV death, according to results from the IRONMAN study published in the Lancet. Compared with patients not receiving iron, those who did also had better overall quality of life and physical domain scores. TCTMD has the full story here.CLF2

In a meta-analysis of 11 RCTs and more than 9,000 high-bleeding risk PCI patients randomized to an abbreviated (1-3 months) or standard dual antiplatelet therapy (DAPT; 6 months or longer), there was less major bleeding and major or clinically relevant nonmajor bleeding with the shorter regimen but no increase in MACE or other ischemic events. “Periprocedural DAPT and P2Y12 inhibitor monotherapy after DAPT withdrawal appear to be the best strategies to optimize the bleeding and ischemic risk tradeoff,” the investigators write in the European Heart Journal.

Longer defibrillation time, hypoalbuminemia, and baseline renal dysfunction are predictors of greater in-hospital mortality risk for patients with out-of-hospital cardiac arrest (OHCA) and shockable rhythm without ST-segment elevation, according to data from an Australian study reported in Catheterization & Cardiovascular Interventions. Those who were younger, had shorter time to return of spontaneous circulation, and had a Glasgow Coma Scale (GCS) > 8 had the highest likelihood of undergoing PCI after OHCA.

Just for Fun

CLF3Christmas music can reduce blood pressure, a small study suggests. Participants saw an average decrease in systolic pressure of 3.5 mm Hg after a Christmas carol intervention versus before (P = 0.12). Of note, anyone identifying as a Grinch was excluded, the researchers report in Ugeskrift for Læger, the journal of the Danish Medical Association.