July 2023 News Roundup

This month: postpartum SCAD, environmental impacts on MACE in cancer, bias and harassment for women in imaging, and more.

July 2023 News Roundup

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

Given that the relatives of patients with bicuspid aortic valve (BAV) themselves show elevated rates of BAV and aortic dilatation, more efforts are needed to understand the value of familial screening, which is recommended in guidelines but only sporadically implemented in clinical practice, a systematic review and meta-analysis suggests. Writing in the European Heart Journal, the authors say to justify systematic, effective, and equitable screening programs, ongoing efforts should focus on reliable estimation of the harms and benefits of screening, patient and family attitudes, and best implementation strategies.

In JAMA Cardiology, a team from New York describes how they managed a case of spontaneous coronary artery dissection (SCAD) of the left main coronary artery in a woman with sudden onset symptoms weeks after giving birth.

CVTD0701Neighborhood and built environment variables are important social determinants of health that contribute to 2-year risk of MACE in patients with breast cancer, particularly for non-Hispanic Black females, according to data from a study in the Journal of the National Comprehensive Cancer Network. “At the patient level, the key clinical and practical implications of this study are the need for proactive screening and management of cardiovascular risk factors and CVD in patients at high risk of MACE who are being considered for anticancer treatments,” the investigators conclude.

In a different study, Black survivors of a variety of cancer types had a greater likelihood of dying from CVD than did white patients. Researchers writing in the International Journal of Epidemiology say these data underscore the importance of neighborhood-level interventions and equitable access to care to mitigate the racial inequities in CVD mortality among cancer survivors.

In chronic kidney disease (CKD) patients undergoing PCI, a simplified rapid hydration protocol was noninferior to a standard hydration protocol in preventing contrast-associated acute kidney injury (CA-AKI), researchers report in a study of over 1,000 patients published in JACC: Cardiovascular Interventions.

CVTD0702Compared with usual care for heart failure, alternative care models in which medication management includes nurses and pharmacists are more likely to result in initiation and/or uptitration of guideline-directed medical therapy (GDMT), a study published in the Journal of Cardiac Failure suggests. In pooled risk estimates, the initiation of renin-angiotensin-aldosterone-system (RAAS) inhibitors and beta-blockers was double that seen in physician-only care models.

What is geroscience and how does it impact CV disease? A scientific statement published in the Journal of the American College of Cardiology reviews how this emerging paradigm “could transform the diagnosis, prevention, treatment, and prognosis of cardiovascular disease in an aging population” through targeted therapy aimed at building resistance to aging-related molecular damage.

A paper published in the American Journal of Cardiology shows variations in catheter-based ablation of atrial fibrillation in Medicare patients by geographic and urban versus rural regions. While the number of electrophysiologists performing ablations and the mean number of procedures per electrophysiologist increased steadily in all regions from 2013 to 2019, the researchers say the disparities have the potential to impact outcomes.

CVTD0703A study of over 300 women from 53 countries who work in CV imaging—including physicians, nurses, and technicians—found that more than half reported experiencing unconscious bias, verbal harassment, conscious bias, anxiety, lack of motivation, imposter syndrome, and burnout. However, more than 80% of those who took the survey, published in the European Heart Journal: Cardiovascular Imaging, said they would still choose a career in CV imaging despite these issues.

The Preventive Cardiovascular Nurses Association (PCNA) has introduced a new PAD screening tool for use in clinical and outreach settings. The four-page screening tool walks clinicians through clinical tests to diagnose PAD and helps patients develop an action plan.