November 2020 News Roundup
This month features PCI in COVID-19, a “hospital-at-home” program, ablation’s impact on dementia, and more.
Cath Lab Dispatch is TCTMD’s monthly roundup of recent news tidbits from journals and medical meetings around the globe.
TAVR in patients with aortic regurgitation results in 30-day all-cause mortality rates that are comparable to prior studies of high- and intermediate-risk patients undergoing TAVR for severe aortic stenosis. The findings come from an analysis of over 900 patients included in the Nationwide Inpatient Sample and were published online in Catheterization and Cardiovascular Interventions.
For the majority of STEMI cases, primary PCI remains the appropriate treatment strategy when there is low suspicion of COVID-19 infection, according to an analysis in Circulation: Cardiovascular Interventions. However, in selected patients with presumptive COVID-19 and nonanterior STEMI without cardiogenic shock, the benefit of primary PCI over pharmacoinvasive therapy “may be minimal relative to the increase in provider infection risk,” the researchers conclude.
A study of 200 consecutive patients with psoriasis suggests that early vascular disease may drive myocardial injury. The association between noncalcified coronary burden and positive high-sensitivity troponin independent of traditional risk factors, coronary plaque, and left ventricular hypertrophy supports future myocardial perfusion studies to better understand the findings, the authors conclude.
The NEAT study suggests that nurse-led educational and risk-factor management sessions that allow patients with A-fib to self-select target goals do not significantly impact quality of life or CV risk factors. Writing in the Journal of Cardiovascular Nursing, the researchers say these findings “highlight the complexity and need for evaluation of interventions of service delivery to ensure optimal design of care models.”
Efforts are needed to improve outcomes in kidney transplant patients who undergo TAVR. A study published in Structural Heart found that transplant recipients had increased rates of post-TAVR in-hospital hemorrhagic stroke, ischemic stroke, acute kidney injury, and sepsis compared with patients with no transplant history.
Catheter ablation for A-fib may decrease the risk of dementia, according to a large, retrospective Korean study published in the European Heart Journal. Over a period of 52 months of follow-up, ablation-treated patients had less development of dementia compared with patients who received medical therapy.
An article in Annals of Internal Medicine describes how one healthcare system modified their preexisting hospital transition and telemedicine programs into a virtual “hospital-at-home” program to address the needs of their patients with SARS-CoV-2. The hybrid model, consisting of virtual and in-person services, allowed for hospital-level care to be provided for both low- and high-acuity patients.
A focused update in Stroke reviews methods for studying racial-ethnic disparities in the United States as they relate to stroke care and outcomes. The authors suggest novel ideas for improving on current methods, as well as ways to minimize or eliminate differences between groups with better outcomes and those who have historically been underserved.
During the first wave of the COVID-19 pandemic (March through early June 2020), the incidence of hospital admission for virus infection among a large group of Scottish healthcare workers and their families was less than 0.5%. Healthcare workers—and the family members of those workers—who had direct patient contact in acute situations had the highest risk, according to the study published online in the BMJ.