2/March/2022 Top Medical Bulletin

Here are top medical stories for today

Non–Vitamin K Antagonist Oral Anticoagulants helpful in Stroke  

 A recent study published in JAMA Network evaluated the safety and functional outcomes of intravenous alteplase among patients who were taking non–vitamin K antagonist oral anticoagulants prior to stroke and compared the outcomes with patients who were not taking long-term anticoagulants. Results from the study concluded that Among patients with acute ischemic stroke treated with intravenous alteplase, use of non–vitamin K antagonist oral anticoagulants within the preceding 7 days was not associated with a significantly increased risk of intracranial hemorrhage.

FDA approves Empagliflozin use for heart failure despite contrary results of trials

he US Food and Drug Administration (FDA) has approved an expanded heart failure (HF) indication for the SGLT2 inhibitor empagliflozin that now includes heart failure with mid-range or preserved left-ventricular ejection fraction despite several results not in favour of the drug. FDA used a cautionary language in using these drugs for treatment of heart failure.

Several trials like EMPEROR PRESERVED Trial, widely anticipated the use of Empagliflozin based on the landmark results of the trial and saw a significant 21% relative reduction of occurrence of heart failure. Similarly another trial PARAGON- HF Trial evaluated sacubitril/valsartan drug, it enrolled patients with Heart Failure and Left Ventricular Ejection Fraction. The trial was "negative" in that it saw no significant advantage to the drug for its primary clinical outcome. T

Myocardial fibrosis and its impact cardiovascular structure and function

Myocardial fibrosis, measured using cardiovascular magnetic resonance extracellular volume (ECV), is associated with adverse outcome in heart failure with preserved ejection fraction (HFpEF), but the mechanisms by which myocardial fibrosis exerts this deleterious effect are unclear. 

Research square  reports study that determines  whether myocardial fibrosis causes changes in cardiovascular structure and function, circulating biomarkers and functional status. According to the study, the regression of myocardial fibrosis was associated with improvements in functional status. The small improvement in Left Ventricular Ejection Fraction was not mediated by myocardial fibrosis regression.

Can individuals' walking pace impact their heart failure risk?

Walking a healthy habit one must inculcate. In a study in the Journal of the American Geriatrics Society of postmenopausal women, those who reported a faster walking pace had a lower risk of developing heart failure. Study confirms other studies demonstrating the importance of walking speed on mortality and other cardiovascular outcomes. Given that limited time for exercise is frequently given as a barrier to regular physical activity, walking faster but for less time might provide similar health benefits as the recommended 150 minutes per week of moderate physical activity.

Atrial fibrillation in cancer patients a serious risk factor to develop stroke 

 The role atrial fibrillation plays in Acute ischemic stroke/ Transient Ischemic Attacks (AIS/TIA) in the setting of cancer is unclear. According to a study published BMC- Cardio-Oncology journal reported that trial fibrillation, previous ischemic stroke, active cancer treatment, dyslipidemia, and renal disease are independent risk factors for Acute ischemic stroke/ Transient Ischemic Attacks and a higher score significantly increases the risk in cancer patients regardless of trial fibrillation.