Contemporary Interventional Approach to Calcified Coronary Artery Disease.

Calcific coronary artery disease is an increasingly prevalent entity in the catheterization laboratory which has implications for stenting and expected outcomes. With new interventional techniques and equipment, strategies to favorably modify coronary calcium prior to stenting continue to evolve. This paper sought to review the latest advances in the management of severe coronary artery calcification in the catheterization laboratory and discuss contemporary percutaneous interventional approaches.

Association of hypertension with mortality in patients hospitalised with COVID-19.

Objective: To assess whether hypertension is an independent risk factor for mortality among patients hospitalised with COVID-19, and to evaluate the impact of ACE inhibitor and angiotensin receptor blocker (ARB) use on mortality in patients with a background of hypertension.

Method: This observational cohort study included all index hospitalisations with laboratory-proven COVID-19 aged ≥18 years across 21 Australian hospitals. Patients with suspected, but not laboratory-proven COVID-19, were excluded.

2020 Asian Pacific Society of Cardiology Consensus Recommendations on Antithrombotic Management for High-risk Chronic Coronary Syndrome.

The unique characteristics of patients with chronic coronary syndrome (CCS) in the Asia-Pacific region, heterogeneous approaches because of differences in accesses and resources and low number of patients from the Asia-Pacific region in pivotal studies, mean that international guidelines cannot be routinely applied to these populations. The Asian Pacific Society of Cardiology developed these consensus recommendations to summarise current evidence on the management of CCS and provide recommendations to assist clinicians treat patients from the region. The consensus recommendations were developed by an expert consensus panel who reviewed and appraised the available literature, with focus on data from patients in Asia-Pacific.

Direct Oral Anticoagulants in Asian Patients with Atrial Fibrillation: Consensus Recommendations by the Asian Pacific Society of Cardiology on Strategies for Thrombotic and Bleeding Risk Management.

The disease burden of AF is greater in Asia-Pacific than other areas of the world. Direct oral anticoagulants (DOACs) have emerged as effective alternatives to vitamin K antagonists (VKA) for preventing thromboembolic events in patients with AF. The Asian Pacific Society of Cardiology developed this consensus statement to guide physicians in the management of AF in Asian populations.

Non-inferiority trials in cardiology: what clinicians need to know.

Clinical trials traditionally aim to show a new treatment is superior to placebo or standard treatment, that is, superiority trials. There is an increasing number of trials demonstrating a new treatment is non-inferior to standard treatment. The hypotheses, design and interpretation of non-inferiority trials are different to superiority trials.

Evaluation of coronary microvascular function by left ventricular contractile reserve with low-dose dobutamine echocardiography.

Aims: Coronary microvascular function has important diagnostic and prognostic implications but routine assessment is difficult. The index of microcirculatory resistance (IMR) is a reliable but invasive measure. We evaluated whether left ventricular contractile reserve (CR), measured with strain imaging on dobutamine echocardiography (DSE), is a reliable non-invasive measure of coronary microvascular function.

Left ventricular longitudinal and radial synchrony and their determinants in healthy subjects.

Objective: The reference values and impact of physiologic variables on echocardiographic quantification of left ventricular (LV) synchrony in a large series of healthy persons are unknown. This study prospectively investigated the impact of age, gender, and other physiologic parameters on LV longitudinal and radial synchrony.

Methods: LV longitudinal systolic and diastolic synchrony using tissue Doppler imaging were measured as the standard deviation of times to 12 regional peak myocardial systolic Sm (SDTs) and early diastolic Em (SDTe) velocities in 122 healthy volunteers (age 19-68 years, 64 men).

Adverse reactions of low osmolar non-ionic and ionic contrast media when used together or separately during percutaneous coronary intervention.

Background: Due to perceived advantages in the use of non-ionic contrast agents for diagnostic angiography and ionic agents for percutaneous coronary intervention (PCI), patients often receive various combinations of both types of agents.

Aim: To assess potential adverse effects of non-ionic and ionic contrast media when used together or separately during percutaneous coronary intervention.

Methods: We retrospectively evaluated the outcomes of 532 patients undergoing percutaneous coronary intervention in our institution.

Use of functional tests before angiography in patients with normal coronary arteries.

Background: Functional tests provide diagnostic and prognostic information in patients with suspected coronary disease and are recommended in investigating and guiding management of these patients. There is little data on their utilization, especially in patients with low to intermediate pre-test probability of disease.

Methods: From 6053 consecutive patients who underwent 6830 coronary angiograms for suspected coronary disease, 758 patients were subsequently found to have normal coronary arteries.