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August 29, 2019
News From Medscape
The following recommended articles on Medscape.com are freely available through the partnership between ABC and Medscape, no registration or login required.
FDA Expands Approval for TAVR Valves to Low-Risk Patients
The US Food and Drug Administration (FDA) has expanded the indication for several transcatheter heart valves to include patients with severe aortic valve stenosis who are at low risk for death or major complications associated with open-heart surgery to replace the damaged valves. These transcatheter valves — the Sapien 3 and Sapien 3 Ultra from Edwards Lifesciences and the CoreValve Evolut R and CoreValve Evolut PRO from Medtronic CoreValve LLC — were previously indicated only for patients at intermediate or higher risk for death or major complications during open-heart surgery.
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AHA Scientific Statement on Critical Limb Ischemia
A new scientific statement from the American Heart Association (AHA) highlights the importance of early diagnosis and treatment of critical limb ischemia (CLI) and addresses the strengths and limitations of noninvasive techniques and devices for assessing blood flow and other diagnostic considerations. The statement was published online August 12 in Circulation. CLI is a severe manifestation of peripheral artery disease (PAD) and the major cause of nontraumatic leg amputation.
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10 Reasons Why Some Doctors Earn More (Even in the Same Specialty)
It's not uncommon for physicians to wonder why some colleagues or physician friends seem to have so much more money. Although some doctors may just be more flamboyant spenders, others are probably earning a higher income. Still, as one physician commented, "I look around at what some of my colleagues have, and I'm thinking, 'What did I do wrong?'" There are large differences in wealth and income among physicians, even those within the same specialty.
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Commentary: ACC Pathway Empowers Cardiologists to Use Diabetes Drugs for Heart Disease
Today I'm going to discuss the American College of Cardiology (ACC) Expert Consensus Decision Pathway on novel therapies—the SGLT2 inhibitors and GLP-1 receptor agonists—for cardiovascular risk reduction in patients with type 2 diabetes and atherosclerotic cardiovascular disease. I joke that this is about cardiologists who finally want to be endocrinologists. In fact, I think they were jealous of us all along.
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At Top Medical Journals, Women Are Gaining Ground — Slowly
Now that women make up a little more than half of the current medical school class, according to the Association of American Medical Colleges, the times they are a changing, though not at the same pace everywhere.
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Items of Interest
Polypill Prevents CV Events in Rural Iran: Can it Work in the U.S?
Fixed-dose oral combination therapy in a single once-daily tablet reduced major cardiovascular events in a trial powered for clinical outcomes. Fewer rural Iranians randomized to long-term "polypill" use had a hospitalization for acute coronary syndrome, fatal MI, sudden death, heart failure, coronary artery revascularization, or stroke over 5 years than did controls. Next question: could 4-drug tablet work in the U.S.?
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Facebook Posts Better at Predicting Diabetes, Mental Health Than Demographic Info
Language in Facebook posts may help identify conditions such as diabetes, anxiety, depression and psychosis in patients, according to a study from Penn Medicine and Stony Brook University researchers. It's believed that language in posts could be indicators of disease and, with patient consent, could be monitored just like physical symptoms. This study was published in PLOS ONE.
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Burden of In-Hospital Cardiac Arrest 38% Higher Than Previously Thought
Upswing Seen in US Adult and Pediatric In-Hospital Cardiac Arrests. Research published in Circulation: Cardiovascular Quality and Outcomes suggests the public health burden of pulseless in-hospital cardiac arrests is around 38% higher in adults and 18% higher in children than was previously believed.
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Scientific Statement on Predicting Survival For Cardiac Arrest Survivors
To better facilitate research on appropriately determining prognosis after cardiac arrest and to establish better treatments for recovering from brain injury, a working group composed of a Johns Hopkins Medicine physician and American Heart Association (AHA) experts have released a scientific statement that provides best practices on how to predict recovery in comatose survivors.
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Fragmented TAVR Care Common, Linked to Death and Readmission
Nearly 60% of patients discharged after undergoing TAVR will be readmitted to a different hospital in the first 90 days, according to data from the STS/ACC TVT Registry. At 1 year, this type of fragmented care was associated with a greater likelihood of death and all-cause readmission compared with continuous care at the same center where the TAVR was performed. Living farther way and needing to drive longer were found to significantly increase care fragmentation.
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Paper Heart Valves Help Scientists Study Calcifying Diseases
An experimental device made from layered filter paper is helping Rice University bioengineers study calcifying heart diseases. The filter paper is structured in a way that mimics the layering of aortic heart valves, recreating the means by which cells spread through cardiac tissue in a laboratory setting. It may not look much like a heart valve, but in practice it simulates the proliferation process in the same way. Given the device’s ability to accurately model the functions of a heart valve’s layers, the research team hopes it could one day support the development of a non-invasive medication for heart disease.
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NIH Funds Eleven Research Centers in Minority Institutions
The National Institute on Minority Health and Health Disparities (NIMHD), part of the National Institutes of Health, has funded three new awards and renewed the awards of eight institutions previously funded under the Research Centers in Minority Institutions (RCMI) Specialized Centers program. The RCMI develops and strengthens the research infrastructure necessary to conduct state-of-the-art biomedical research and foster the next generation of researchers from underrepresented populations. The centers will share approximately $187 million over their five-year project periods, subject to available funds.
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FDA Gives Fast Track Status to AstraZeneca's Diabetes Drug Farxiga
AstraZeneca Plc said on Tuesday that the U.S. Food and Drug Administration has granted fast track status for the development of its diabetes drug Farxiga (Dapagliflozin) to prevent heart and kidney failure in patients with chronic kidney disease (CKD).
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DAPA-HF: Dapagliflozin Scores a Win in Heart Failure
Dapagliflozin (Farxiga), originally developed for the treatment of type 2 diabetes, has become the first drug in its class to show a significant clinical benefit in a phase III trial of patients with chronic heart failure with reduced ejection fraction who were not required to have diabetes, drugmaker AstraZeneca announced Tuesday. The full results will be presented at the upcoming 2019 European Society of Cardiology Congress in Paris, France.
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Is Your Physician Colleague At Risk For Suicide? Signs to Look For
Two-thirds of people who attempt suicide do so after having seen a physician within the previous month. It’s a strong statement about the importance of being alert for telltale signals. That extends to high-risk individuals who aren’t patients, but who many physicians see every day—their colleagues. Recently released CME covering suicide screening and prevention for patients also addresses what physicians should look for among their colleagues—and themselves—to reduce the chances of suicide. The CME video, “Identifying and Responding to Suicide Risk,” is designated by the AMA for one AMA PRA Category 1 Credit™.
Featured Articles by Members
ABC Members: We welcome your published research submissions and articles for inclusion in future issues of Clinical Updates and Insights. Email Rachel Williams at rwilliams@abcardio.org and please attach file or include links to the original published work and/or abstract.
Health Literacy Burden Is Associated With Access to Liver Transplantation
Co-authored by Faith Njoku (with Yanik Bababekov; Ya-Ching Hung; Charles Rickert; Bonnie Cao; Joel Adler; Angela Brega; James Pomposelli; David Chang and Heidi Yeh)
Getting listed for liver transplantation is a complex process. Institutional health literacy may influence the ability of patients with limited educational attainment (EA) to list. As an easily accessible indicator of institutional health literacy, we measured the understandability of liver transplant center education websites and assessed whether there was any association with the percentage of low EA patients on their waitlists.
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Effects of APOC3 Heterozygous Deficiency on Plasma Lipid and Lipoprotein Metabolism
Co-authored by Lead Author Gissette Reyes-Soffer (with Carol Sztalryd, Richard B. Horenstein, Stephen Holleran, Anastasiya Matveyenko, Tiffany Thomas, Renu Nandakumar, Colleen Ngai, Wahida Karmally, Henry N. Ginsberg, et al.)
Apo (apolipoprotein) CIII inhibits lipoprotein lipase (LpL)-mediated lipolysis of VLDL (very-low-density lipoprotein) triglyceride (TG) and decreases hepatic uptake of VLDL remnants. The discovery that 5% of Lancaster Old Order Amish are heterozygous for the APOC3 R19X null mutation provided the opportunity to determine the effects of a naturally occurring reduction in apo CIII levels on the metabolism of atherogenic containing lipoproteins.
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Emergent Transcatheter Aortic Valve Replacement for Aortic Insufficiency
Co-authored by Christopher Irobunda, MD (John M. Trahanas, MD, Benjamin S. Van Boxtel, MD, Steven E. Miller, MD, Susheel K. Kodali, MD and Isaac George, MD)
There are few case reports in the literature of transcatheter aortic valve replacement used as emergent therapy for aortic insufficiency. We present a case in which transcatheter aortic valve replacement was implemented successfully as a salvage therapy in a hemodynamically unstable patient having aortic insufficiency as a result of a torn bioprosthetic leaflet during an unrelated abdominal operation. The successful use of this technique in a noncardiac operating room allowed the patient to be placed on extracorporeal support and ultimately to be discharged home.
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We LOVE to LEARN how our ABC Members are making a difference! Please Share. Giving a keynote speech? Presenting at a Grand Round? Receiving an Award? Interviewed by the Press? Published in a journal? Presenter or Panelist at a Conference? Graduating? Email Rachel Williams at rwilliams@abcardio.org or please tag or DM us on Facebook, Twitter or Instagram with links/details, so we can spotlight your excellence in our newsletter!

Announcements
NHLBI Seeking exceptional candidates. Scientific excellence. Passion for leading change & leading people.
Send CV to lhellinger@nhlbi.nih.gov.
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ABC Members Speaking for Named Lectures
at ESC Congress 2019

George A. Mensah, MD (Bethesda, USA)
Saturday 31 August | 13:05


The 2019 Bongani Mayosi Memorial Lecture:
Cardiovascular health research, training, and capacity building in low-income and middle-income countries


Roxana Mehran, MD (New York, USA)
Monday 2 September | 15:50


ESC Andreas Grüntzig Lecture
on Interventional Cardiology:

The evolution of dual antiplatelets therapies/antithrombotic regimens in interventional cardiology: A thirty year journey


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Upcoming Events
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Richard Allen Williams, M.D., FACC, FAHA, FACP, President
Past President of the National Medical Association

Presents


The 3rd Annual Minority Health Summit and Networking Luncheon
Theme: “Black Health Matters: DO YOU CARE?”

Thursday, September 12, 2019
10:00 a.m. - 2:00 p.m.

Renaissance Washington, DC Downtown Hotel
999 9th Street NW, Washington, DC 20001

Sponsored by




Tax deductible contribution: $65 per person

Visit here to purchase tickets


Featuring presentations by thought leaders on:
African-American Medical School Enrollment Crisis
Mental Health Care
Chronic Kidney Disease
Obesity Epidemic
Hypertension and Heart Disease
HIV/AIDS
Sickle Cell Anemia
Opioid Drug Crisis Is Killing More Blacks
Healthcare Reform


Several public officials and attendees of the Congressional Black Caucus Foundation's 49th Annual Legislative Conference will be present.

Tax deductible contribution: $65 per person

Visit here to purchase tickets


For more information, please email mhinst3425@gmail.com.


Policy Pulse
Dinner Program


Fri, Oct 11 2019
6:00 PM PST


InterContinental Los
Angeles Downtown
Fall Symposium
“Current Trends in Cardiovascular and Cardio-metabolic Disease Prevention, and Updates in Cardiac Devices and Advanced Cardiac Failure”

Sat, Oct 12 2019
8:00 AM - 1:00 PM PST


InterContinental Los
Angeles Downtown
10th Annual Spirit of the Heart Awards Program

Sat, Oct 12 2019
6:00 PM PST


InterContinental Los
Angeles Downtown

ACCOMMODATIONS

InterContinental Los Angeles Downtown
900 Wilshire Blvd
Los Angeles, CA 90017





THE WAIT IS OVER: SEE WHAT TCT 2019 HAS TO OFFER!

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Mark your calendar: The 14th Annual Cardiometabolic Health Congress is right around the corner!
Combined, diabetes, obesity, and insulin resistance are the most common cause of preventable death in the United States--responsible for millions of deaths and more than $600 billion in health care costs. As the largest, US-based, multidisciplinary conference centered on the management and prevention of cardiovascular and metabolic disease, CMHC is a can’t-miss event for health care practitioners committed to joining the fight against cardiometabolic disease.





Friday, October 11
Cardiovascular Mechanisms and Safety of Established and Emerging Peptide Therapies
Keynote: Daniel J. Drucker, MD


FDA Update and Late Breaking Trials
Christie M. Ballantyne, MD; Deepak L. Bhatt, MD, MPH; Robert H. Eckel, MD; Keith C. Ferdinand, MD; Jay S. Skyler, MD


Saturday, October 12
Treatment of High-Risk Patients with CVD and Elevated TGs: REDUCE-IT and Beyond
Deepak L. Bhatt, MD, MPH


Sunday, October 13
NASH/NAFLD
Christos S. Mantzoros, MD, DSc


Through our partnership with CMHC and mutually aligned goals, we are offering an exclusive discount to our network. Insert coupon code ABC19 to save $100 on your registration!





Hotel Reservations for ABC @ AHA Scientific Sessions
Philadelphia, Pennsylvania | November 15-18, 2019

The Logan
1 Logan Square | Philadelphia, PA
$329/night


BOOK YOUR ROOM TODAY
Deadline for Reservations: September 11th



Register for ABC @ AHA Events


Saturday, November 16th | Philadelphia Marriott Downtown
1201 Market Street, Philadelphia, PA 19107

‘A New Beat’ Reception | 5:15pm – 6:00pm
ABC General Membership Dinner Meeting | 6:00pm – 7:00pm
ABC’s Dr. Walter M. Booker, Sr. Memorial Symposium | 7:00pm – 9:00pm
“Navigating and Translating Guideline Directed Therapies and Interventions to Real-World Management of Cardiovascular Disease:
A Case Based Analysis of Therapeutic Conundrums”

Co-Chairs: John M. Fontaine, MD, MBA & Gerald DeVaughn, MD


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