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Nature Reviews Cardiology - Issue - science feeds

Nature Reviews Cardiology provides physicians and academics with authoritative and topical discussions of key developments in the field.


Enhancing the value of clinical trials: the role of data sharing


Sharing of data from clinical trials provides the opportunity to improve the value and integrity of data analyses, but there are risks, and the primary duty for responsible reporting should reside with the investigators.

Interventional cardiology: Drug-eluting or bare-metal stents?


Patients receiving newer-generation drug-eluting stents have similar rates of death or spontaneous myocardial infarction than those receiving contemporary bare-metal stents, but the rate of repeat revascularization is lower with the use of drug-eluting stents. These findings come from the NORSTENT trial that was presented at

Thrombosis: Targeting factor XIa


Current anticoagulants act by inhibiting components of the extrinsic and common pathways of the coagulation cascade, which are essential for haemostasis. Therefore, the clinical effect of these anticoagulants is a balance between antithrombotic benefit and bleeding complications, and the need for safer anticoagulants remains. Now,

Atrial fibrillation: Catheter ablation in pole position for AF treatment


Radiofrequency catheter ablation (RFA) might be more effective than antiarrhythmic drug (AAD) therapy as a first-line treatment for paroxysmal atrial fibrillation (AF). This result comes from the 5-year follow-up of the multicentre, randomized, unblinded MANTRA-PAF trial. “These are promising findings indicating that RFA may prevent

Dyslipidaemia: Balancing the benefits and risks of statin therapy


“The numbers of people who avoid heart attacks and strokes by taking statin therapy are very much larger than the numbers who have side effects with it,” claims Rory Collins, lead author of a Review into the efficacy and safety of statin therapy published in

Prevention: No cardiovascular benefit with CPAP use in patients with OSA


In patients with cardiovascular disease and comorbid moderate-to-severe obstructive sleep apnoea (OSA), continuous positive airway pressure (CPAP) therapy did not prevent cardiovascular events, but improved mood, work productivity, and quality-of-life measures. This finding was presented at the ESC Congress 2016 in Rome, Italy by the

Dyslipidaemia: PCSK9 inhibitor reduces need for lipoprotein apheresis in familial hypercholesterolaemia


The need for lipoprotein apheresis — the removal of apoprotein B100-containing lipoproteins from the blood — is reduced in patients with heterozygous familial hypercholesterolaemia treated with the PCSK9 inhibitor alirocumab. In the double-blind ODYSSEY ESCAPE trial, 62 patients were randomly assigned to receive 150 mg

Dyslipidaemia: Benefit of dual lipid-lowering therapy after CABG surgery for ACS


Patients who have undergone coronary artery bypass graft (CABG) surgery for acute coronary syndrome (ACS) derive particular benefit from the addition of ezetimibe to statin therapy. This finding comes from an analysis of the IMPROVE-IT trial in which 18,134 patients with ACS were randomly allocated

Anticoagulation therapy: Use of edoxaban in cardioversion for AF


In the open-label, phase IIIb ENSURE-AF trial, 2,199 patients undergoing electrical cardioversion of atrial fibrillation (AF) were randomly assigned to receive the oral direct factor Xa inhibitor edoxaban (60 mg daily), or enoxaparin and warfarin. The primary efficacy and safety end points occurred in only

Heart failure: CA125-guided therapy reduces AHF rehospitalizations


Carbohydrate antigen 125 (CA125)-guided treatment of acute heart failure (AHF) reduces the rate of rehospitalizations compared with standard of care (SOC). This finding was reported by the CHANCE-HF investigators and published in JACC: Heart Failure.The majority of patients with AHF show symptoms and

Atrial fibrillation: New score for stroke risk


A novel biomarker-based risk score for predicting stroke in patients with atrial fibrillation (AF) shows good discriminative ability and consistently performed better than the guideline-recommended CHA2DS2-VASc score and the recently developed ATRIA stroke score, according to findings from a study published

Imaging: OCT-guided PCI improves procedural strategy


Optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) is linked with higher postprocedural fractional flow reserve (FFR) compared with angiography-guided PCI in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). This finding was presented at the ESC Congress 2016 in Rome, Italy and simultaneously published

Anticoagulation therapy: Reversal of factor Xa activity


Andexanet alfa (andexanet) rapidly reverses anti-factor Xa activity in patients with acute major bleeding associated with factor Xa inhibitor therapy. This finding comes from the ANNEXA-4 trial, which was presented at the ESC Congress 2016 in Rome, Italy, and simultaneously published in The New England

Acute coronary syndromes: Plaque erosion — antithrombotics without stenting


Conservative treatment with antithrombotic therapy without stenting might be a safe option for patients with acute coronary syndrome (ACS) caused by plaque erosion, according to findings from the EROSION trial presented at the ESC Congress 2016 in Rome, Italy. “This is a completely different approach

Acute coronary syndromes: Long-term benefits of invasive therapy


Invasive treatment of patients with non-ST-elevation acute coronary syndrome postpones death or next myocardial infarction by 18 months compared with noninvasive treatment, according to a follow-up analysis of the FRISC-II trial published in Lancet. This finding further supports revascularization as an early treatment strategy

Hypertension: Lower or higher blood-pressure targets for high-risk patients?


Blood-pressure lowering has undisputable benefits, but the optimal values to which blood pressure should be lowered are debated. Interpretation of recent trials is controversial, and post-hoc analyses to investigate the inflection point of the curve relating events to blood pressure are disputed. Meta-analyses of randomized trials and prospective, cohort studies might guide decision-making.

Antiplatelet therapy: What have we learned from the ANTARCTIC trial?


The ANTARCTIC trial does not provide sufficient evidence to refute the utility of platelet function monitoring in patients with high risk of coronary artery disease. Future trials on personalized antiplatelet therapy should try to address the limitations of previous studies.

Arterial access and arteriotomy site closure devices


Arterial access and haemostasis are fundamental aspects of procedures performed in the cardiac catheterization laboratory. The first description of arterial access for cardiac catheterization was in 1948, when surgical cut-down was used to access the radial artery. Over the next 2 decades, the preferred arteriotomy

Update on hypertrophic cardiomyopathy and a guide to the guidelines


Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiovascular disorder, affecting 1 in 500 individuals worldwide. Existing epidemiological studies might have underestimated the prevalence of HCM, however, owing to limited inclusion of individuals with early, incomplete phenotypic expression. Clinical manifestations of HCM include diastolic dysfunction,

Myocardial energy depletion and dynamic systolic dysfunction in hypertrophic cardiomyopathy


Evidence indicates that anatomical and physiological phenotypes of hypertrophic cardiomyopathy (HCM) stem from genetically mediated, inefficient cardiomyocyte energy utilization, and subsequent cellular energy depletion. However, HCM often presents clinically with normal left ventricular (LV) systolic function or hyperkinesia. If energy inefficiency is a feature of

Psychosocial and psychoneuroendocrinal aspects of Takotsubo syndrome


Great advances have been made in our understanding of Takotsubo syndrome in the past decade, but the aetiology of the condition remains incompletely understood. The most established theory, that catecholamine-mediated myocardial stunning is provoked by emotional or physiological stress, is supported by the presence of

Reply: Platelet noradrenaline uptake is unrelated to renal denervation


We read with interest the Perspectives article by Gulati and colleagues (The rise, fall, and possible resurrection of renal denervation. Nat. Rev. Cardiol.13, 238–244; 2016). The subsequent correspondence by Shi-Sheng Zhou and Yiming Zhou (Renal denervation for resistant hypertension: the wrong

Reply: Platelet noradrenaline overload — cause of increased noradrenaline spillover in hypertension?


We thank Barber-Chamoux and Esler for their Reply (Platelet noradrenaline uptake is unrelated to renal denervation. Nat. Rev. Cardiol.doi:10.1038/nrcardio.2016.144) to our Correspondence (Renal denervation for resistant hypertension: the wrong target? Nat. Rev. Cardiol.13, 388; 2016), in which we