Study: Robotic PCI reduces radiation exposure

Vascular robotics-focused Corindus Inc., a Waltham, Mass.-based company that is part of Siemens Healthineers AG, said that Circulation: Cardiovascular Interventions has published clinical results from a comparative study between robotic percutaneous coronary intervention (PCI) and manual PCI. Of note, robotic PCI with the Corpath Grx system reduced patient exposure to radiation by 20% vs. manual PCI with no increase in fluoroscopy time or contrast utilization. The study featured 996 consecutive patients, 310 of whom underwent robotic PCI and 686 manual PCI. The study, which was published May 14, 2020, sought to measure air kerma, dose area product, fluoroscopy time, volume of contrast and total procedural time. According to the company, the solution's design protects physicians by removing them from the radiation field. Further, it has been shown to reduce radiation exposure by more than 95%.

COVID-19 and cardiovascular problems

Patients with COVID-19 can experience a range of cardiovascular issues. Unfortunately, treatments for the condition also can interact with medicines used to manage patients’ existing cardiovascular conditions. To that end, a new paper from University of Virginia (UVA) Health’s William Brady and colleagues aims to serve as a guide for clinicians treating patients who may or are known to have COVID-19. “In writing this article, we hope to increase emergency physicians’ knowledge and awareness of this new pathogen and its impact on the cardiovascular system,” said Brady, of UVA’s department of emergency medicine. “As we encounter more and more patients with COVID-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular. The rate of learning on this area is amazingly rapid. Information continues to change weekly, if not daily.” The authors highlighted studies that found that almost a quarter of COVID-19 patients were suffering from acute heart failure when first diagnosed. In addition, they described potential drug interactions, including hydroxychloroquine interacting with medications designed to regulate heart rhythm. Also of note, remdesivir can cause low blood pressure and abnormal heart rhythm. Their findings were published April 17, 2020, in the American Journal of Emergency Medicine.

Heart attack prevention falls short for stroke, PAD patients

Research presented at the American Heart Association’s Quality of Care & Outcomes Research Scientific Sessions 2020, which took place virtually May 15 and 16, found that patients with peripheral artery disease (PAD) or stroke were less likely than those with coronary artery disease to receive recommended treatments to prevent a heart attack. Guidelines from 2016 recommend aspirin for patients with symptomatic PAD to prevent major adverse cardiovascular events. Another set of guidelines from 2018 noted that statin therapy reduces the risk of atherosclerotic events. The researchers compared more than 14,000 U.S. adults – average age 65 – enrolled in the 2006-2015 Medical Expenditure Panel Survey. Slightly more than half of the patients were men, and all had either coronary artery disease, stroke or PAD. Compared to those with coronary artery disease, participants with PAD were twice more likely to report no statin use and three times more likely to report no aspirin use. They also had the highest annual total out-of-pocket expenditures among the three atherosclerotic conditions. In addition, PAD participants with stroke were more than twice as likely to report no statin or aspirin use. Finally, those with stroke were more likely to report poor patient-provider communication and health care satisfaction, as well as more emergency room visits. “Our study highlights a missed opportunity for implementing life-saving preventive medications among these high-risk individuals,” said senior study author Erin Michos, associate professor of medicine at the Ciccarone Center for the Prevention of Cardiovascular Disease at The Johns Hopkins University School of Medicine in Baltimore. “Peripheral artery disease and stroke should generally be treated with the same secondary prevention medications as coronary artery disease.”

Integrated herpesvirus-6 is a pre-eclampsia risk factor

Researchers from Cambridge University have identified integrated human herpesvirus 6 (HHV6) in fetuses as a risk factor for the development of pre-eclampsia by mothers. So far, there is no way to predict who is at risk for developing pre-eclampsia, but epidemiological studies have demonstrated that pregnancies fathered by some men are more likely to lead to pre-eclampsia. In their work, the authors investigated the presence of inherited HHV6, which is present in about 1% of the population, because chronic viral infection can contribute to organ failure in other contexts. They demonstrated that pregnancies in which the fetus had integrated HHV6 had a threefold increased likelihood of resulting in pre-eclampsia. In addition to its association with pre-eclampsia, previous work has demonstrated that integrated HHV6 predisposes to the development of heart disease, and that women who develop pre-eclampsia also have an elevated risk of heart disease. The study, which appeared in the May 4, 2020, online issue of Nature Genetics, suggests that pre-eclampsia and heart disease risk may be linked via HHV6.

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