Cardiology Today's top 5 articles posted in July

Cardiology Today compiled a list of the top 5 stories posted in July.

This month, our readers were most interested in CV risk for people with normal weight but central obesity, the promise of low-dose anticoagulation beyond standard uses, the ability of triglycerides in LDL to predict CV events, the results of the NODE-1 study, the decline in use of implantable cardioverters not meeting Medicare criteria and more.

Normal weight with central obesity increases CV risk

SANTA ANA PUEBLO, N.M. — Patients who had normal weight and central obesity had an increased CV risk compared with those with normal BMI without central fat distribution, according to data presented at the American Society for Preventive Cardiology Congress on CVD.

Jose R. Medina-Inojosa, MD, MSc, senior research fellow in preventive cardiology at Mayo Clinic and International Clinical Research Center, St. Anne’s University Hospital, Brno, Czech Republic, and colleagues analyzed data from 1,692 patients (mean age, 61 years; 48% men). Those with HF, CAD, COPD, underweight or death from cancer within 5 years were excluded. Patients underwent a clinical examination and anthropometric measurements between 1997 and 2000, where BMI was calculated and central obesity was determined by waist-to-hip ratio (at least 0.85 for women and at least 0.9 for men).

Low-dose anticoagulation shows promise beyond stroke, VTE prevention

Use of oral anticoagulants is expanding beyond stroke prevention in patients with atrial fibrillation and venous thromboembolism prevention to treatment in coronary and peripheral artery disease.

One particular study in a new population that received attention was COMPASS, published in The New England Journal of Medicine in 2017, which showed that patients with stable atherosclerotic vascular disease treated with 2.5 mg rivaroxaban (Xarelto, Janssen) twice per day plus aspirin had a decreased risk for CV death, stroke or MI compared with those treated with aspirin alone. This benefit, however, came with an increased risk for major bleeding events.

LDL triglycerides predict CVD events

Triglycerides in LDL predicted CVD events and were associated with a genetic variant, according to new findings.

The researchers assessed whether triglycerides in LDL and remnant-like particle cholesterol were associated with incident CVD and genetic variants in 9,334 participants (5,527 women) from the ARIC study without CVD at baseline.

NODE-1: Etripamil may halt supraventricular tachycardia

Etripamil, a novel fast-acting calcium channel blocker administered via nasal spray, quickly terminated supraventricular tachycardia, according to the results of the NODE-1 trial.

Researchers performed a phase 2 study during electrophysiological testing of 104 patients (median age, 55 years; 57% women) with supraventricular tachycardia who were induced into supraventricular tachycardia before catheter ablation. Patients were randomly assigned to placebo or one of four doses — 35 mg, 70 mg, 105 mg or 140 mg — of etripamil (Milestone Pharmaceuticals) after 5 minutes in supraventricular tachycardia.

Use of ICDs not meeting Medicare criteria declined after DOJ investigation

After a U.S. Department of Justice investigation into implantable cardioverter defibrillators, there was a decrease in the volume of ICDs for primary prevention and in the proportion of devices that did not meet CMS National Coverage Determination from 2007 to 2015.

This decrease was substantially larger at hospitals that reached settlements from the investigation performed by the DOJ, according to the analysis published in JAMA.