Plus, get ready for high sensitivity cardiac Troponin assays in practice.
Laboratory medicine experts discovered a new lipid biomarker panel to detect heart failure with reduced ejection fraction (HFrEF) even before symptoms present, with "much greater certainty than standard tests for this condition," according to a January 5 press release from the American Association for Clinical Chemistry (AACC).
The January issue of the AACC's journal, Clinical Chemistry focuses on cardiovascular disease and features research reflecting a "growing understanding of the molecular signatures of heart disease," according to the press release, and a trend towards developing "more precise tests for the early diagnosis, monitoring, and targeted treatment."
The study in question identified three new cardiac lipid biomarkers, a cardiac lipid panel (CLP), which "significantly improved diagnostic performance" when combined with the current standard biomarker approach for diagnosing heart failure, NT-proBNP.
Continue reading AACC scientists identify new cardiac biomarker
Results from the CE-MARC 2 trial, announced today at the European Society of Cardiology (ESC) Congress, suggest that unnecessary angiography could be significantly reduced by favoring noninvasive cardiovascular magnetic resonance (CMR) imaging or single photon emission computed tomography (SPECT) to initially investigate patients with suspected coronary artery disease (CAD).
These findings could have an "important impact on referral rates for invasive coronary angiography," says the ESC press release.
Continue reading Broader CMR or SPECT imaging reduces unnecessary angiography
Even in low-volume VA centers, mitral valve repair outcomes best replacement.
A large multi-center study presented at the 96th American Association for Thoracic Surgery Annual Meeting followed trends in mitral valve (MV) surgeries in the Veterans Administration Health System from 2001-2013 and provided further evidence to support the use of mitral valve repair over mitral valve replacement in patients with degenerative MV disease.
"MVRepair has a greater short-term protective effect against mortality than MVReplace has in patients with primary degenerative MR," write the authors. "Despite this survival advantage, the rate of MVRepair is low at some centers; therefore, there is clearly an opportunity for quality improvement."
Beyond a survival advantage, mitral valve repair was also found to result in fewer complications and shorter hospital stays.
Is that success dependent on volume? Not necessarily.
Continue reading Mitral Valve Repair: “An Opportunity for Quality Improvement”
"Exercise stress electrocardiography (ExECG) is underutilized as the initial test modality in patients with interpretable electrocardiograms who are able to exercise. Although stress myocardial imaging techniques provide valuable diagnostic and prognostic information, variables derived from ExECG can yield substantial data for risk stratification, either supplementary to imaging variables or without concurrent imaging. (abstract)
What's your diagnostic test workflow?
A recent paper in JACC: Cardiovascular Imaging reviewed literature on the latest advances in exercise stress electrocardiography (ExECG) and argued that despite the ACC's recommendations, the test is still "underutilized" as the initial diagnostic test modality for suspected coronary artery disease.
Continue reading Is ExECG your default diagnostic?