Cardio Round-up: Some Athletes Retain Damage After COVID-19; Empagliflozin Fast-Tracked; and More

On-Scene Resuscitation Better than Intra-arrest Transport?

This study, published in JAMA, included consecutive nontraumatic adult EMS-treated patients who suffered out-of-hospital cardiac arrest. The propensity-matched cohort included 27,705 patients with a primary outcome of interest of survival to hospital discharge. In the propensity-matched cohort, survival to hospital discharge was 4.0% in patients undergoing intra-arrest transport and 8.5% in those receiving on-scene resuscitation (a risk difference of 4.6% [95% CI, 4.0% to 5.1%]). For the secondary outcome of a favorable neurological outcome, it occurred in 2.9% of patients undergoing intra-arrest transportation compared with 7.1% receiving on-scene treatment (risk difference, 4.2%; 95% CI, 3.5% to 4.9%).

On-scene Treatment Bests Routine Transport to Hospital for Cardiac Arrest

FDA Green Lights FastTrack for Empagliflozin

“Ischemic heart disease is the leading cause of death and disability in the U.S. Myocardial infarction, or heart attack, is the deadliest acute manifestation of ischemic heart disease, and treatment options are urgently needed to help improve outcomes,” Mohamed Eid, MD, MPH, MHA, vice president, Clinical Development & Medical Affairs, Cardio-Metabolism & Respiratory Medicine, Boehringer Ingelheim Pharmaceuticals, Inc., said in a press release. “We look forward to working closely with the FDA as we explore the potential for Jardiance to improve survival and prevent hospitalization for heart failure for adults who have had a heart attack, through our EMPACT-MI trial.”

FDA OKs FasTrack for Empagliflozin in Heart Failure, Acute MI Patients

Routine Biomarker Screening Not Beneficial for COVID-19 Patients

Publishing the findings in a research letter in Circulation, this research team conducted a prospective, observational study that included consecutive adult patients (n=135) hospitalized with COVID-19 in Norway between March 18 and May 4, 2020. The primary endpoint of interest was a composite of hospital mortality and admission to the ICU with a need for mechanical ventilation and lasting more than 24 hours. Forty patients reached the primary endpoint, of whom 36 went to the ICU and eight died. The authors reported that NEWS score at admission, white blood cell count, CRP, ferritin, LD, D-dimer, NT-proBNP and high-sensitivity cardiac troponin were all higher in patients who achieved the primary endpoint. The link was attenuated, however, after adjustment for demographics, and further when adjusting for factors in the second and third models.

COVID-MECH: CVD Biomarker Screening Yields No Additional Information

Some Athletes Retain Cardiac Damage From COVID-19 Infection

Researchers for this study performed comprehensive cardiac MR examinations in  26 competitive collegiate athletes who were referred to the sports medicine clinical after testing positive for COVID-19. The sports included football, soccer, lacrosse, basketball, and track. Four of the athletes (15%, all male) showed cardiac MR findings “consistent with myocarditis based on the presence of two main features of the updated Lake Louise Criteria: myocardial edema by elevated T23 signal and myocardial injury by presence of nonischemic late gadolinium enhancement.” Pericardial effusion was present in two of the athletes with evidence of myocarditis. The researchers noted that while the results were in line with other research showing lingering cardiac injury in some individuals recovering from COVID-19, the overall data on the matter are still unclear.

Some College Athletes who Recovered from COVID-19 Still Showed Signs of Cardiac Injury