Risk factors for heart disease put expectant mothers at higher risk for adverse pregnancy outcomes (APO) as well as increased chances of high blood pressure years after delivery, according to a recent study published online in the Journal of the American Heart Association. The researchers found that women with an APO/gestational diabetes mellitus (1,102 women) had more atherogenic characteristics (obesity; higher blood pressure, diastolic blood pressure, glucose, insulin, triglycerides, and high-sensitivity C-reactive protein; lower high-density lipoprotein cholesterol) versus women without an APO/gestational diabetes mellitus.
A new study suggests that the use of and ‘awake’ management strategy of venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock is safe and effective. The study was conducted as a propensity score-matched analysis of a data from 7-year database of patients given peripheral VA-ECMO support. The patient population included 213 patients, 91 of whom were awake and 140 who were non-awake. After adjusting for propensity-matching, the patients in the awake VA-ECMO group had lower rates of pneumonia, tracheostomy, renal replacement therapy, and less antibiotic and sedative consumption. The authors also reported a reduction in 60-day (P=0.018) and 1-year mortality rates (P=0.021) compared to the non-awake group.
Patients who experience ST-elevation myocardial infarction (STEMI) after transcatheter aortic valve replacement (TAVR) tend to have higher mortality rates and worse outcomes, a new study suggests. The multicenter study included included 118 patients presenting with STEMI after TAVR (median of 255 days). The authors compared all-comer STEMI to procedural features of STEM after TAVR managed with percutaneous coronary intervention (PCI). The authors reported that median door-to-balloon time was higher in TAVR patients, along with longer procedural times, fluoroscopy times, dose-area product, and contrast volume (P<0.01 for all). Additionally, PCI failure occurred more frequently in TAVR recipients (P<0.001). In-hospital and late mortality rates were high in TAVR patients, as was Killip class ≥2 and PCI failure.