After Lariat LAA Ligater Disappoints in aMAZE, is a Path Ahead Still Possible?
Adjunctive left atrial appendage (LAA) ligation failed to increase the efficacy of catheter pulmonary vein isolation (PVI) in the aMAZE trial, though it appeared safe enough for further clinical investigation. In a population of people with nonparoxysmal atrial fibrillation (Afib), LAA ligation plus PVI was associated with no better primary effectiveness by 12 months — […]
Most People With TB Report No Persistent Cough
A significant proportion of people in the community with pulmonary tuberculosis (TB) have subclinical disease, according to a meta-analysis involving survey studies across Africa and Asia. In adjusted analyses, 82.8% (95% CI 78.6-86.6) of participants with TB reported no persistent cough and 62.5% (95% CI 56.6-68.7) reported no cough at all, according to Frank Cobelens, […]
Female Reproductive Factors Linked to COPD Risk
Female reproductive factors were associated with risk of chronic obstructive pulmonary disease (COPD), including age at menarche, number of children, miscarriage, stillbirth, and age at natural menopause, according to an analysis of three cohorts. Among nearly 300,000 women, a U-shaped association was observed between age at menarche and COPD (≤11 vs 13 years: HR 1.17, […]
Gabapentinoids in COPD Patients May Raise Risk for Severe Exacerbations
Gabapentinoid use in patients with chronic obstructive pulmonary disease (COPD) was associated with a higher risk for severe exacerbations, a population-based cohort study from Canada indicated. Among more than 27,000 COPD patients, those who started therapy with the anticonvulsant for either epilepsy, neuropathic pain, or some other form of chronic pain had a 39% greater […]
Mortality Reaches 20% for Hospitalized Patients With High-Risk Pulmonary Embolism
Mortality rates were high among patients with high-risk pulmonary embolism (PE), with the worst outcomes in those with hemodynamic collapse, according to a retrospective analysis of the Pulmonary Embolism Response Team (PERT) Consortium Registry. In nearly 5,800 patients, in-hospital mortality occurred over five times more frequently among those with high-risk PE compared with those with […]
High-Sensitivity Troponin Test May Overestimate Risk in PE
For patients with hemodynamically stable pulmonary embolism (PE), there was no prognostic value found for the mild elevations in cardiac troponin captured only on high-sensitivity assays at the emergency room, based on an exploratory analysis of the PROTECT cohort study. Whereas a finding of conventional cardiac troponin I (cTnI) elevation was associated with a complicated […]
High-Sensitivity Troponin Test May Overestimate Risk in PE
For patients with hemodynamically stable pulmonary embolism (PE), there was no prognostic value found for the mild elevations in cardiac troponin captured only on high-sensitivity assays at the emergency room, based on an exploratory analysis of the PROTECT cohort study. Whereas a finding of conventional cardiac troponin I (cTnI) elevation was associated with a complicated […]
Acetazolamide May Help COPD Patients Reach New Heights
Acetazolamide may prevent some patients with chronic obstructive pulmonary disease (COPD) from suffering altitude-related adverse health effects (ARAHE) when traveling, a randomized controlled trial showed. In patients with moderate to severe COPD traveling to and staying for 2 days at 3,100 m, ARAHE occurred in 50% of those taking acetazolamide compared with 74% of those […]
Shorter TB Regimen Misses the Mark
Shorter high-dose rifampicin regimens proved safe for treating pulmonary tuberculosis (TB), but failed to demonstrate noninferiority compared with the standard 6-month regimen, a phase III trial found. For the primary efficacy outcome, an absolute 6.3% more adults receiving a 4-month regimen that included the highest dose of rifampicin had an unfavorable outcome at 12 to […]
Surveillance Still Not an Option for Many With Subsegmental Pulmonary Embolism
Only a narrow pool of outpatients with acute subsegmental pulmonary embolism (PE) may be candidates for structured surveillance without anticoagulation based on current guideline restrictions, a retrospective study found. At one large integrated health system, only one person out of 229 low-risk adults received structured surveillance for subsegmental PE — a “remarkably low” 0.4% over […]