The use of percutaneous ventricular assist devices (PVADs) has grown by leaps and bounds in recent years, but a study published online March 30 in JAMA Internal Medicine casts doubt on their overall benefit, given the high costs and mortality rates.
Multisite patient-centered disease management may not be able to compete with the level of care patients already receive at Veterans Affairs medical centers. At one year, cardiomyopathy scores for heart failure patients in an intervention arm were no better than those getting usual care.
While guidelines warn against giving anticoagulation to patients with heart failure but without atrial fibrillation, there may be some evidence that a subgroup of these patients may be at increased risk for stroke and could benefit from additional therapy.
A simple blood test done immediately after cardiac surgery may provide an effective indication of a patient’s postoperative stroke risk. An acutely elevated blood urea nitrogen (BUN) level after an operation was “by far” the most powerful predictor of postcardiac surgical stroke in a case-control study.