General Anesthesia Ups Heart Failure Risk After Valve Surgery

Researchers conducted a retrospective observational cohort study using data from the TriNetX Global Collaborative Network, including adults who underwent their first TAVR from 2015 to 2024.
Patients either received general or nongeneral anesthesia, the latter of which was comprised of moderate sedation or nerve block, regional, epidural, local, or injection anesthesia.
A target trial emulation framework was used to compare the two types of anesthesia, and 1:1 propensity score matching was used to balance baseline characteristics.
A total of 1793 patients were included in each anesthesia group (mean age, 78.7 years; 44.6% women; more than 90% White individuals).
Clinical outcomes assessed at 30, 90, and 365 days included all-cause mortality, acute kidney injury, major vascular complications, respiratory failure, and hospital readmission.

At 1 year, the incidence of heart failure was higher in the general anesthesia group than in those who received nongeneral anesthesia (HR, 1.44; P = .023).
At 1 month after TAVR, all-cause mortality did not differ between patient groups (hazard ratio [HR], 1.19; P = .300), and no differences were observed in rates of stroke, kidney injury, myocardial infarction, atrial fibrillation, major vascular complications, heart failure, or respiratory failure.
At 90 and 365 days, all-cause mortality and most major complications did not differ between groups.

New horizons of cardiotherapy Since the introduction of the first implantable stimulator and defibrillator (ICD), cardiological science has advanced far. ICDs are highly effective, but their main disadvantage is the complications associated with the electrodes. To avoid the need for venous access and complications caused by transvenous electrodes, a fully subcutaneous ICD system (pc-ICD) was developed.

Integrated model of medical care for the treatment of ST-segment elevation myocardial infarction in China A new study involving 6817 patients with acute ST-segment elevation myocardial infarction has shown that every minute of life counts. Chinese scientists have tested an integrated aid model. This study assessed the impact of a comprehensive IMPST treatment strategy in China.

The relationship between low‑density lipoprotein cholesterol, the apolipoprotein B ratio, and sarcopenia The ratio of low‑density lipoprotein cholesterol to apolipoprotein B (LDL‑C/ApoB) (LDL-C/ApoB), which reflects the cholesterol content in an atherogenic lipoprotein particle, may serve as a new biomarker for the risk of sarcopenia. Scientists conducted a study based on data from the largest American representative survey (NHANES).

Blood Pressure Variability Linked to Cognitive Decline in High-Risk Adults Higher visit-to-visit systolic blood pressure variability was independently associated with faster cognitive decline in adults at elevated cardiovascular risk, regardless of mean blood pressure levels in a study.

General Anesthesia Ups Heart Failure Risk After Valve Surgery Transcatheter aortic valve replacement (TAVR) patients who received general anesthesia had a higher incidence of heart failure at 1 year than those who received nongeneral anesthesia.

CARDIOPROGRESS
Foundation for the advancement of cardiology