Concerning gaps in post-TAVI antithrombosis therapy
Almost one third of Australian patients are not receiving antithrombotic medicines after discharge post-TAVI suggesting suboptimal adherence to best practice care.
A retrospective study in NSW found 66.4% of patients were dispensed an antithrombotic medicine within 30 days of discharge and 77.8% of patients within 60 days of discharge.
Clopiogrel was the most commonly dispensed antithrombotic medicine.
The strongest predictor of post-discharge dispensing was the dispensing of antithrombotic (RR 1.07; 95% CI 1.03–1.11) or ACE/ARB medicines (RR 1.04; 95% CI 1.00–1.07) in the 6 months prior to hospitalisation.
“In patients exposed to antithrombotic medicines in the 6 months prior to TAVI, 61.8% were dispensed the same therapy in the 30 days post discharge, and 68.3% of those who had prior exposure to multiple antithrombotic medicines were dispensed at least one of those medicines,” the study said.
Read more in Heart, Lung and Circulation
Mitral calcification clue to valvular disease
Mitral valve dysfunction is more than twice as prevalent in patients with mitral annulus calcification (MAC) than those without MAC, according to US research.
The study of more than 24,000 patients evaluated with transthoracic echocardiography (TTE) found 23% had MAC.
Patients with MAC more frequently had valvular diseases as well as cardiovascular diseases, and the presence of MAC was associated with 1.3- fold higher mortality even after adjustment for most of these diseases.
“These results indicate that MAC was not only a marker of cardiovascular and valvular diseases but also a predictor of mortality.”
“Although MAC is usually an incidental finding, it may predict the progression of cardiovascular or valvular diseases because cardiovascular death has been more frequently seen in patients with MAC than in those without.”
Read more in Mayo Clinic Proceedings
Long COVID common in healthcare staff
Almost three-quarters of healthcare staff continue to suffer from the consequences of COVID-19 for months after acute infection, a German study has found.
A survey of 2053 healthcare workers who had PCR confirmed COVID-19 disease in 2020 found that 73% experienced persistent symptoms for more than three months, with fatigue/exhaustion, concentration/memory problems and shortness of breath being most frequently reported.
Ongoing symptoms were associated with poor physical and mental health-related quality of life, with one-fifth of staff with persistent symptoms reporting depression and anxiety symptoms.
Risk factors for long term symptoms after acute infection included older age, female gender, previous illness, many and severe symptoms during the acute infection, and outpatient medical care.
The findings “demonstrate the urgent need for rehabilitation measures among those affected so that they can achieve an improved quality of life in terms of their health and work ability,” the researchers said.