Here’s a snapshot of some of the most recent Heart, Lung and Circulation Journal articles for December 2023.

Anticoagulation During PCI:  Is It Time for RCTs?

Unfractionated heparin (UFH) has been the preferred anticoagulant in percutaneous coronary intervention (PCI) for over 40 years, say Al-Mukhtar and colleagues. Recently, they surveyed interventional cardiologists in Australia and New Zealand and found that, while this practice is indeed standard, there’s a lot of variation in not only how much (and when) UFH is used in PCI, but also whether (and when) activated clotting time is measured. Al-Mukhtar et al. say their survey results reflect variations in international guidelines and the findings of past studies and meta-analyses. They call for further randomised controlled trials to guide clinical practice and optimise the clinical outcomes of contemporary PCI. 

Sudden Death in the Young:  Autopsies for Underlying Causes?

One in four cases of young sudden death have more than one potential primary cause of their death identified, according to Paratz and colleagues. In an analysis of 3 years of data from the End Unexplained Cardiac Death (EndUCD) Registry, they determined, among other things, that comprehensive autopsy remains the gold standard investigation in this circumstance, complemented by other data such as, from post-mortem whole-body CT scanning, and biochemical and toxicological assessment. Paratz et al. say identifying all contributors to a sudden death is important, especially as diagnoses may carry important implications for surviving family members.

After SCAD: What Could Standard Care in Recovery Look Like?

Not only physical but also emotional recovery is important for patients after spontaneous coronary artery dissection. So say Turner and colleagues, who conducted a comprehensive literature review that identified, and then examined the findings of, five studies involving 447 patients after SCAD. They suggest that the ideal recovery program would reflect the patients’ preference for tailored cardiac rehabilitation and web-based resources, both specifically designed for SCAD. For example, with respect to emotional recovery, cognitive behavioural therapy-based groups and online peer support have been shown to benefit patients with spontaneous coronary artery dissection (SCAD) and could be integrated into standard care.

These highlights and more are available online now in the December 2023 edition of Heart, Lung and Circulation.

Compiled by Dr Ann Gregory, Commissioning Editor, Heart, Lung and Circulation.  ([email protected])