- N Engl J Med 2022; 387:840-841
In contemporary clinical practice, interventional cardiologists use both fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) to guide percutaneous coronary intervention (PCI) for intermediate coronary stenosis (i.e., a narrowing of the coronary-artery lumen by 40 to 70%). FFR, a physiological test, is used to evaluate the ischemic potential of a...
- N Engl J Med 2022; 387:779-789
In a randomized trial of fractional flow reserve versus IVUS to guide PCI, the use of FFR resulted in fewer coronary interventions and was noninferior to IVUS with respect to clinical outcomes at 2 years.
- Original ArticleAug 28, 202210.1056/NEJMoa2208335
In a randomized trial involving patients who had undergone percutaneous coronary intervention, routine functional testing did not improve clinical outcomes at 2 years.
- Original ArticleAug 28, 202210.1056/NEJMoa2206485
In a prospective global study, extravascular implantable cardioverter–defibrillators with a substernal lead were implanted safely and were able to detect and terminate induced ventricular arrhythmias at the time of implantation.
- EditorialAug 28, 202210.1056/NEJMe2210021
More than 100 years ago, Einthoven reported the presence of ST-segment changes on electrocardiography in a patient during exercise.1 His discovery led to the development of the modern-day stress test. In patients with known coronary artery disease, the stress test is useful in assessing residual ischemia after an...
In a trial involving patients with heart failure and a mildly reduced or preserved ejection fraction, dapagliflozin reduced the risk of worsening heart failure or cardiovascular death.
In comatose patients after out-of-hospital cardiac arrest, the incidence of death or severe disability was similar regardless of whether a restrictive or a liberal oxygenation strategy was used.
- EditorialAug 27, 202210.1056/NEJMe2210177
More than 6 million adults in the United States have heart failure, accounting for at least 800,000 hospitalizations annually.1 More than half of these persons have heart failure with a preserved left ventricular ejection fraction.1 As the population ages, the overall prevalence of patients with heart...
- EditorialAug 27, 202210.1056/NEJMe2210183
Ischemic cardiomyopathy represents the pathophysiological convergence of two growing clinical problems: atherosclerotic coronary artery disease and congestive heart failure. When a patient presents with congestive heart failure, it is incumbent on clinicians to undertake an etiologic workup that includes evaluation for a diagnosis of coronary artery disease1 ; simply...
Among older men in Denmark, the incidence of death from any cause at a median follow-up of 5.6 years was not significantly lower among those randomly invited to undergo screening for subclinical cardiovascular disease.
In a randomized trial involving patients with a low LVEF and viable myocardium who received optimal medical therapy, PCI did not lead to a lower incidence of death or hospitalization for heart failure.
This trial showed no significant difference in the percentage of patients who died or had severe disability or coma when higher or lower blood-pressure targets were used after an out-of-hospital cardiac arrest.
- EditorialAug 26, 202210.1056/NEJMe2210020
Next year marks the 20th anniversary of the first appearance of the polypill in the medical literature. Wald and Law coined the term to denote a fixed-dose combination of medications for preventing cardiovascular disease.1 They suggested that administering a polypill to all adults 55 years of age or...
- Original ArticleAug 26, 202210.1056/NEJMoa2208275
Among patients with recent MI, therapy with a polypill containing aspirin, ramipril, and atorvastatin led to a lower incidence of major adverse cardiovascular events at a median of 3 years than usual care.
- N Engl J Med 2022; 387:565-567
This interactive feature about screening for atrial fibrillation in asymptomatic older adults offers a case vignette accompanied by two essays, one supporting screening and the other supporting deferral of screening.
- N Engl J Med 2022; 387:491-493
A shortage of contrast material has made weighing value an urgent aspect of imaging decisions and provided a stark example of the consequences of low-value imaging for public health and health equity.
- N Engl J Med 2022; 387:e8
A 47-year-old woman presented with shortness of breath. Chest CT showed a filling defect in the left atrium, and a mobile left atrial mass was seen on transthoracic echocardiography (shown in a video).
- N Engl J Med 2022; 387:77-78
Since 1902, animals have been studied and occasionally used as sources of organs for transplantation, usually when human organs were unavailable. Clinical organ xenotransplantation invariably failed, whereas clinical organ allotransplantation rose to become a primary treatment for failure of the heart, kidneys, liver, and lungs. Still, a shortage of human...
- N Engl J Med 2022; 387:e1
The neo-Nazi march on Brigham and Women’s Hospital and attacks on health equity interventions are stark reminders of the obligation of physicians to denounce White supremacism and reaffirm race-conscious antiracism efforts.
- N Engl J Med 2022; 387:35-44
In this report, a porcine-to-human heart transplantation is described. Videos show transthoracic echocardiography in the patient who received the heart.