Omar Khalique, MD on the ABIM Foundation’s decision to list cardiologists as “not certified” if they haven’t paid their MOC fees.

Preventive Cardiology

Is Moderate Exercise Safe on Statins?

Statin users commonly experience muscle pain and weakness, and previous research has shown that they risk muscle damage by participating in strenuous exercise. But an interesting new study out of the Netherlands revealed that statins don’t exacerbate muscle-related harms from prolonged moderate-intensity exercise, and statin-associated muscle symptoms (SAMS) shouldn’t stand in the way of physical activity.

The researchers recruited 100 people in their 60s (35 statin users with SAMS, 34 statin users without SAMS, 31 healthy controls) to be evaluated while participating in Nijmegen, Netherlands’ 4Days March, which requires four daily walks of 18.6 to 31 miles. 

Surprisingly to some observers, each group had similar…

• Increases in muscle injury biomarkers
• Decreases in handgrip strength and muscle peak force
• Levels of Leukocyte CoQ10… and CoQ10 levels weren’t associated with muscle injury markers, fatigue resistance, or muscle symptoms
• Increases in muscle pain scores, although statin users with SAMS had higher baseline muscle pain scores

Statin users might still risk muscle injuries with strenuous exercise, but these findings suggest that “moderate” exercise (like four straight 31-mile walks) doesn’t damage statin users’ muscles, while reinforcing recommendations to combine statin therapy with a physically active lifestyle. 

The Takeaway

Statin-associated muscle symptoms earned its own medical abbreviation (SAMS) for a reason, and concerns about statin’s muscle risks are well established. That’s what makes the findings of this study so beneficial from a patient and clinician education standpoint, especially if it helps get more statin users exercising.

The Benefits of Outsourced Post-Processing

Using an outsourced cardiac image post-processing solution doesn’t have to mean sacrificing control of the results. Discover how PIA’s customizable post-processing workflow can help you get the most out of your images.

Overcoming Cardiovascular Data Challenges

Aggregating multisource cardiology data is a worthy mission, but it’s often thwarted by confusion and complexity. This Change Healthcare article with Dr. Jennifer Hall, chief of data science at the American Heart Association, outlines best practices to help you overcome your cardiology data challenges and start leveraging deeper insights.

How Precision Heart Therapy Advances the Business of Healthcare

Health systems continue to face economic and regulatory pressure to reduce care costs and improve outcomes. See how Cleerly’s precision heart care approach helps enhance patient care, avoid unnecessary and high-cost procedures, and improve the patient and provider experience.

The Wire

• ABIM MOC Backlash: Much of CardioTwitter was up in arms after news emerged that the ABIM Foundation is now listing cardiologists as “not certified” if they haven’t paid their MOC fees, even if they did pay for and pass their certification exams. Unsurprisingly, cardiologists were against this move, calling it “extortion,” “greedy,” “shameless,” “a scam,” and a “self serving money grab.” They also called upon cardiology societies to help change this policy, while urging health systems to make NBPAS a more widely-accepted alternative.

• NSAID’s Diabetes HF Risks: Short-term NSAID use might increase heart failure risks among people with type 2 diabetes (T2D). Analysis of 331k T2D patients found that 16% of the 23k people who were hospitalized with first-time heart failure received at least one NSAID prescription during the previous year. Based on that data, short-term NSAID use was associated with greater risk of HF hospitalization (OR: 1.43), especially among the elderly, those with elevated hemoglobin A1c levels treated with antidiabetic drugs, and people who hadn’t previously used NSAIDs.

• Illumina & Henry Ford’s CVD Genomics Alliance: Genomics testing leader Illumina is partnering with Henry Ford Health System to study the impact of cardiovascular genomic testing. Illumina and Henry Ford will use whole-genome sequencing to analyze genetic mutations in 7,000 patients with cardiovascular disease to evaluate genomics-based precision medicine’s potential to improve CVD patient outcomes and reduce associated healthcare costs.

• Early Detection Key for CIED Infections: A JAMA study of nearly 20k patients suggests that early detection and treatment of cardiac implantable electronic device (CIED) infections significantly reduces mortality risks. The researchers found that early localized CIED infections did not raise mortality risks, but early systemic infections and delayed localized infections increased mortality risks three-fold, with delayed systemic infections posing the highest risk.

• HeartFlow Launches RoadMap Analysis: Six months after gaining FDA clearance, HeartFlow officially launched its RoadMap Analysis solution, which uses AI to help CCTA readers identify stenosis. RoadMap Analysis provides visual and quantitative insights into the narrowing of all major coronary arteries (RCA, LAD, LCX, and Left Main), including stenosis location and severity. The addition of RoadMap Analysis makes HeartFlow the only company supporting anatomical and physiological visualization of the coronary arteries.

• Dronedarone Outshines Sotalol: A meta-analysis of 37 studies comparing the safety and efficacy of the antiarrhythmic drugs dronedarone and sotalol found that AFib patients who took dronedarone were significantly less likely to die from any cause (HR: 0.38). However, the researchers saw no significant differences between the two drugs in terms of AF recurrence and CV death. These findings are consistent with previous meta-analyses that indicate a higher risk of death for sotalol, and lower risk of stroke with dronedarone.

• The “King Kong” of GLP-1s: Eli Lilly is setting its sights on the white-hot weight loss market through the development of the “King Kong” of obesity medications – Mounjaro. The Wall Street Journal published a solid breakdown of how Eli Lilly needed to overhaul long-held but failing practices to pave the way for Mounjaro, which appears to be more powerful than leading GLP-1s such as Novo Nordisk’s Wegovy and Ozempic. Mounjaro can reportedly help a typical person weighing 230lbs lose up to 50lbs in 17 months, results that Eli Lilly expects to be worth about $25B annually.

• CKD Proteomics CV Risk Prediction: A Penn Medicine-led team developed a proteomic risk model that accurately predicts chronic kidney disease patients’ cardiovascular risks. The researchers used machine learning to evaluate 4,628 unique proteins from 2,667 participants with CKD and no history of CVD, to select the 32 proteins used in their proteomic risk prediction model. In a validation using blood samples from 485 participants with CKD, 60% of those deemed by the model as highest risk experienced MACE within 10 years.

• Implicity Targets AF Monitoring Fatigue: Remote cardiac monitoring AI company, Implicity, announced the launch of a new algorithm designed to reduce providers’ alert fatigue when monitoring patients with atrial fibrillation – addressing a major pain point for AI-based triage and monitoring solutions. Implicity’s AF Alert Management tool reduces alerts for low-risk patients who are taking anticoagulants, while triggering and prioritizing provider alerts when more significant changes and events are detected.

• More Burnout Evidence: A new study of over 43k healthcare workers suggests that about half are burned out. Nurses posted the highest burnout rate (56%), followed closely by other clinical staff and physicians (54.1% & 47.3%). The researchers advise a more standardized approach to burnout that focuses on workload – which other studies have found to be a leading cause of work stress.

• Predicting Angina After PCI: A Circulation study of 230 patients suggests that FFR improvements following PCI are linked to lower rates of angina. In the TARGET-FFR trial, 38.3% of patients reported angina three months post-PCI, while patients who didn’t develop post-PCI angina had lower pre-PCI FFR values (0.56 vs. 0.62). The percentage change in FFR after PCI moderately correlated with angina frequency score at follow-up (r=0.36), suggesting that  pre-PCI FFR information may help determine patients’ PCI appropriateness by predicting angina relief and quality of life improvements.

Us2.ai Brings Clarity to Cardiac Imaging

Learn about how Us2.ai is bringing simplicity and clarity to the world of cardiac ultrasound, on the latest episode of The Bleeding Edge of Digital Health featuring Us2.ai’s founders, James Hare and Dr. Carolyn Lam.

PRECISE Trial Rewrites the Patient Pathway

HeartFlow’s landmark PRECISE trial found that their precision approach for evaluating people with stable chest pain avoided unnecessary testing and improved care without putting patients at risk of a missed heart disease diagnosis.

Monebo’s AF ECG Algorithm

Atrial fibrillation is often difficult to characterize with an automated algorithm due to the changing waveform morphology, system, or muscle noise. This is especially true given the size constraints of ambulatory devices to detect AFib. See how Monebo’s Kinetic AF ECG Algorithm overcomes these size limitations without sacrificing accuracy.