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Journal and News Scan
There could be some translational value for cardiovascular surgical practice from this prospective cardiovascular health study. The mechanistic link warrants further investigation and interpretation.
This is an interesting, well-written account of pooled results of two medium-size RCTs . It would be interesting to see a third arm of optimum medical therapy in follow-up studies ...
Analysis of the Arterial Revascularization Trial indicated that multiple arterial grafting was linked to lower mortality in the ten years after CABG in diabetic patients when compared with the single arterial grafting approach. This assertion was in contrast to the same trial's main intention-to-treat results, which had previously shown that there was no discernible benefit between use of single arterial grafts over bilateral internal-thoracic artery grafts. Yet the original trial's high rate of crossover and range of expertise levels appeared to omit the presence of better outcomes where multiple grafts were used, especially in cases with highly experienced surgeons.
In January 2022, University of Maryland School of Medicine surgeon-scientists made history by successfully implanting a genetically modified pig heart into a fifty-seven-year-old patient in end-stage heart failure who did not qualify for a traditional heart transplant. It was considered an early success because the transplanted pig heart functioned well for several weeks without signs of rejection, but the patient ultimately died two months after the surgery. An autopsy determined the cause of death to be heart failure likely caused by variety of factors, including the use of intravenous immunoglobulin.
A Columbia University cardiologist calls out a lack of diversity in respected medical journal editorial boards. His analysis demonstrates that as of October 2020, of fifty-one editorial board members at the New England Journal of Medicine, just one was Black and one was Hispanic, four were East Asian, and two were South Asian. Of the forty-nine editorial board members at JAMA, two were Black, two were Hispanic, three were East Asian, and one was South Asian. No board member at either publication was Native American.
This scientific statement is a granular contribution to a major cardiovascular issue, illuminating nuances of the "generally recognized as safe" (GRAS) FDA designation. One would expect the relevant Thoracic Associations in North America and Europe to contribute to this debate.