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Lifelong atrial fibrillation risk may be higher for big babies

Parents are usually pleased when their newborn seems big and strong, but new research suggests that large babies may be at higher risk for the heart rhythm disorder atrial fibrillation later in life.

Atrial fibrillation (a-fib) is the most common heart rhythm disorder, affecting more than 40 million people worldwide. People with a-fib have a five times increased risk of stroke.

The association between birth weight and a-fib is controversial, which led the authors of this study to investigate it.

Using a special data analysis technique, the researchers concluded that there was a link between greater birth weight and an increased risk of a-fib later in life.

Specifically, people with a birth weight that’s 1 pound above the average 7.5 pounds are 30% more likely to develop a-fib, the findings showed.

The study is scheduled to be presented Monday at a virtual meeting of the European Society of Cardiology (ESC).

“Our results suggest that the risk of atrial fibrillation in adulthood may be higher for large newborns [over 8 pounds, 13 ounces] than those with normal birth weight,” said study author Songzan Chen, from Zhejiang University, in Hangzhou, China.

“Preventing elevated birth weight could be a novel way to avoid atrial fibrillation in offspring — for example with a balanced diet and regular check-ups during pregnancy, particularly for women who are overweight, obese or have diabetes,” Chen suggested in a meeting news release.

“People born with a high weight should adopt a healthy lifestyle to lower their likelihood of developing the heart rhythm disorder,” Chen recommended.

According to Michel Komajda, a past president of the ESC, “Atrial fibrillation is a devastating illness that causes avoidable strokes if left untreated. We know that people with unhealthy lifestyles are more likely to develop atrial fibrillation, and risk can be lowered through physical activity and keeping body weight under control. This study is a welcome addition to our knowledge about how to prevent atrial fibrillation.”

More information

The U.S. National Heart, Lung, and Blood Institute has more on atrial fibrillation.

Copyright 2020 HealthDay. All rights reserved.

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Data Presented at TCT Connect Finds Pre-PCI Use of Impella for AMI Cardiogenic Shock is Associated with Higher Survival, Particularly in Women

Two studies of AMI cardiogenic shock (AMICS) patients found higher survival when Impella was placed pre-PCI, compared to when Impella was placed after PCI. The findings were presented at TCT Connect, the 32nd annual scientific symposium of the Cardiovascular Research Foundation.

This press release features multimedia. View the full release here: https://www.businesswire.com/news/home/20201016005118/en/

Figure 1 (Graphic: Business Wire)

In the first study, presented by Hemindermeet Singh, MD, of Ascension St. John Hospital, researchers compared 649 patients from two cohorts: a recent cohort (2017–2019) from the RECOVER III post-market approval (PMA) study, after the widespread adoption of the best practice of placing Impella pre-PCI, and a cohort from before PMA (2008–2014) when the practice of placing Impella pre-PCI was not yet widely adopted. Researchers found an 18% relative improvement in overall survival in the recent cohort, indicating an associated benefit to placing Impella pre-PCI. The recent cohort also had lower incidences of peri-PCI acute kidney injury (AKI) and major bleeding or vascular complications. This is despite a higher prevalence of hypertension, smoking, stroke, and New York Heart Association (NYHA) class III/IV heart failure in the recent cohort. (see figure 1)

“This data shows increased adoption of the cardiogenic shock best practices over the last three years has led to an improvement in overall survival rates,” said Amir Kaki, MD, the study’s senior author, an interventional cardiologist and director of mechanical circulatory support at Ascension St. John Hospital. “In order to improve outcomes for our patients, it is important for practitioners to apply these best practices, which include early identification of shock, use of a right heart cath, reduction of toxic inotropes and use of Impella prior to the PCI.”

“Our study demonstrates growing physician and institutional experience. The implementation of standardized cardiogenic shock protocols and the increasing use of strategies to reduce vascular and bleeding complications are associated with better survival. In-depth understanding of these factors has significant potential of improving outcomes in cardiogenic shock patients in the community at large,” said Dr. Singh.

The second study, presented by Tayyab Shah, MD, of the Yale School of Medicine, analyzed data collected from the RECOVER III trial between 2017-2019. It found that placing Impella pre-PCI in AMICS patients is associated with higher survival than placing Impella post-PCI, especially in women. Study investigators determined women had a 74% relative survival benefit with Impella use pre-PCI as compared to post-PCI. The study authors conclude early implantation of Impella provides a significant survival benefit, particularly to women. (see figure 2)

“This study suggests that the early use of the Impella device to support patients in cardiogenic shock, before PCI and inotrope/vasopressor usage, may provide a survival benefit particularly to females,” said Dr. Shah. “This is an interesting result from an observational study with meaningful clinical implications, which need to be further explored in the upcoming RECOVER IV randomized controlled trial.”

Since FDA PMA approval, Abiomed (NASDAQ: ABMD) has collected data on nearly 100% of U.S. Impella patients in the observational

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