NEJM Journal Watch

Jan 21, 2025 | jwatch.org | Howard C Herrmann

Howard C. Herrmann, MD, reviewing The coronary sinus reducer, approved in Europe, appears to improve angina and quality of life in patients with CMD or refractory angina. Coronary microvascular dysfunction (CMD), characterized by abnormal vasodilatory capacity or intense vasoconstriction affecting smaller coronary arteries, can occur without epicardial obstructive coronary artery disease (CAD) and is a challenging condition without widely effective treatments.

Jan 21, 2025 | jwatch.org | Anthony Kim

Anthony S. Kim, MD, reviewing In a pooled individual patient-level meta-analysis of data from four trials, functional outcomes and mortality improved with endovascular therapy despite increased hemorrhage risks. Stroke thrombectomy trials have focused on mainly anterior-circulation large-vessel occlusion stroke.

Jan 16, 2025 | jwatch.org | Daniel D. Dressler

Daniel D. Dressler, MD, MSc, MHM, FACP, reviewing In patients with hip fracture and an elevated troponin level, rapid surgical intervention was associated with lower mortality. In the HIP ATTACK trial ( NEJM JW Gen Med Mar 15 2020 and Lancet 2020; 395:698), nearly 3000 patients who presented with hip fracture after low-energy trauma (e.g., ground-level fall) were randomized to undergo either accelerated surgery (i.e., within 6 hours) or standard-timing surgery (i.e., within 24 hours).

Jan 16, 2025 | jwatch.org | Patricia Kritek

Patricia Kritek, MD, reviewing The data are relatively convincing for hypoxemic respiratory failure but are less so for COPD exacerbations with hypercarbia. Avoiding intubation is a priority for patients with acute respiratory failure. Data support use of noninvasive ventilation (NIV) for patients with some types (e.g., chronic obstructive pulmonary disease [COPD] exacerbations), but NIV can be uncomfortable and difficult to tolerate.

Jan 14, 2025 | jwatch.org | Karol E. Watson