Contemporary Coronary Stents

Percutaneous treatment for obstructive coronary artery disease has evolved in conjunction with technological advances from the initial era of balloon angioplasty to the first bare metal stents (BMS) and then through various iterations of drug eluting stent (DES) technology.  Current generation DES data suggest progressively improved re-stenosis and thrombosis rates and on-going trials are examining […]

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CPAP fails to improve cardiovascular outcomes in OSA

Obstructive sleep apnea (OSA) is associated with increased cardiovascular events in observational studies. Randomized trials have demonstrated continuous positive airway pressure (CPAP) therapy reduces blood pressure, markers of oxidative stress and insulin insensitivity.  Yet, it remains unclear whether treatment with CPAP reduces cardiovascular events.  In the largest study of its kind, 2717 patients aged 45 […]

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Von Willebrand Factor Multimers during Transcatheter Aortic-Valve Replacement

Patients with stenotic or regurgitant aortic valve disease appear to cleave multimers of Von Willebrand factor (HMW-multimer), presumably due to high-shear stresses and non-laminar flow. Van Belle and colleagues hypothesized that transcatheter aortic valve replacement (TAVR) would correct this process, but that significant residual paravalvular leak (PVL) following TAVR would abrogate this corrective effect. Moderate […]

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Genetic analysis of sudden cardiac death in the young

Sudden cardiac death (SCD) is a rare but devastating event among children and young adults. SCD in which no obvious cause is apparent despite comprehensive toxicological and histological autopsy analysis is particularly vexing.  The role of genetic testing in unexplained SCD is studied in this prospective analysis of  Australians and New Zealanders 1 to 35 […]

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Long-term survival benefit for coronary artery bypass grafting surgery in ischemic cardiomyopathy

The Surgical Treatment for Ischemic Heart Failure (STICH) trial asked the important question whether coronary artery bypass grafting surgery (CABG) in patients with severe ischemic cardiomyopathy would provide a survival advantage over contemporary medical therapy alone. Reporting 5-year data in 2011, the study reported no significant difference but did demonstrate a tantalizing divergence in survival […]

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Ablation superior to drugs in recurrent ventricular tachycardia

Nearly 100, 000 implantable cardiac defibrillators (ICDs) are implanted every year in N. America to treat patients at risk of ventricular tachycardia (VT)  following myocardial infarction.  ICD activation for VT is relatively common and associated with recurrent hospitalizations, reductions in quality of life and mortality. It is therefore important to understand the best course of […]

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Cholesterol Lowering in Intermediate-risk Persons without Cardiovascular Disease.

Implementation of statin therapy in practice for primary prevention of cardiovascular disease is controversial due to concerns over costs and side-effects with broader use and uncertainty regarding LDL goals in the primary prevention population. Previous primary prevention trials suggest a reduction in cardiovascular outcomes in largely white patients with significant risk factors for coronary disease. […]

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Genetic variant protects against coronary disease

The links between cholesterol and coronary artery disease are well established and incontrovertible, with modification of serum LDL cholesterol levels repeatedly shown to reduce risk of myocardial infarction and cardiovascular death. But total non-HDL cholesterol levels, encompassing multiple other lipid fractions including Lp(a) and chylomicrons, have the strongest overall association with the risk of incipient […]

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