No benefit from irbesartan in patients with normal ejection fraction heart failure

The I-PRESERVE study (Irbesartan in Heart Failure with Preserved Ejection Fraction) assessed the efficacy of the angiotensin II receptor blocker (AIIRB) irebesartan on mortality and cardiovascular morbidity in patients with heart failure and a preserved LVEF. This was a multi-centre international trial which enrolled 4128 patients with a minimum age of 60 years and NYHA […]

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Beta-blockers: all are equal, but some more than others

Carvedilol, Metoprolol and Bisoprolol have all been shown to improve outcomes in patients with heart failure. These evidence based beta-blockers (EBBB) are in contrast to atenolol, propranolol, and timolol, which have not been directly tested in heart failure. Therefore if a patient on one of these agents develops heart failure, is it neccesary to switch […]

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Exercise induced arrhythmia associated with increased mortality

The prognostic importance of exercise-induced ventricular arrhythmia (EIVA) remains unclear. Left bundle branch block (LBBB)-morphology ventricular ectopics may originate from the right ventricular outflow tract and are often benign, whereas right bundle branch block (RBBB)-morphology ventricular ectopics may originate from the left ventricular and may be associated with left ventricular (LV) disease or depressed LV […]

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Percutaneous aortic valve replacement – patient selection is key

Studies among elderly populations demonstrate that conventional aortic valve replacement (AVR) remains the gold standard for the treatment of critical aortic stenosis compared to medical therapy. However, among populations deemed too high-risk for conventional surgery, or among those who decline surgical intervention, percutaneous procedures such as transcatheter aortic valve implantation (TAVI) may be an option. […]

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Genetic study suggests CRP not causal in atherosclerosis

Increased levels of C-Reactive Protein (CRP) are associated with an increased risk of ischaemic heart and cerebrovascular disease. But is CRP a causal factor in atherosclerosis development or merely a marker for ischaemic vascular disease?  Evidence to suggest a role for CRP in the pathogenesis of atherosclerosis is predominantly from epidemiological studies. These have consistently […]

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Off-pump CABG lowers early post-operative risk in women

Previous studies of patients undergoing coronary artery bypass grafting (CABG) describe, in the majority, an increased rate of early mortality and morbidity among women as compared with men. Retrospective reviews of large observational studies have shown decreased early risk-adjusted mortality and morbidity among patients undergoing off pump CABG (OPCABG) as compared with those placed on […]

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Decrease in risk of community sudden cardiac death over the last 30 years

Although several large clinical trials have recently examined the risk of sudden cardiac death after myocardial infarction (MI), community-based data reflecting the contemporary risk of sudden cardiac death after MI are lacking. Adabag et al. determined to evaluate the risk of sudden cardiac death after MI and the impact of recurrent ischemia and heart failure […]

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Effective Risk-Factor Reduction Could Eliminate Socioeconomic differences in cardiovascular health

A socioeconomic gradient in coronary mortality is well established in developed countries, and is becoming increasingly apparent in low- and middle-income countries too.  Previously, it has not been clear to what extent the classical cardiovascular risk factors are responsible for this difference, nor indeed whether by treating them effectively it could be possible to balance […]

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JUPITER puts primary prevention into new orbit

Current guidelines recommend statin treatment for patients with known vascular disease, diabetes or elevated lipid levels. Yet half of myocardial infarctions and strokes occur in apparently healthy individuals with levels of low density lipoprotein (LDL) cholesterol that are below current threshold levels for treatment. High sensitivity C-reactive protein (CRP) is an inflammatory biomarker which can […]

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