Short telomere length associated with family history of premature myocardial infarction

Telomeres are specialised DNA-protein structures at the end of chromosomes, and are vital to preserve chromosome integrity and stability.  Telomeres are known to shorten with age, but prematurely shortened telomeres have been found in cells from human atherosclerotic plaques, and a previous relationship between telomere length and coronary artery disease has been described. […]

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No additional benefit from thrombolysis during out-of-hospital cardiac arrest

Myocardial infarction and pulmonary embolism account for approximately 70% of out of hospital cardiac arrests. Cardiac arrest itself activates systemic coagulation hence thrombolytic therapy delivered during cardiopulmonary resuscitation can dissolve intravascular blood clots and has beneficial effects on microcirculatory reperfusion, improving survival and neurological recovery. […]

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64-slice CT unable to out-perform coronary angiography

Previous studies comparing CT coronary angiography with the current gold standard of coronary angiography have been limited by single-centre design and inherent bias in small studies.  This multi-centre, international study, CORE 64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) used central blinded analysis to evaluate the diagnostic accuracy of MDCT angiography involving 64 slice […]

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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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