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Novel risk markers – CT looks strong

2 Oct, 12 | by Alistair Lindsay

The primary prevention of cardiovascular disease involves classifying individuals according to their global cardiovascular risk. However, those at intermediate risk represent a particular challenge; while some may require aggressive treatment, others may be best managed by lifestyle measures alone. Biomarkers that have shown promise in improving risk discrimination include carotid intima-media thickness (CIMT), coronary artery calcium (CAC) scoring, brachial flow-mediated dilation (FMD), ankle-brachial index (ABI), high-sensitivity C-reactive protein (CRP) and, in addition, having a family history of coronary heart disease (CHD). Determining whether – and by how much – risk prediction can be improved by various markers could help to determine the most efficient strategy for the use of primary prevention drugs. more…

Fish oils fail to prevent cardiovascular events in diabetics

19 Sep, 12 | by Alistair Lindsay

The use of fish derived n-3 fatty acids following myocardial infarction has been shown to be beneficial in preventing further cardiovascular events and reducing mortality, particularly from sudden cardiac death. However the effects of these drugs in preventing cardiovascular events in high risk patients with (or at risk for) type 2 diabetes mellitus, but who are otherwise stable, are unknown. In the double-blind, multi-centre ORIGIN study 12,536 patients who had impaired fasting glucose, impaired glucose tolerance, or diabetes, were randomised in a 2-by-2 factorial design to receive either a 1-g capsule of n-3 fatty acids or placebo daily (with the other arm of the study randomising to receive either insulin glargine or standard care). Mean age of participants was 64 and 59% had had a previous cardiovascular event at baseline. The primary outcome was death from cardiovascular causes. After a median follow up of 6.2 years there was no significant difference between the n-3 fatty acids and placebo arms as regards the primary outcome (574 patients [9.1%] vs. 581 patients [9.3%];HR, 0.98; 95% CI, 0.87 to 1.10; P=0.72). The use of n-3 fatty acids also had no significant effect on the rates of major vascular events (P=0.81), death from any cause (P=0.63), or death from arrhythmia (P=0.26). Similarly, the use of insulin glargine in the other arm of the study failed to improve cardiovascular outcomes. more…

Chronic NSAID use increases mortality from cardiovascular disease

14 Aug, 11 | by Alistair Lindsay

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective and extensively used pain-killers, particularly in the treatment of chronic musculoskeletal problems.  However, doubts about their safety in patients with coronary disease have surfaced, particularly since the NSAID-like COX1 inhibitor, rofecoxib, was withdrawn from the market after a demonstrated  increase in cardiovascular events.  Despite these concerns, compelling data on the effects of other NSAIDs are still sparse and their safety when used chronically is largely unknown. more…

Lipid metabolism by gut flora influences cardiovascular disease

2 Jul, 11 | by Alistair Lindsay

Although the relationship between cholesterol, triglycerides, and cardiovascular disease is well established, little is known about the role of the third major class of lipids – phospholipids.  In this regard, the intestinal microflora play a crucial role in that they digest and absorb many crucial nutrients, including lipids.  Therefore in this study the authors attempted to discover whether a link exists between gut-flora-dependent phospholipid metabolism and atherosclerosis risk through generation of pro-atherosclerotic metabolites. more…

Plastics additive linked to cardiovascular disease

14 Oct, 08 | by Alistair Lindsay

Bisphenol A (BPA) is the base chemical used to make several plastic containers, cans and dental sealants.  Evidence from animal studies has suggested several potential biological effects of BPA, including estrogenic activity, liver damage, thyroid hormone dysfunction, and obesity-promotion. more…

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