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Colchicine Reduces Recurrent Pericarditis

22 Nov, 13 | by Alistair Lindsay

Acute pericarditis is a common self-limiting illness which usually has few sequelae.  However, in a small proportion of patients, pericarditis can become recurrent making treatment more challenging.  The use of colchicine to treat acute pericarditis and prevent recurrence has been a topic of increasing interest in recent years. In this multicentre, double-blind trial, adults with acute pericarditis were randomly assigned to receive either colchicine (at a dose of 500 mcg twice daily for 3 months for patients weighing >70 kg or 500 mcg once daily if ≤70 kg) or placebo in addition to conventional anti-inflammatory therapy (high dose aspirin or ibuprofen). A total of 240 patients diagnosed on clinical history, imaging and ECG criteria were randomised in a 1:1 fashion to either colchicine or placebo and followed for a median of 18 months. The primary outcome w, defined as incessant or recurrent pericarditis, occurred in 20 patients (16.7%) in the colchicine group and 45 patients (37.5%) in the placebo group (RR reduction in the colchicine group, 0.56; 95% CI, 0.30 to 0.72; NNT, 4; P<0.001). In addition to the primary outcome, benefits of colchicine therapy included a reduced rate of symptom persistence at 72 hours (19.2% vs. 40.0%, P=0.001), fewer recurrences per patient (0.21 vs. 0.52, P=0.001), a lower hospitalization rate (5.0% vs. 14.2%, P=0.02) and a higher  remission rate at 1 week (85.0% vs. 58.3%, P<0.001).  Adverse event rates were similar in the two study groups. more…

HIV and arterial inflammation

22 Aug, 12 | by Alistair Lindsay

Patients with Human Immunodeficiency Virus (HIV) demonstrate a high prevalence of noncalcified coronary atherosclerotic lesions.  However, the specific mechanisms that lead to this remain unknown.  In this study Subramanian et al. used 18fluorine-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) to assess arterial wall inflammation in patients with HIV, and compared this to traditional and nontraditional risk makers. more…

Acute effects of air pollution – Beijing Olympics study

3 Jul, 12 | by Alistair Lindsay

Although it is now well established that air pollution is a risk factor for cardiovascular disease (CVD), the mechanisms by which air pollution leads to CVD are not well understood.  Postulated mechanisms include systemic inflammation and thrombosis or endothelial dysfunction.  However, pollution-associated increases in these biomarkers have been inconsistent, partly due to inherent limitations of panel study designs that assessed biomarker changes in relation to concentrations of air pollutants.  Therefore this innovative study used the greatly restricted air pollution emissions enforced during the Beijing Olympics to measure various biomarkers that would inform the physiological effect of decreased atmospheric pollution. more…

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