In the United States, 30-day risk standardised readmission rates for heart failure (HF), acute myocardial infarction (MI), and pneumonia are now publicly reported. In order to better facilitate interventions targetted at reducing readmission rates, Dharmarajan et al. investigated readmission diagnoses and timings among Medicare beneficiaries readmitted within 30 days after hospitalisation for HF, MI, or […]
Category: General cardiology
Acute heart failure with deteriorating renal function: no role found for ultrafiltration
Deteriorating renal function in patients with heart failure is a common situation, affecting approximately a third of patients presenting with acute pulmonary oedema, and is associated with worse outcomes. Due to the potentially nephrotoxic nature of many heart failure therapies, renal failure leads to difficult treatment decisions regarding ongoing diuretic therapy. Few options yet exist […]
Bone marrow cells as therapy for ischaemic cardiomyopathy
Two trials in the Journal of the American Medical Association (JAMA) address the impact of bone marrow-derived cell therapy on safety and surrogate endpoints in patients with ventricular dysfunction due to ischaemic heart disease. […]
PCSK9 antibody decreases LDL cholesterol in statin-intolerant patients
Approximately 10-20% of patients are unable to tolerate statins or the higher doses needed to achieve LDL cholesterol goals. Perprotein convertase subtilisin/kexin type 9 (PCSK9) mediates the binding and trafficking of LDL receptors, and in phase 1 studies a human monoclonal antibody to to PCSK9 (AMG145)lowered LDL levels. The Goal Achievement after Utilizing an anti-PCSK9 […]
Early atherosclerosis declines in autopsy study
In 1953 a report from the Armed Forces Institute of Pathology reported a 77% prevalence of coronary atherosclerosis among US soldiers killed in the Korean War. This revolutionary study demonstrated that atherosclerosis was present in a large number of young patients without clinical evidence of heart disease. A new study aimed to estimate the current […]
FREEDOM: CABG superior to PCI in diabetics
Diabetes is one of the principle aetiological factors for coronary artery disease with vascular disease in diabetics displaying a particularly aggressive phenotype, often resulting in multivessel disease. Current evidence suggests that CABG is particularly beneficial in these patients as compared with PCI. however, much of this evidence was either gathered in the era before modern […]
CETP inhibition fails to lower risk after ACS
The reduction of low-density lipoprotein (LDL) cholesterol levels has been consistently shown to lead to cardiovascular benefits, but whilst in observational analyses higher levels of high-density lipoprotein (HDL) are associated with a lower risk of coronary events, it remains uncertain whether raising HDL therapeutically reduces cardiovascular risk. One strategy to increase HDL is through inhibition […]
Apixaban shows safety in secondary analysis
The decision to anticoagulate a patient with atrial fibrillation involves a balance between the risks of thromboembolism against those of haemorrhage, with both risks imperfectly predicted by even the best stratification scoring systems. Although warfarin reduces the risk of stroke in patients with atrial fibrillation, its use remains limited by several limitations. Apixaban is a […]
PARAMOUNT offers hope for HF-PEF
Inhibition of the renin-angiotensin system with ACE-inhibitors or ARBs has failed to convincingly show that these drugs can improve survival and lower the risk of hospitalisation in patients with heart failure with preserved ejection fraction (HF-PEF). LCZ696 is a novel investigational combination angiotensin-receptor/neprilysin inhibitor (ARNI) consisting of valsartan and AHU-377 in a 1:1 mixture. AHU-377 […]
PCSK9 shows benefit in cholesterol lowering
Despite the potency of high dose statins, many patients fail to reach targets for LDL cholesterol reduction. Whilst the addition of a second agent such as niacin or ezetemibe results in an additional 10-20% reduction in cholesterol, there remains an unmet need for more potent therapies. Serum proprotein convertase subtilisin/kexin 9 (PCSK9) binds to low-density […]