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 […]
Category: General cardiology
Fish oils fail to prevent cardiovascular events in diabetics
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 […]
Novel cholesterol lowering agent shows promise
Serum PCSK9 plays an active role in controlling the expression of LDL receptors by targeting them for lysosomal destruction. REGN727/SAR236553 (REGN727) is a novel human monoclonal antibody which inhibits PCSK9 binding to the LDL receptor; a previous phase 1 proof of concept trial suggested the potential for significant reductions in LDL in familial hypercholesterolaemia. […]
Flec-SL: short- vs. long-term flecainide after AF cardioversion
The goal of antiarrhythmic therapy following cardioversion for atrial fibrillation (AF) is to prevent further recurrences for as long as possible. However, it is known that the atrial action potential normalises after 2-4 weeks of sinus rhythm, suggesting that drugs may not be essential in the long-term. The goal of this study was to investigate […]
Hormonal contraceptives and the risk of arterial thrombosis
The risks of venous thromboembolism with hormonal contraception are well publicised, but the risks of arterial thrombotic complications are less well described with conflicting studies in the literature pertaining to the risk of myocardial infarction and stroke. In this retrospective cohort study of the entire Danish population of women aged 15 to 49 years old, […]
CIMT does little to augment Framingham risk score
Although current cardiovascular risk equations perform reasonably well in predicting disease, improvement is still needed. One way to do this would be to include a measure of preclinical atherosclerosis in risk prediction algorithms. Measurement of common carotid initima-media thickness (CIMT) could be of use in this regard, but evidence that it can aid existing risk […]
HIV and arterial inflammation
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. […]
RAPID GENE shows utility of bedside genetic testing
The CYP2C19*2 allele is a common genetic variant that has been associated with a significantly increased risk of major cardiovascular events and stent thrombosis following percutaneous coronary intervention (PCI). In this study a novel point-of-care genetic test was used to identify carriers of the CYP2C19*2 allele and to tailor a pharmacogenetic appriach to dual antiplatelet […]
cIMT progression poor predictor of cardiovascular outcomes
Carotid intima-media thickness (cIMT) is an ultrasound marker of early atherosclerosis. Increasing cIMT thickness has been shown to correlate with an increased risk of subsequent cardiovascular events in general populations, independent of other major risk factors. However, whether a change in cIMT thickness over time affects the risk of cardiovascular events has not been systematically […]
Timing of surgery for endocarditis
Bacterial endocarditis continues to carry a substantial risk of death. Whilst surgical intervention in patients with incipient heart failure is recognised as efficacious, the timing and indications for surgical intervention to prevent systemic embolism remain controversial. In this small, single centre study Kang et al compared the clinical outcome of early surgery versus conventional treatment […]