Oral anticoagulants have been demonstrated to reduce the incidence of, and mortality secondary to, embolic strokes associated with atrial fibrillation. Despite this, oral anticoagulants are underprescribed with some estimates suggesting as few as 40% of eligible patients receive therapy. The risk of falls is the most commonly cited reason for not providing oral anticoagulation, although […]
Category: General cardiology
Glucose-Insulin-Potassium shows some benefit in acute coronary syndrome
Intravenous glucose-insulin-potassium (GIK) is postulated to be beneficial in acute ischaemic syndromes via two mechanisms: by providing metabolic support to ischaemic myocardium, and by preventing arrhythmias and cardiac arrest due to ischaemia-related metabolic derangements. Importantly, these benefits are most likely to be seen if GIK is started as soon as possible after the onset of […]
Acute effects of air pollution – Beijing Olympics study
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 […]
Lipid-related markers improve cardiovascular disease prediction
While the measurement and management of cholesterol forms an integral part of cardiovascular risk management, it has been suggested that risk assessment could be improved by the assessment of various additional lipid-related markers either to supplement or replace traditional cholesterol measurements. The aim of this paper was to determine whether cardiovascular risk prediction could be […]
Aspirin use and major bleeding
The American Diabetes Association recommends low-dose aspirin (75-162mg per day) for adults with diabetes and no previous history of vascular disease, but with a 10-year risk of cardiovascular events greater than 10% and who do not have an increased risk for bleeding. However, as the benefits of low-dose aspirin in the primary prevention setting are […]
Quality improvement measures ameliorate ACS outcomes
While multiple randomised controlled trials have outlined the optimal care for patients with acute coronary syndromes (ACS), evidence-based therapies are not always applied, particularly in low- and middle-income countries. In this Brazilian study, the authors hypothesised that a multifaceted quality improvement (QI) intervention could improve the use of evidence-based therapies and improve ACS outcomes. […]
Atrial Fibrillation: Women at higher stroke risk
Patients with atrial fibrillation (AF) have a risk of stroke that is five times greater than that of the general population. Moreover, it has previously been described that women with atrial fibrillation have a higher annual rate of stroke than men (3% vs. 1.6%). The reasons for this remain unclear, although previous studies have […]
Varenicline: no link with cardiovascular events found in meta-analysis
Varenicline (Champix) is a partial agonist to nicotine receptors, and is approved for smoking cessation therapy. However, the FDA has raised concern about a possible increase in the incidence of cardiovascular events of patients taking the drug in randomised trials. In this meta-analysis, Prochaska et al. looked at 22 randomised controlled trials of current tobacco […]
FOCUS-CCTRN: Autologous bone marrow cells fail to improve heart failure
Autologous stem/progenitor cells have been investigated for several years as a novel therapy for patients with advanced ischaemic heart disease, particularly those with ongoing angina or heart failure. In particular, for patients with ischaemic cardiomyopathy, autologous bone marrow mononuclear cells (BMCs) have been shown to be safe and possibly effective. However, none of the trials […]
Infective endocarditis caused by cardiac devices
The number of electronic cardiac devices, including pacemakers and cardioverter-defibrillators, being implanted each year is increasing. As a result, there has been a 210% increase in the incidence of device infection between 1993 and 2008 in the United States. Cardiac device infective endocarditis (CDIE) is significant in that it is associated with a higher mortality […]