Dilated cardiomyopathy (DCM) is the most common form of non-ischemic cardiomyopathy. While clinical evaluation identifies 30 to 50% of DCM patients as having a relative who is affected or likely to be affected, indicating a possible genetic cause, pathogenic mutations are found in only 20 to 30% of patients. Therefore a large degree of uncertainty […]
Category: General cardiology
CE-MARC shows strength of perfusion MRI
In recent years it has become clear that treatment of coronary artery disease – and in particular percutaneous coronary intervention (PCI) – must be guided by imaging techniques that give some information on the extent of myocardial ischaemia. While nuclear medicine techniques such as SPECT (single-photon emission computed tomography) have become widespread, and have a […]
ADHD medications and cardiovascular events
Adults with attention-deficit/hyperactivity disorder (ADHD) are often treated with stimulants such as mephyphenidates and amphetamines, and additionally with a newer non-stimulant agent, atomoxetine. Placebo-controlled studies have shown that all of these drugs are capable of increasing systolic and diastolic blood pressure in addition to heart rate. However, no clinical trial to date has been large […]
Long-term efficacy and safety of statins
Alth0ugh an overwhelming amount of evidence now points towards the beneficial effects of statins, most of the large statin studies have only had 5-year follow-up and there have been observational studies that have suggested a long-term increased risk of particular types of cancer, and of other non-vascular morbidity and mortality. […]
Cardiac arrest in marathon runners investigated
Despite the increasingly sedentary nature of society, one participation sport that is thriving is long-distance running with approximately 2 million people participating in marathon or half-marathons in the United States annually. Tragically, this increase in participants has led to an increase in reports of race-related cardiac arrests and in this study by Kim et al […]
Subclinical AF significantly increases stroke risk
Approximately 25% of all strokes are of unknown cause, and it has long been hypothesised that short subclinical episodes of atrial fibrillation (AF) may be an important common etiologic factor. While several studies have attempted to detect episodes of subclinical AF, most have been hampered by the infrequency of such episodes and the unlikelihood of […]
Hybrid revascularisation moves forward
Use of the left internal mammary artery (LIMA) in coronary artery bypass (CABG) procedures has led to 10 year patency rates approaching 90%, far surpassing rates for other graft types or for stents implanted percutaneously. Anastomosed to the left anterior descending artery, the LIMA provides reassuring protection in this critical territory, however it generally involves […]
Changing trends in AMI
Large series from around the Western world have consistently shown falling mortality and morbidity from cardiovascular disease but less information is available about age- and sex-specific outcomes and their changes in the recent past. […]
Early diagnosis of MI using serial troponin measurements
The recent introduction of high sensitivity troponin assays (hsT) has improved the sensitivity of this assay for the detection of myocardial infarction, whilst simultaneously decreasing specificity. To overcome this problem, the use of troponin kinetics – to identify acute myocardial damage – has been proposed, either alone or in combination with other diagnostic markers of […]
Vorapaxar fails to improve outcomes
Thrombin is a key component in the coagulation cascade, cleaving fibrinogen to form insoluble fibrin, and also acting as a potent platelet activator through its action on protease activated receptors. In the TRACER study the efficacy of the oral PAR-1 antagonist vorapaxar was assessed in patients presenting with non-ST elevation acute coronary syndromes. […]