More than 50% of all cardiac deaths are due to sudden cardiac death (SCD), and in the majority of individuals SCD is the first sign of coronary heart disease – this is especially true in women. The aim of this study was to determine the degree to which adherence to a healthy lifestyle may lower […]
Category: General cardiology
High-dose statin therapy linked to diabetes
Three recent trials comparing intensive- to moderate-dose statin therapy have suggested an increased risk of incident diabetes in patients treated with high-dose statin regimens. To investigate this phenomenon further, the authors conducted a collaborative meta-anlysis of published and unpublished data from five statin trials, all of which were randomise controlled end-point trials that compared intensive-dose […]
Lipid metabolism by gut flora influences cardiovascular disease
Although the relationship between cholesterol, triglycerides, and cardiovascular disease is well established, little is known about the role of the third major class of lipids – phospholipids. In this regard, the intestinal microflora play a crucial role in that they digest and absorb many crucial nutrients, including lipids. Therefore in this study the authors attempted […]
LDL cholesterol lowering in CKD looks SHARP
While the cardiovascular benefits of LDL cholesterol lowering in patients without kidney disease are well established, the effects on people with moderate to severe kidney disease has remained unproven. The SHARP (Study of Heart and Renal Protection) study was a randomised double-blind trial that included 9270 patients with chronic kidney disease (3023 of whom were […]
Fibrate use on the increase in the USA
Evidence regarding the clinical benefit of fibrate therapy remains mixed. Although some older trials suggested a reduction cardiovascular events compared to placebo, more recent studies (e.g. ACCORD, FIELD) have failed to show any added benefit over statin therapy. The aim of this study was to examine trends in the use of fibrates in the US […]
STICH examines the role of CABG in heart failure
While the efficacy of CABG in improving both morbidity and mortality in patients with severe coronary artery disease and angina was established in the 1970’s, the majority of patients who took part in these initial ground-breaking studies had normal or near normal ventricular function. The role of CABG in treating patients with poor systolic LV […]
PRECOMBAT: PCI viable for unprotected left main disease
The SYNTAX study, which randomised patients with complex severe coronary disease to either CABG or PCI, found that CABG remains a superior treatment option for the majority of these patients. However, in a substudy of patients who had left main stem (LMS) disease, SYNTAX suggested equipoise between the two treatments. Since then, the debate about […]
Coronary CT in a low-risk population
The role of atherosclerotic plaque imaging techniques in the primary prevention of cardiovascular disease remains to be determined. Perhaps the most promising technique at the moment is coronary CT, which has a high sensitivity for the detection of atherosclerosis. However, the benefits of CT must be balanced against the risks of contrast and radiation exposure. […]
Medical therapy underused in patients undergoing PCI
Optimal medical therapy (OMT) has previously been shown to lead to similar rates of cardiovascular events as percutaneous coronary intervention (PCI) in patients with stable coronary artery disease. Most noticeably, the COURAGE trial showed that PCI did not improve patient survival or prevent myocardial infarction. However, it is also known that the findings of important […]
CABG rates decline in USA over the last decade
Coronary revascularisation, either by coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI), is one of the most commonly performed procedures in the USA. Over the last ten years a number of technological and pharmacological improvements have changed the landscape of coronary revascularisation and led to a number of changes in guidelines and appropriateness […]