The importance of clinical measures of adiposity (such as body-mass index [BMI], waist circumference, and waist-to-hip ratio) in calculating cardiovascular risk remains controversial. For example, both the World Health Organisation and the United States National Heart, Lung and Blood Institute recommend assessment of BMI, however several common cardiovascular disease risk scores (e.g. PROCAM) omit adiposity […]
Category: General cardiology
Use of evidence-based treatments improves STEMI outcomes
Over the last two decades several new treatments, both pharmacological and mechanical, have become available for the treatment of ST-elevation myocardial infarction (STEMI). As a result, several rounds of national and international guidelines have been developed to guide the implementation of these evidence-based treatments in clinical practice. However, relatively few data are available on how […]
Adolescent BMI predicts future cardiovascular risk
The emerging pandemic of obesity is threatening to reverse the gains in cardiovascular mortality and morbidity that have occurred during the latter half of the 20th century. While adult obesity is clearly related to cardiovascular risk the association of body-mass index (BMI) in adolescence to future adult cardiovascular disease has not been completely delineated. […]
Percutaneous Treatment of Mitral Regurgitation
Just as percutaneous therapy for coronary artery disease has revolutionized the management of patients with atherosclerosis and offered an alternative to traditional surgical management, percutaneous treatments are now becoming established for valvular heart disease. While percutaneous aortic valves are becoming increasingly common-place, treatment options for mitral regurgitant disease remain limited. One such option in development […]
Frusemide strategies in heart failure
While loop diuretics are an acknowledged component of therapy for patients with acute decompensated heart failure, as they were introduced into clinical practice prior to the era of large randomised controlled trials there are few prospective data to guide their use. […]
ARB not found to benefit AF
Whilst reducing blood pressure reduces the risk of heart failure and stroke this relationship has thus far not been demonstrated in patients with atrial fibrillation. This is despite the fact that recent mechanistic work and retrospective analyses have suggested that both ACE inhibitors and ARBs have specific properties that alter atrial mechanical and electrical remodelling […]
Does physical activity trigger cardiac events?
Physical activity conveys many health benefits including a reduction in the chances of developing cardiovascular disease. However, it has also been suggested that physical activity, as well as others acute exposures such as sexual activity and psychological stress, can actually trigger acute cardiac events. […]
Novel diagnostic pathway improves chest pain assessment
Although 75-85% of patients presenting to the emergency department with chest pain ultimately do not receive a diagnosis of acute coronary syndrome, a lengthy assessment process is still mandatory as patients with a missed diagnosis of myocardial infarction are at increased risk for a cardiovascular event. Than et al. prospectively validated the safety of a […]
High-sensitivity troponin assay improves patient outcomes
In recent years clinical troponin assays have become increasingly sensitive, however whether this translates into improved clinical outcomes for patients with suspected acute coronary syndromes (ACS) has not previously been examined. Mills et al. investigated whether the introduction a new, high-sensitivity, troponin assay led to an improvement in patient outcomes. […]
Apixaban shows promise
Warfarin has been the primary treatment to mitigate the increased risk of stroke associated with atrial fibrillation for more than 40 years. However, up to 30% of patients are not suitable candidates for or are unwilling to receive warfarin therapy despite having a high risk of stroke. A host of new oral agents are now […]