The 2008 Physical Activity Guidelines for Americans recommended 150 to 300 minutes of moderate-intensity or 75 to 150 minutes of vigorous-intensity aerobic activity weekly for optimal health. However, these guidelines acknowledged uncertainty on the upper threshold of benefit or potential harms of high activity levels. Using data from 6 pooled cohorts from the National Cancer Institute Cohort Consortium (baseline 1992-2003) […]
Category: General cardiology
Second-generation stents fail to BEST CABG
The technology of drug eluting stents for percutaneous coronary intervention (PCI) has improved over time with resultant improvements in patient outcomes. Although prior studies have demonstrated the benefit of surgical coronary artery bypass grafting (CABG) over transcatheter PCI among patients with multivessel coronary artery disease (CAD), these studies did not incorporate newer generation drug-eluting stents. […]
Aspiration thrombectomy fails to demonstrate benefit in primary PCI
Although primary percutaneous coronary intervention (PPCI) restores epicardial coronary flow in the majority of patients with ST-segment myocardial infarction, this approach can lead to microvascular obstruction resulting from distal embolization of thrombus. Manual thrombectomy (i.e. aspiration thrombectomy) prior to PPCI has been proposed as a method to reduce thrombus burden and resultant distal embolization with […]
Risk of adverse events changes over time following hospitalization
Readmissions and death after hospitalization are common. However, there no data on how the risk for these adverse events changes over time following hospitalization. In this study, the authors explored the absolute risk and changes in risk over time for readmission and mortality in the year following hospitalization for myocardial infarction (MI), pneumonia or heart […]
Risks of NSAID Use after Myocardial Infarction
Nonsteroidal anti-inflammatory drugs (NSAID) are frequently used as over-the-counter and prescription medications. Although prior studies have raised concern about the cardiovascular safety of these medications, detailed information on the risk of these medications in patients after myocardial infarction (MI) is lacking. In this study, retrospective Danish National Patient Registry data was evaluated for all patients […]
HDL and Cardiovascular Risk: Rethinking the Relationship
Although lower HDL levels are associated with increased cardiovascular risk, therapies to raise HDL levels have failed to reduce cardiovascular events. In this sub-study of the longitudinal Dallas Heart Study, the authors turn their attention from absolute levels of HDL to reverse cholesterol transport in the shape of HDL efflux capacity. This efflux capacity is […]
Surgical Repair of Moderate Mitral Regurgitation at the Time of CABG Lacks Clear Benefit
Ischemic mitral regurgitation (MR) is common and associated with poor outcomes among patients undergoing bypass surgery. However, it remains unknown whether repair of ischemic MR concurrent to CABG leads to better patient outcomes. To address this important clinical question, this multi-center study randomly assigned 301 patients with moderate ischemic MR to CABG alone or CABG […]
The DENERHTN Randomized Controlled Trial: Renal Denervation for Resistant Hypertension Revisited
Despite large reductions in blood pressure seen in early studies of renal denervation, the SYMPLICITY HTN-3 randomized trial failed to show a reduction in systolic blood pressure with renal denervation when compared to medical therapy alone. As a result, interest in renal denervation as a treatment for resistant hypertension has waned. In the DENERHTN trial, […]
Coronary Artery Disease Screening Using CT Angiography Lacks Benefit
Although prior studies of screening for coronary artery disease (CAD) in high-risk patients have failed to demonstrate benefit, screening with cardiac coronary computed tomography (CCTA) may hold promise by providing more detail on the extent of coronary atherosclerosis. This trial randomized 900 patients with a 3 to 5 years history of type 1 or 2 […]
Why is Atherosclerotic Cardiovascular Disease Risk Overestimated by the ACC/AHA Pooled Cohort Equation?
The 2013 ACC/AHA Cholesterol Guidelines expand the recommendations for statin use to populations previously felt to be at lower risk. Central to risk-estimation in these guidelines is a new equation for determination of atherosclerotic cardiovascular disease (ASCVD) risk. However, this risk model has been criticized overestimating ASCVD risk in validation studies of the model. Using […]