Despite the success of statins for both primary and secondary prevention, many patients continue to have a high residual risk of cardiovascular events related to sub-optimal lipid control. One approach to raising HDL cholesterol is to inhibit the cholesteryl ester transfer protein (CETP), a plasma protein that promotes the transfer of cholesteryl esters from HDL […]
Category: General cardiology
Telemonitoring heart failure
Despite a decade of incremental advances in the treatment of heart failure, readmission rates remain persistently high at 50% at 6 months. Telemonitoring has been championed as a potential strategy to improve outcomes so that clinicians can intervene early if there is evidence of clinical deterioration. Small studies have suggested that this strategy works, and […]
Many US ICD implants not evidence based
For patients with severe systolic heart failure, several randomised trials have shown the ability of implantable cardioverter-defibrillator (ICD) devices to prevent sudden cardiac death. However, current US guidelines recommend against ICD insertion within 3 months of an initial heart-failure diagnosis, or within forty days of a myocardial infarction. […]
Cardiovascular risk of rofecoxib persists after discontinuation
After the use of rofecoxib was associated with an increased risk of cardiovascular events in the APPROVe (Adenomatous Polyp Prevention on Vioxx) trial, the drug was withdrawn from the worldwide market in 2004. A 1-year period of postdrug observation has already revealed an increased cardiovascular risk even after stopping treatment, therefore the aim of this […]
High sensitivity troponin detects subclinical cardiovascular disease
Although most commonly used in the setting of acute coronary syndromes, it is also recognised that elevated troponin levels are seen in other clinical scenarios such as chronic kidney disease, heart failure, and chronic kidney disease. Troponin T (TnT) is occasionally detectable in individuals from the general population, and although this has been associated with […]
Statins safe in patients with abnormal liver function
Although statins are known to cause rises in liver function tests after their initiation, they have also been noted to improve liver function and biochemical tests in patients with non-alcoholic fatty liver disease, the most common cause of abnormal liver function tests in the developed world. […]
Prophylactic omeprazole reduces antiplatelet associated bleeding
Clopidogrel is now the second most commonly used prescription drug world wide, driven by its adjunctive use in interventional cardiology with aspirin as dual antiplatelet therapy (DAPT). Upper gastrointestinal (GI) bleeding is the most common serious complication associated with the long-term use of DAPT and some observational data have suggested that the prophylactic use of […]
Chest-compression-only CPR encouraged for out-of-hospital arrest
The optimal resuscitation method for out-of-hospital cardiac arrest remains controversial. Although current basic life-support guidelines recommend both chest compressions and rescue ventilation, more recent evidence has questioned the usefulness of rescue ventilation. […]
Blood transfusion overused following cardiac surgery
Although cardiac surgery is associated with a high rate of allogeneic blood transfusion, evidence about the optimal protocol for blood transfusion for patients undergoing heart surgery is lacking. The rationale for treatment is based on the fact that anaemia is an independent risk factor for morbidity and mortality following cardiac operations, but transfusions themselves have […]
Adenosine antagonist fails to improve heart failure symptoms
Deterioration in renal function during the acute treatment of heart failure is a common problem, limiting the ability to up-titrate therapy, and is associated with adverse outcomes. Accrued evidence has implicated physiologically released adenosine as an important mediator of both worsening renal function and diuretic resistance. Adenosine, acting on adenosine A1 receptors in the afferent […]