Rimonabant is a selective cannabinoid-1 receptor antagonist that has previously been shown to reduce waist circumference and body weight, in addition to improving metabolic factors such as highdensity lipoprotein-cholesterol, adiponectin, triglyceride, insulin and leptin levels. However, no previous trial has been adequately powered to assess whether this can lead to improved clinical outcomes. […]
Category: General cardiology
Targeting valvular heart disease
The prevalence of valvular heart disease, in particular stenotic aortic disease, increases with age and reaches 13% in individuals over the age of 75 years. Despite this the aetiology and molecular mechanisms remain unclear, although several lines of evidence have suggested that its pathogenesis shares similarities to atherosclerotic disease, namely infiltration of inflammatory cells and […]
Rosiglitazone linked to increased vascular events
In 2007 a meta-anlaysis of 42 randomised trials involving rosiglitazone found a 1.4 fold increase in the risk of acute myocardial infarction (AMI) compared with non-thiazolidinedione therapies. Subsequently, a metaanalysis of 19 pioglitazone trials found a significant reduction in a composite outcome of non-fatal AMI, stroke and all-cause mortality. Therefore, this study set out to […]
Self-monitoring of hypertension in primary practice
Despite substantial advances in lifestyle and pharmaceutical interventions, only half of people on treatment for hypertension have their blood pressure controlled to current recommended levels. Patient selfmanagement with self-titration (ie, adjustment) of antihypertensive drugs has previously only been tested on a small scale, therefore this study assessed whether self-management by people with poorly controlled hypertension […]
Meta-analysis outlines true risks of diabetes
Although diabetes mellitus is an established risk factor for coronary heart disease (CHD) and stroke, a number of questions remain. For example, to what extent is diabetes associated with fatal vs non-fatal myocardial infarction? How much of the effect of diabetes on vascular risk is due to the effect of diabetes on lipids and blood […]
No role for B12/Folate Post Myocardial Infarction
Homocysteine has been noted to be consistently higher in patients with occlusive vascular disease than in controls, and this difference is also seen prior to the onset of disease. Although previous large-scale randomised trials have failed to show any benefit from lowering homocysteine levels through the use of folic acid based supplements, the reasons for […]
Modern Trends in Myocardial Infarction
Heart disease, and in particular coronary heart disease, is the leading cause of death worldwide but rates have actually been declining since the 1950s likely due to reductions in smoking prevalence and the availability of effective treatments for hypertension. Consequently, rates of death from acute myocardial infarction (MI) have also been falling but there is […]
Little Change in Prognosis for Ventricular Septal Rupture
Ventricular septal rupture following myocardial infarction is a rare but potentially catastrophic complication. Current ACC and AHA guidelines recommend immediate operative intervention in patients with postinfarction ruptures, regardless of their clinical status, but surgical repair remains very challenging with reported in-hospital mortality being reported in the range of 20-60%. […]
Allopurinol anti-ischaemic in stable angina
Allopurinol is a xanthine oxidase inhbitor which has previously been shown to reduce myocardial oxygen consumption in patients with heart failure. As such, as the authors of this paper decided to investigate the potential benefit of high-dose allopurinol in patients with chronic stable angina. […]
Triglyceride association with coronary disease strengthened
It is uncertain whether conditions characterized by increased circulating triglyceride concentrations are causal in coronary heart disease. Although epidemiological associations have suggested a positive correlation between triglyceride levels and coronary risk, these associations disappear after controlling for HDL and LDL cholesterol. […]