The outcomes of coronary artery bypass grafting (CABG), when compared with percutaneous coronary intervention (PCI) might vary according to the patient characteristics, such as the presence of diabetes or the number of diseased vessels. However, no randomized trial to date has been large enough to provide adequate statistical power for sub-group analysis, and meta-analyses have […]
Category: General cardiology
MONICA – evidence based medicine in the real world
Previous studies, such as the World Health Organisation MONICA (monitoring trends and determinants in cardiovascular disease) project, have demonstrated the rapid and progressive uptake of medical care that has been shown in randomised clinical trials to reduce cardiovascular mortality [Lancet 2000;355:688-700]. However, there are relatively few population based studies available that describe how this apparent […]
Catheter-based treatment of hypertension shows promise
Renal sympathetic efferent and afferent nerves are crucial for the initiation and maintenance of systemic hypertension, and as such renal sympathetic denervation is a potential therapeutic target for hypertension.Krum et al. describe the development of a novel, percutanoeus, catheter-based approach to renal sympathetic denervation.The lumen of the main renal artery is cannulated and the surrounding […]
Fasting blood glucose levels identify high-risk individuals across the ACS spectrum
Elevated blood glucose at hospital admission, and elevated fasting blood glucose levels during admission, have been shown to predict worse outcome among patients with STEMI, however, the contribution of glucose levels to risk predictive algorithms involving patients with acute coronary syndromes (ACS) remains unclear. […]
Omega-3 meta-analysis shows mortality benefit
Data from the GISSI-Prevenzione study[Lancet 1999;354:447-55] suggested that omega-3 fatty acids may have the ability to reduce death from cardiovascular causes, mainly through a reduction in sudden cardiac death (SCD). However, subsequent studies among patients with implantable cardiac defibrillators (ICD) failed to demonstrate any reduction in device therapy with supplemental fish oils, possibly due to […]
Assessing Risk in ACS – Risk Scores More Reliable
How well do physicians assess risk in non-ST elevation (NSTEMI) acute coronary syndrome (ACS) patients? Recent studies have suggested that often high-risk patients are the ones who receive less aggressive therapy – the so called “treatment-risk paradox”. This study sought to identify the patient characteristics that physicians considered to be high-risk, and to examine how […]
Depression and reduced survival among patients with heart failure
In order to evaluate the association of long-term mortality with antidepressant use and severity of depression, assessed using the Beck Depression Inventory (BDI), O’Connor and colleagues studied 1,006 patients, aged 18 years or older who were admitted to hospital with clinical (NYHA ≥ II) and/or echocardiographic evidence of systolic heart failure (left ventricular ejection fraction […]
Role of thrombolysis for PE not yet clear
Standard therapy for the treatment of acute pulmonary embolism (PE) consists of regimes involving anticoagulation therapy alone. Thrombolytic therapy (TT) may provide a mechanism for more rapid thrombus resolution and improvement in pulmonary blood flow and may therefore offer benefit among certain patient groups, such as those presenting with features of cardiopulmonary compromise. However, previous […]
Diastolic dysfunction leads to decreased exercise capacity
Determining the most important parameters affecting exercise performance, particularly in relation to age, could have important implications for rehabilitation. Although a reduction in maximal heart rate is known to be important, previous studies have implied that left ventricular systolic function did not correlate with maximal exercise time. […]
NSAIDs in Chronic Heart Failure – Further Evidence of Harm
Current guidelines advise against the use of NSAIDs in patients with chronic heart failure (CHF) due to the increased risk of fluid retention. However, many NSAIDS are available over the counter (OTC), and patients obtaining them in this manner may be putting themselves at increased risk of myocardial infarction or worsening heart failure. […]