VAD survival rate lower than expected in new analysis

In 2003 Medicare extended coverage of ventricular assist devices (VAD) as destination (permanent) therapy for end-stage heart failure in the USA.  Hernandez et al. performed an analysis to determine the short- and long-term clinical outcomes of patients receiving VAD therapy, as well as the costs involved, since this change. […]

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Thrombolysis in stroke: minutes mean mind

The current thrombolysis guidelines for acute ischaemic stroke recommend thrombolysis with alteplase initiated within 3 hours of symptom onset.  This was following the landmark findings of the 1995 National Institute of Neurological Disorders and Stroke (NINDS) study group.  The ECAS III trial (European Cooperative Acute Stroke Study), a multi-centre, randomised, placebo controlled phase 3 trial […]

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SEAS apart: no role for lipid lowering in aortic valve disease

Calcific aortic stenosis shares risk factors with coronary heart disease and predicts death and MI without the need for large gradients.  Hyperlipidaemia has been suggested as a risk factor for the development of aortic stenosis but to date lipid lowering studies have demonstrated conflicting results. […]

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ARIA suggests diagnostic angiography underused

Deciding which patients presenting with chest pain should undergo diagnostic coronary angiography (DCA) is an everyday dilemma for the cardiologist.  In the ARIA (Appropriateness of Referral and Invesigation of Angina) study, Hemingway and colleagues used scoring criteria, based on patient-specific characteristics and validated by 2 panels of experts made up of 22 UK physicians, in […]

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Plastics additive linked to cardiovascular disease

Bisphenol A (BPA) is the base chemical used to make several plastic containers, cans and dental sealants.  Evidence from animal studies has suggested several potential biological effects of BPA, including estrogenic activity, liver damage, thyroid hormone dysfunction, and obesity-promotion. […]

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Metabolic assays of ischaemia show early promise

Metabolic technologies allow the profiling of low-molecular weight biochemicals such as amino acids, sugars, and lipids that are substrates and products in important biological processes, such as ischaemia.  To examine whether this techology could be used to allow earlier detection of myocardial ischaemia and infarction, Lewis et al. applied mass spectrometry-based metabolite profiling to 36 […]

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Bicuspid aortic valves – increased morbidity but not mortality

Bicuspid aortic valve is the commonest congenital cardiac abnormality in the adult population.  Previous pathological studies have outlined aortic valve dysfunction, endocarditis, and even aortic dissection as potential causes of increased morbidity in this patient group.  The purpose of this study was to observe the disease progression and cardiac outcomes of a large contemporary adult […]

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BEAUTIFUL – no go for go slow with ivabradine

Ivabradine is a pure heart-rate lowering agent that is a specific inhibitor of the If current in the sino-atrial node; currently it is licenced for the treatment of angina.  The BEAUTIFUL (morbidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left-ventricUlar dysfunction) trial aimed to determine if heart rate lowering with […]

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SEARCHing For A Genetic Cause of Statin Myopathy

The incidence of myopathy secondary to statin use is approximately 1 in 10,000 patients/year on standard doses, but increases with higher doses or concurrent prescription of drugs such as cyclosporine that can inhibit statin metabolism.  Identification of genetic factors that influence an individual’s susceptibility to these complications would improve patient management by identifying those who […]

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