Limited data exists on how frequently guidelines change over time. This study examined how frequently class I recommendations (“procedure/treatment should be performed/administered”) in ACC/AHA guidelines were downgraded to a lower class over time. Four independent reviewers examined 619 class I ACC/AHA recommendations in 11 guidelines released between 1998-2007 and revised between 2006-2013. Overall, 495 recommendations […]
Category: General cardiology
Differences in Statin Eligible Patients across Guidelines
Recent ACC/AHA guidelines recommend consideration of statin therapy among patients with a 7.5% 10-year risk of atherosclerotic cardiovascular disease (CVD). In this study, the authors examined implications of these new guidelines as compared with previous European Society of Cardiology (ESC) and Adult Treatment Panel III (ATP III) guidelines in a Dutch population-based prospective cohort of […]
Validation of the Pooled Cohort Risk Equations from Recent ACC/AHA Guidelines
Recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for the assessment of cardiovascular risk recommend a new 10-year atherosclerotic cardiovascular disease (CVD) risk prediction tool called the Pooled Cohort risk equation. This new predictive model developed from cohorts of patients that were largely studied prior to the year 2000. In light of the declining […]
Clonidine and Aspirin Fail to Reduce Peri-operative Myocardial Infarction
Myocardial infarction (MI) is the most common major vascular event that occurs after planned non-cardiac surgery. Multiple strategies have been assessed to try and reduce the rates of peri-operative MI, but few have consistently demonstrated substantial benefit. With a pro-thrombotic environment and marked sympathetic activation thought to play etiological roles, in the POISE-2 study, the […]
Vegetarian diet associated with lower blood pressure
Conflicting evidence exists on the association between a vegetarian diet (involving no or rare meat consumption) and hypertension. In this meta-analysis, the authors included 7 controlled trials and 32 observational studies examining the association between vegetarian diets and hypertension. The 7 trials included 311 individuals with a mean age of 44.5 years. After pooling of […]
ACEI reduce mortality whereas ARB did not in diabetic populations
Where the benefits of renin-angiotensin-aldosterone system blockade for reduction of cardiovascular risk are similar for ACE inhibitors (ACEI) and ARBs are unknown. The answer to this question is of particular importance among diabetics, given the higher cardiovascular risk in this patient population. In this meta-analysis, the authors examined effect of ACEI and ARBs on the […]
Epinephrine for Non-Shockable In-hospital Cardiac Arrest — Time is of the Essence
Guidelines recommend epinephrine as the primary medical intervention for cardiac arrest. However, no randomized trial data are available to support this recommendation. In this observational study from the American Heart Association’s Get With The Guidelines – Resuscitation multi-center registry of in-hospital cardiac arrest, the authors sought to determine if timing of epinephrine administration in the […]
Renal denervation misses the mark in resistant hypertension
The prospect of percutaneous renal-artery denervation to treat hypertension has been widely heralded in response to pilot studies that demonstrated marked reductions in blood pressure after renal denervation. Despite the rapid adoption of catheter-based renal artery denervation, data from large scale randomised controlled trials remains absent. A total of 535 patients with severe resistant hypertension […]
β-blockers beneficial in some, but not all, ischemic heart disease patients undergoing non-cardiac surgery
Whether β-blockers reduce adverse events among patients with stable ischemic heart disease (IHD) undergoing non-cardiac surgery remains in debate. In this Danish study, the authors retrospectively identified 28,263 IHD patients who underwent non-cardiac surgeries and examined the association between pre-procedural β-blockers use and a major adverse cardiovascular event (MACE) defined as 30-day cardiac death, myocardial […]
Glycemic measurements are not helpful in CVD risk prediction among non-diabetics
Several clinical guidelines recommend measurement of glycated hemoglobin (HbA1c) to guide cardiovascular risk (CVD) risk assessment. In this study, the authors examined the utility of adding HbA1c measurements to conventional risk factors in prediction of CVD among non-diabetic patients. Data from 73 prospective studies with nearly 300,000 non-diabetic patients without known CVD at enrollment was […]