Familial hypercholesterolaemia is characterised by substantially raised plasma concentrations of low-density lipoprotein cholesterol (LDL-C) and is associated with a risk of coronary heart disease that is five to eight times higher than average. One charity has estimated a saving of £378.7 million from cardiovascular events avoided if all relatives of index cases were identified and […]
Category: General cardiology
Triple therapy post-PCI? WOEST clarifies
20-30% of patients taking oral anticoagulants also have ischaemic heart disease that requires treatment by percutaneous coronary intervention (PCI), thereby necessitating dual anti-platelet therapy to prevent stent thrombosis. However, the combination of dual anti-platelet therapy (DAP) and anti-coagulants is associated with a high annual risk of fatal and non-fatal bleeding episodes. This study hypothesised that […]
Atherosclerosis: not just a disease of the modern age?
As life expectancy doubled between 1800 and 2000, atherosclerosis replaced infectious diseases as the main cause of death in the developed world. But is atherosclerosis a purely modern phenomenon, precipitated by lifestyle changes and an ageing population, or was it common in ancient societies too? […]
Breast radiotherapy increases heart disease risk
Breast cancer remains the commonest cancer in women with approximately 1 million new cases diagnosed annually. However, survival rates have increased year-on-year with 5 year disease free survival as high as 90% in women in whom the tumour is diagnosed early. Large numbers of cancer survivors are therefore present in the population – an estimated […]
SYNTAX II: Improved predictive value
The anatomical SYNTAX score is advocated in both US and European guidelines to help establish the best revascularisation approach in patients with complex coronary artery disease. The purpose of this study was to improve the SYNTAX score further by including prognostically important clinical variables, as opposed to the anatomical variables that are used for the […]
Weight gain, smoking cessation, and cardiovascular risk
It is known that smoking cessation substantially reduces the risk of cardiovascular disease (CVD), but does any subsequent weight gain attenuate the benefits of quitting smoking? The goal of this study was to answer this question in adults with and without diabetes. Specifically, the authors tested the hypothesis that quitting smoking decreases CVD risk compared […]
Ramipril improves symptoms of intermittent claudication
Approximately a third of patients with peripheral arterial disease (PAD) will develop intermittent claudication. A previous pilot trial found that the angiotensin-converting enzyme inhibitor ramipril is associated with increased pain-free and maximum walking times, contrasting with previous ACE inhibitor studies which may have been limited by issues of small sample size, short intervention duration, and […]
Reducing blood transfusions after cardiac surgery: clinical and economic benefits
Following cardiac surgical operations, blood transfusions are associated with a host of complications, including nosocomial infections, immunosuppression, transfusion-related acute lung injury, decreased health-related quality of life, and reduced early and long-term survival. A number of guidelines now emphasise the importance of conservative transfusion strategies and in this study, Lapar et al examine the impact of […]
Aldo-DHF: spironolactone improves diastolic function
Heart failure with preserved ejection fraction (HF-PEF) accounts for more than 50% of heart failure cases. To date, medical therapy has failed to show improvements in diastolic dysfunction, cardiac remodelling, or cardiovascular outcomes. As mineralocorticoid receptor activation by aldosterone contributes to the pathophysiology of HF through several different mechanisms, the Aldosterone Receptor Blockade in Diastolic […]
Cinacalcet fails to improve cardiovascular outcomes in dialysis
The risk of cardiovascular death in patients with chronic kidney disease is increased by a factor of ten in comparison with the general population. While a host of factors including chronic inflammation, increased oxidative stress and endothelial dysfunction contribute to this risk, disorders of mineral metabolism, including secondary hyperparathyroidism, are thought to contribute by promoting […]