CRISP-AMI: No role for counterpulsation in non-shock STEMI

Although door-to-balloon times have declined over the last few years, mortality rates from acute ST-elevation myocardial infarction (STEMI) have not improved.  One proposed method to counteract this has been the routine use of intra-aortic balloon counter pulsation (IABC) during primary PCI; animal studies have suggested a reduction in infarct size, and a possible clinical benefit […]

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Coronary Artery Calcium Scanning Improves Risk Stratification

In the JUPITER study, patients with low cholesterol levels but raised high-sensitivity C-reactive protein (hsCRP) levels were seen to benefit from treatment with rosuvastatin, although overall cardiovascular events were low.  In this study, the authors investigated whether the use of coronary artery calcium (CAC) scoring could further stratify risk in a population of patients from […]

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ATOLL: enoxaparin improves STEMI outcomes

Primary Percutaneous Coronary Intervention (PPCI) has traditionally been performed with the use of boluses of unfractionated heparin administered throughout the procedure.  The use of newer agents, such as enoxaparin administered intravenously throughout the procedure, has not previously been compared to this standard of therapy. […]

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When good cholesterol turns bad

Increasing levels of circulating HDL (“good cholesterol”) has been targeted as an important therapeutic goal in reducing the risk of patients with coronary disease.  HDL has been shown to have a variety of potentially beneficial effects including cholesterol efflux from foam cells, promotion of endothelial repair mechanisms and stimulation of the enzyme eNOS to increase […]

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Chronic NSAID use increases mortality from cardiovascular disease

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective and extensively used pain-killers, particularly in the treatment of chronic musculoskeletal problems.  However, doubts about their safety in patients with coronary disease have surfaced, particularly since the NSAID-like COX1 inhibitor, rofecoxib, was withdrawn from the market after a demonstrated  increase in cardiovascular events.  Despite these concerns, compelling data on […]

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Omega-3 fatty acid levels and congestive heart failure

Long-chain omega-3 polyunsaturated fatty acids have previously been associated with a reduced risk of coronary death, however their effect on other cardiovascular outcomes – such as congestive heart failure (CHF) – are less well established.  As CHF is one of the leading causes of hospitalisations, novel targets for its prevention are a priority. […]

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MRI study gives new insights into stress (takotsubo) cardiomyopathy

Stress Cardiomyopathy (SC), originally described as takotsubo, is characterised by severe – but reversible – impairment of left ventricular function in the absence of significant coronary artery disease.  The vast majority of patients present with symptoms similar to those of an acute coronary syndrome, and tend to have good outcomes despite the initial severity of […]

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Clarifying the role of nicotine in weight control

Despite the impressive gains in cardiovascular morbidity and mortality that have occurred over the past decades, a veritable elephant still exists in the room in the shape of the tidal wave of obesity sweeping the globe, which may reverse these advances.  Obesity has proved fundamentally difficult to manage, with few therapies demonstrating sustained weight loss […]

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