Differentiation of resident stem cell population improves cardiac function

The quest to regenerate functional myocardium from stem cells following myocardial infarction has garnered a great deal of media attention and has become something of a holy grail in cardiovascular medicine.  Despite the basic science of stem cells still being at an early stage, the first human trials have already been conducted – but the […]

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How appropriate is coronary intervention?

When is a PCI procedure “appropriate” and when is it not?  The answer depends on how you define “appropriate”, and recently appropriate use criteria for coronary revascularisations have been jointly developed by six professional organisations, including the AHA and ACC.  The aim of this study, therefore, was to assess the appropriateness of PCI in the […]

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HORIZON-AMI: 3 year outcomes remain positive

The HORIZONS-AMI trials previously reported a reduction in major bleeding and net adverse clinical events in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) and treated with bivalirudin, as apposed to the use of heparin and a glycoprotein IIb/IIIa inhibitor.  In addition, if eligible, patients were randomised to receive a paclitaxel-eluting […]

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High-dose statin therapy linked to diabetes

Three recent trials comparing intensive- to moderate-dose statin therapy have suggested an increased risk of incident diabetes in patients treated with high-dose statin regimens.  To investigate this phenomenon further, the authors conducted a collaborative meta-anlysis of published and unpublished data from five statin trials, all of which were randomise controlled end-point trials that compared intensive-dose […]

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Lipid metabolism by gut flora influences cardiovascular disease

Although the relationship between cholesterol, triglycerides, and cardiovascular disease is well established, little is known about the role of the third major class of lipids – phospholipids.  In this regard, the intestinal microflora play a crucial role in that they digest and absorb many crucial nutrients, including lipids.  Therefore in this study the authors attempted […]

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LDL cholesterol lowering in CKD looks SHARP

While the cardiovascular benefits of LDL cholesterol lowering in patients without kidney disease are well established, the effects on people with moderate to severe kidney disease has remained unproven. The SHARP (Study of Heart and Renal Protection) study was a randomised double-blind trial that included 9270 patients with chronic kidney disease (3023 of whom were […]

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STICH examines the role of CABG in heart failure

While the efficacy of CABG in improving both morbidity and mortality in patients with severe coronary artery disease and angina was established in the 1970’s, the majority of patients who took part in these initial ground-breaking studies had normal or near normal ventricular function.  The role of CABG in treating patients with poor systolic LV […]

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PRECOMBAT: PCI viable for unprotected left main disease

The SYNTAX study, which randomised patients with complex severe coronary disease to either CABG or PCI, found that CABG remains a superior treatment option for the majority of these patients.  However, in a substudy of patients who had left main stem (LMS) disease, SYNTAX suggested equipoise between the two treatments.  Since then, the debate about […]

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