The role of atherosclerotic plaque imaging techniques in the primary prevention of cardiovascular disease remains to be determined. Perhaps the most promising technique at the moment is coronary CT, which has a high sensitivity for the detection of atherosclerosis. However, the benefits of CT must be balanced against the risks of contrast and radiation exposure. […]
Latest articles
Medical therapy underused in patients undergoing PCI
Optimal medical therapy (OMT) has previously been shown to lead to similar rates of cardiovascular events as percutaneous coronary intervention (PCI) in patients with stable coronary artery disease. Most noticeably, the COURAGE trial showed that PCI did not improve patient survival or prevent myocardial infarction. However, it is also known that the findings of important […]
Erythropoietin fails to reduce myocardial damage in STEMI
Patients who survive STEMI often go on to develop infarct expansion and myocardial thinning which can lead to heart failure and, ultimately, death. In an attempt to limit this phenomenon, several agents have been proposed, amongst them erythropoietin. In addition to its effects on red blood cell production, erythropoietin also stimulates angiogenesis and apoptosis, and […]
CABG rates decline in USA over the last decade
Coronary revascularisation, either by coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI), is one of the most commonly performed procedures in the USA. Over the last ten years a number of technological and pharmacological improvements have changed the landscape of coronary revascularisation and led to a number of changes in guidelines and appropriateness […]
Measures of clinical adiposity and cardiovascular risk
The importance of clinical measures of adiposity (such as body-mass index [BMI], waist circumference, and waist-to-hip ratio) in calculating cardiovascular risk remains controversial. For example, both the World Health Organisation and the United States National Heart, Lung and Blood Institute recommend assessment of BMI, however several common cardiovascular disease risk scores (e.g. PROCAM) omit adiposity […]
Use of evidence-based treatments improves STEMI outcomes
Over the last two decades several new treatments, both pharmacological and mechanical, have become available for the treatment of ST-elevation myocardial infarction (STEMI). As a result, several rounds of national and international guidelines have been developed to guide the implementation of these evidence-based treatments in clinical practice. However, relatively few data are available on how […]
Adolescent BMI predicts future cardiovascular risk
The emerging pandemic of obesity is threatening to reverse the gains in cardiovascular mortality and morbidity that have occurred during the latter half of the 20th century. While adult obesity is clearly related to cardiovascular risk the association of body-mass index (BMI) in adolescence to future adult cardiovascular disease has not been completely delineated. […]
Percutaneous Treatment of Mitral Regurgitation
Just as percutaneous therapy for coronary artery disease has revolutionized the management of patients with atherosclerosis and offered an alternative to traditional surgical management, percutaneous treatments are now becoming established for valvular heart disease. While percutaneous aortic valves are becoming increasingly common-place, treatment options for mitral regurgitant disease remain limited. One such option in development […]
PPCI less effective in the elderly
In the Apex-AMI (Assessment of Pexelizumab in Acute Myocardial Infarction) trial, the novel anti-inflammatory agent Pexelizumab was not found to improve outcomes when given during PPCI. However, the study did enrol the largest group of patients 75 years or older with ST-segment elevation myocardial infarction to be treated with primary percutaneous coronary intervention (PPCI) in […]
Impaired monocyte recruitment leads to plaque stabilisation
Recruitment of monocytes into atherosclerotic plaque has been shown to drive disease progression, and the presence of a higher number of macrophages has been associated with increased plaque vulnerability. Conversely, a reduction in plaque macrophage content has been associated with plaque stabilisation; however, it has not previously been described exactly how macrophages are removed from […]