Candesartan shows superiority in heart failure

In patients with reduced left ventricular ejection fraction (LVEF), angiotensin II receptor blockers (ARBs) have been shown to decrease cardiovascular mortality and hospital admissions for heart failure.  However, despite having different affinities for the AT1 receptor and different effects on outcomes, few ARBs have been compared head-to-head. This study aimed to compare the effects of […]

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Anacetrapib shows promise

Despite the success of statins for both primary and secondary prevention, many patients continue to have a high residual risk of cardiovascular events related to sub-optimal lipid control.  One approach to raising HDL cholesterol is to inhibit the cholesteryl ester transfer protein (CETP), a plasma protein that promotes the transfer of cholesteryl esters from HDL […]

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Telemonitoring heart failure

Despite a decade of incremental advances in the treatment of heart failure, readmission rates remain persistently high at 50% at 6 months.  Telemonitoring has been championed as a potential strategy to improve outcomes so that clinicians can intervene early if there is evidence of clinical deterioration.  Small studies have suggested that this strategy works, and […]

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Many US ICD implants not evidence based

For patients with severe systolic heart failure, several randomised trials have shown the ability of implantable cardioverter-defibrillator (ICD) devices to prevent sudden cardiac death.  However, current US guidelines recommend against ICD insertion within 3 months of an initial heart-failure diagnosis, or within forty days of a myocardial infarction. […]

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Cardiovascular risk of rofecoxib persists after discontinuation

After the use of rofecoxib was associated with an increased risk of cardiovascular events in the APPROVe (Adenomatous Polyp Prevention on Vioxx) trial, the drug was withdrawn from the worldwide market in 2004.  A 1-year period of postdrug observation has already revealed an increased cardiovascular risk even after stopping treatment, therefore the aim of this […]

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p53, microRNAs, and myocardial infarction

MicroRNAs (miRNA) are short nucleotide chains that act as inhibitors of gene expression.  Specifically, miR-499 is a cardiac-abundant microRNA that can prevent cardiomyocyte apoptosis by targeting calcineurin-mediated activation of Drp1, an enzyme that normally results in fission of mitochondrial tubules into fragments.  miR-499 may therefore have a key role to play following myocardial infarction, as […]

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High sensitivity troponin detects subclinical cardiovascular disease

Although most commonly used in the setting of acute coronary syndromes, it is also recognised that elevated troponin levels are seen in other clinical scenarios such as chronic kidney disease, heart failure, and chronic kidney disease.  Troponin T (TnT) is occasionally detectable in individuals from the general population, and although this has been associated with […]

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Efficacy of CRT shown in mild-moderate heart failure

Cardiac-resynchronisation therapy (CRT) benefits patients with severe (NYHA III or IV) symptoms of left ventricular systolic dysfunction and a wide QRS complex, reducing both mortality and morbidity, and is often combined with implantable cardioverter-defibrillator (ICD) therapy. Many patients with milder degrees of heart failure (NYHA II or III) are candidates for ICDs but it is […]

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No benefit seen from using omega-3 fatty acids for atrial fibrillation

Fish oils, principally omega-3 fatty acids, have previously been investigated as a potential anti-arrhythmic agent for patients suffering from atrial fibrillation. However, the results of several small trials performed to date have been unclear. Therefore this randomised trial was designed to assess the effect of omega-3 fatty acids on patients with paroxysmal or persisting atrial […]

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