Clopidogrel is now the second most commonly used prescription drug world wide, driven by its adjunctive use in interventional cardiology with aspirin as dual antiplatelet therapy (DAPT). Upper gastrointestinal (GI) bleeding is the most common serious complication associated with the long-term use of DAPT and some observational data have suggested that the prophylactic use of […]
Latest articles
Chest-compression-only CPR encouraged for out-of-hospital arrest
The optimal resuscitation method for out-of-hospital cardiac arrest remains controversial. Although current basic life-support guidelines recommend both chest compressions and rescue ventilation, more recent evidence has questioned the usefulness of rescue ventilation. […]
Blood transfusion overused following cardiac surgery
Although cardiac surgery is associated with a high rate of allogeneic blood transfusion, evidence about the optimal protocol for blood transfusion for patients undergoing heart surgery is lacking. The rationale for treatment is based on the fact that anaemia is an independent risk factor for morbidity and mortality following cardiac operations, but transfusions themselves have […]
Adenosine antagonist fails to improve heart failure symptoms
Deterioration in renal function during the acute treatment of heart failure is a common problem, limiting the ability to up-titrate therapy, and is associated with adverse outcomes. Accrued evidence has implicated physiologically released adenosine as an important mediator of both worsening renal function and diuretic resistance. Adenosine, acting on adenosine A1 receptors in the afferent […]
Acute alcohol consumption causes myocardial inflammation
Acute alcohol consumption is known to induce a systemic inflammatory reaction that might lead to alcohol-induced myocardial inflammation. Cardiac Magnetic Resonance Imaging (MRI) is capable of detecting both acute inflammation and fibrosis of the myocardium; the authors of this paper therefore set out to investigate whether binge drinking could indeed induce myocardial inflammation. […]
Genetic score improves cardiovascular risk prediction
Genome-wide association studies have found single nucleotide polymorphisms (SNPs) at 13 genomic regions that are associated with coronary artery disease, myocardial infarction, or both. However, genetic discovery studies have the potential for several types of bias, therefore this prospective cohort study attempted to determine whether precise risk estimates could be made using these genetic association […]
Optimal doses for aspirin and clopidogrel
Despite the ubiquitous use of aspirin and clopidogrel in acute coronary syndromes for over a decade there remains a lack of consensus over optimal dosing strategies and a paucity of modern data to guide clinicians in this most pertinent of issues. As compared with the standard dose of clopidogrel used in early trials, more recent […]
Long-term benefits of CEA for asymptomatic stenosis
Severe stenosis of the carotid artery (60–90%) has been associated with an increased long-term risk of ischaemic stroke. Although carotid endarterectomy can remove the narrowing, the procedure itself is associated with a significant risk of stroke or death. […]
Evidence mounts to RE-LY on dabigatran
Dabigatran etecxilate is a novel anti-coagulant that acts a direct thrombin inhibitor and provides stable anticoagulation at a fixed dose without any need for a laboratory control. In the RE-LY trial (Randomised Evaluation of Long-term Anticoagulation Therapy), dabigatran was shown to reduced strokes and peripheral embolic events in patients with atrial fibrillation when compared to […]
No benefit seen from low dose heparin in PCI
In the OASIS-5 trial (Organzation to Assess Strategies in Acute Ischaemic Syndromes), fondaparinux was found to be non-inferior to enoxaparin for the primary outcome, but was noted to halve major bleeding, leading to a significant mortality reduction. However, a small but significant increase in catheter-related thromboses was also seen, therefore the FUTURA/OASIS-8 trial was set […]