Coronary arteries form from reprogramming of venous cells

The cellular and developmental origins of the coronary arteries remain relatively poorly studied; determining how coronary vessels arise during development, are maintained in adult life, and remodel under pathological conditions could further our understanding of diseases such as atherosclerosis. In the paper Red-Horse et al. carried out anatomical and histological analysis of coronary vessel development […]

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Optimal Duration of Dual Antiplatelet Therapy Remains Unclear

Dual antiplatelet therapy with aspirin and clopidogrel has become the cornerstone of the treatment of acute coronary syndromes. While 12 months has become the standard treatment time for most patients, it remains unclear whether longer durations of treatment may provide additional benefit, and in particular whether it allay fears regarding the risk of late stent […]

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Novel blood pressure agent shows promise

Natriuretic peptides have a number of beneficial vascular effects: vasodilator and natriuretic properties, reduced sympathetic drive, antiproliferative effects, and inhibition of the renin-angiotensin-aldosterone (RAAS) system.  Inhibition of neprilysin (neutral endopeptidase 24.11) leads to an increase in natriuretic peptide levels, however on its own this mechanism does not lead to a clinically significant decrease in blood […]

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Aortic valve reoperative outcomes improve dramatically

With an increasingly elderly population and improvements in surgical and medical management, patients are living longer after cardiac surgery. Consequently, a higher percentage of patients with aortic valve disease are likely to undergo reoperative aortic valve replacement (AVR) in the foreseeable future. Previously, reoperative AVR was considered a high-risk operation with quoted mortality figures up […]

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ABPI cannot be used to determine primary prevention benefit from aspirin

A low ankle brachial index (ABI) indicates the presence of atherosclerotic arterial disease, and therefore an increased risk of cardiovascular and cerebrovascular events. Screening for a low ABI may therefore identify a group of asymptomatic individuals who may benefit from preventive treatments. The Aspirin for Asymptomatic Atherosclerosis (AAA) trial was therefore established to investigate the […]

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Anticholinergics and Cardiovascular Safety

Increasingly, the cardiovascular safety of commonly prescribed drugs has been brought into question with the notable recent examples of the COX-2 inhibitors and the thiazolidinediones.  Among the most frequently prescribed inhaled medications for COPD, a common condition in patients with coronary disease due to the shared aetiology of cigarette smoking, are anticholinergic agents such as […]

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Preconditioning Prior to Primary PCI shows benefit

Remote ischaemic preconditioning, induced by brief periods of limb ischaemia (for example by inflating a blood pressure cuff), has previously been shown to reduce ischaemic damage in the heart if applied prior to predictable ischaemia (e.g. cardiac surgery).  However, it has not previously been investigated whether remote ischaemic preconditioning can be used to reduce myocardial […]

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Moderate emphysema impairs diastolic function

Severe chronic obstructive pulmonary disease leads to cor pulmonale , characterised by elevated pulmonary vascular resistance and secondary reductions in left ventricular filling, stroke volume, and cardiac output.  However, whether similar changes occur in more moderate emphysematous disease is unknown.  In order to investigate this question the authors of this papar studied 2816 people between […]

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