The traditional diagnosis of myocardial infarction (MI) used the World Health Organization definition and required the concentration of a cardiac biomarker to be above twice the upper limit of normal. However, more recent guidelines have defined a troponin level above the 99th percentile of normal as being diagnostic of MI. […]
Latest articles
No role for intermittent amiodarone in AF
Although amiodarone maintains sinus rhythm in 45% to 70% of patients during 12 to 54 months follow-up, it is also associated with many serious non-cardiac side effects. To investigate if episodic treatment with amiodarone could still be effective in preventing atrial fibrillation (AF), but without causing significant side-effects, Ahmed et al. randomised 209 patients with […]
Lp-PLA2 Inhibiton Decreases Complex Plaque Development
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme that is produced by inflammatory cells in atherosclerotic lesions. It has previously been shown to be present at higher levels in the core of ruptured atherosclerotic plaques, although it was unclear whether this was merely an association or whether the enzyme played a key role in plaque vulnerability. […]
UKPDS – 10 year Follow-Up Data Reported
The United Kingdom Prospective Diabetes Study (UKPDS) was a randomised multi-centre trial which demonstrated that intensive glucose therapy in patients with newly diagnosed type 2 diabetes mellitus resulted in a decreased risk of clinically evident microvascular complications and a non-significant reduction in the relative risk of myocardial infarction (p=0.052). The results of 10 year follow […]
A return to rhythm? PVI proves superior in low EF CHF
Atrio-ventricular node ablation has been used to treat symptomatic atrial fibrillation with poor rate control although these studies have contained few subjects with low ejection fractions. Biventricular pacing has recently been shown to be superior to right ventricular pacing following atrio-ventricular node ablation. […]
Noninvasive testing underused prior to PCI
Current ACC/AHA guidelines recommend that in patients with stable angina, noninvasive testing is used to prove mild or moderate ischaemia prior to performing PCI. […]
Polyunsaturated fatty acids improve outcome in heart failure
In the initial Gruppo Italiano per lo Studio della Sopravvivenza nell’infarto miocardico (GISSI) trial, patients taking n-3 polyunsaturated fatty acids (PUFA) after myocardial infarction had a lower mortality rate than those in the control group. The purpose of the GISSI-HF trial was to determine if PUFA could improve morbidity and mortality in patients with symptomatic […]
Ezetimibe and Cancer: What is the risk?
The recent Simvastatin and Ezetimibe in Aortic Stenosis (SEAS) Trial showed that the combined treatment had no impact on the progression of aortic stenosis – but an excess of incident cancers was identified in the simvastatin-ezetimibe group when compared to placebo (105 vs 70, p=0.01). Deaths from cancer were also more frequent in the simvastatin-ezetimibe […]
Beta-blockers could increase risk in noncardiac surgery
Many trials have suggested a protective role for beta-blockade in noncardiac surgery, and the current ACC/AHA guidelines recommend their use in high-risk patients. However, preliminary results from the recent POISE (Perioperative Ischemic Evaluation (POISE) trial showed a higher incidence of total deaths and stroke in patients receiving peri-operative bera-blockade compared with placebo. […]
Anticholinergics increase risk of cardiovascular death
Inhaled anticholinergics – such as ipratropium or tiotropium bromide – are commonly prescribed to patients with chronic obstructive pulmonary disease (COPD). A previous analysis of 19 short-term placebo-controlled trials had suggested a possible increased risk of stroke with inhaled tiotropium, therefore Singh et al. performed a meta-analysis of 17 trials enrolling 14783 patients in order […]