Where the benefits of renin-angiotensin-aldosterone system blockade for reduction of cardiovascular risk are similar for ACE inhibitors (ACEI) and ARBs are unknown. The answer to this question is of particular importance among diabetics, given the higher cardiovascular risk in this patient population. In this meta-analysis, the authors examined effect of ACEI and ARBs on the […]
Tag: diabetes
Bilateral internal mammary grafts in diabetics: benefits outweigh perioperative risks
Patients with diabetes have more severe coronary disease at presentation and worse overall outcomes than their non-diabetic counterparts, even following surgical revascularisation. Whilst use of the left internal thoracic artery (LITA) is well established and improves event free survival when anastomosed to the LAD, the use of both right and left internal thoracic arteries in […]
Weight gain, smoking cessation, and cardiovascular risk
It is known that smoking cessation substantially reduces the risk of cardiovascular disease (CVD), but does any subsequent weight gain attenuate the benefits of quitting smoking? The goal of this study was to answer this question in adults with and without diabetes. Specifically, the authors tested the hypothesis that quitting smoking decreases CVD risk compared […]
FREEDOM: CABG superior to PCI in diabetics
Diabetes is one of the principle aetiological factors for coronary artery disease with vascular disease in diabetics displaying a particularly aggressive phenotype, often resulting in multivessel disease. Current evidence suggests that CABG is particularly beneficial in these patients as compared with PCI. however, much of this evidence was either gathered in the era before modern […]
Fish oils fail to prevent cardiovascular events in diabetics
The use of fish derived n-3 fatty acids following myocardial infarction has been shown to be beneficial in preventing further cardiovascular events and reducing mortality, particularly from sudden cardiac death. However the effects of these drugs in preventing cardiovascular events in high risk patients with (or at risk for) type 2 diabetes mellitus, but who […]
High-dose statin therapy linked to diabetes
Three recent trials comparing intensive- to moderate-dose statin therapy have suggested an increased risk of incident diabetes in patients treated with high-dose statin regimens. To investigate this phenomenon further, the authors conducted a collaborative meta-anlysis of published and unpublished data from five statin trials, all of which were randomise controlled end-point trials that compared intensive-dose […]
No benefit from screening asymptomatic type 2 diabetics for CAD
Should patients with type 2 diabetes be screened for coronary artery disease if asymptomatic? In the DIAD study (Detection of Ischemia in Asymptomatic Diabetics), 1123 patients with type 2 diabetes and no symptoms of coronary artery disease (CAD) were randomly assigned to be screened with adenosine-stress myocardial perfusion imaging (MPI) or to no screening. The […]
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 […]
Longer antiplatelet therapy gives good DES outcomes
Recently an excess of acute adverse coronary events has been reported among diabetic patients treated with drug eluting coronary stents (DES) who received short-term (<6 months) dual antiplatelet therapy (Circulation 2007;115:1440-55). […]
Plastics additive linked to cardiovascular disease
Bisphenol A (BPA) is the base chemical used to make several plastic containers, cans and dental sealants. Evidence from animal studies has suggested several potential biological effects of BPA, including estrogenic activity, liver damage, thyroid hormone dysfunction, and obesity-promotion. […]