Ischemic mitral regurgitation (MR) is common and associated with poor outcomes among patients undergoing bypass surgery. However, it remains unknown whether repair of ischemic MR concurrent to CABG leads to better patient outcomes. To address this important clinical question, this multi-center study randomly assigned 301 patients with moderate ischemic MR to CABG alone or CABG […]
Tag: ischaemic heart disease
Benefits of beta-blockade in stable coronary disease may be overestimated
While the benefits of beta-blockade following myocardial infarction (MI) are well known, these benefits have been extrapolated to all patients with coronary artery disease (CAD), and even to high risk patients without coronary artery disease. However, beta-blockers also have a number of side effects and their tolerability is not ideal. Therefore, the objective of this […]
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 […]
Depression and reduced survival among patients with heart failure
In order to evaluate the association of long-term mortality with antidepressant use and severity of depression, assessed using the Beck Depression Inventory (BDI), O’Connor and colleagues studied 1,006 patients, aged 18 years or older who were admitted to hospital with clinical (NYHA ≥ II) and/or echocardiographic evidence of systolic heart failure (left ventricular ejection fraction […]
Fractional Flow Reserve achieves FAME at last
Fractional flow reserve (FFR), calculated using a coronary presure wire, is an index of the physiological significance of a coronary stenosis and is defined as the ratio of maximal blood flow in a stenotic artery to normal maximal flow. FFR in a normal artery is 1.0 – a value <0.80 identifies ischaemia causing lesions with […]
Exercise caution when using treadmill ECGs for angina assessment
Prompt assessment and risk stratification is fundamental to the early management of patients presenting for the first time with suspected angina. Within the setting of rapid access chest pain clinics (RACPC), risk stratification is traditionally achieved by history taking, examination, resting ECG and exercise ECG (ex-ECG). However, it remains unclear whether the inclusion of resting […]