Confabulation of a cardiologist – post ISCHEMIA trial !

I have never found it difficult to retrogradely cross a dangerous epicardial collateral in complex CTO. Delivering a twin stent in a partial culotte strategy for a bifurc lesion has never tested my talents. Stenting a left main across the LAD, jailing the LCX with OCT support is my favorite time pass. Crushing a calcium infested diffuse long lesion with diamond-tipped ablator appear as breezy as shopping in a mall. But this one is really challenging  What is that? Understanding these four studies (Ref 1-4 ). They dogmatically say medical management confers definitive protection in chronic coronary syndromes. It stretches our limits of Imaginary Intelligence! How can a near tight coronary obstruction sitting right across your eyes, be left untouched? The latest one seems to suggest we can even ignore FFR positive lesions. It requires 4 negative forces . . . to bring one big positive Impact! I don’t understand who is funding these negative trials and glorify it, and trying to defame the talents in me. All these studies have a huge lacuna. They conveniently exclude high-risk cases and allowed liberal cross over to PCI later on. Even the just-released ISCHEMIA trial had 38 % patient with no angina. (But why they received PCI ?) How to Interpret these trials and extract the true conclusion? .One consolation is, I know these negative trials have a very short memory and expiry date. Very soon I shall be liberated from the clutches of this negativism. Even as I ...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: acute coronary syndrome acc esc guidelines scai pci ptca stable chd courage bari 2d orbita ischemia trials tips and tricks in ptca Source Type: blogs

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Purpose of review High-protein intake is commonly recommended to help people manage body weight. However, high-protein intake could have adverse health consequences. Here we review the latest findings concerning the effect of high-protein intake on cardiometabolic health. Recent findings Calorie-reduced, high-protein, low-carbohydrate diets lower plasma glucose in people with type 2 diabetes (T2D). However, when carbohydrate intake is not markedly reduced, high-protein intake often does not alter plasma glucose and increases insulin and glucagon concentrations, which are risk factors for T2D and ischemic heart disease...
Source: Current Opinion in Clinical Nutrition and Metabolic Care - Category: Nutrition Tags: NUTRITION AND PHYSIOLOGICAL FUNCTION: Edited by Annemie M.W.J. Schols and Labros S. Sidossis Source Type: research
It is well known that individuals with type 2 diabetes (T2D) have a higher incidence of heart failure than those without.(1) Less is known, however, about the relationship between impaired glucose tolerance (IGT) and heart failure incidence, and whether treating IGT to delay or prevent development of T2D might reduce the incidence of heart failure. China has one of the highest rates of IGT and new-onset T2D in the world.(2) In addition, the China Heart Survey showed that the prevalence of IGT is significantly higher in individuals with coronary heart disease (CHD), compared with those without CHD.(3) Thus, the combination ...
Source: Diabetes Research and Clinical Practice - Category: Endocrinology Authors: Source Type: research
ERα in the Control of Mitochondrial Function and Metabolic Health. Trends Mol Med. 2020 Oct 02;: Authors: Hevener AL, Ribas V, Moore TM, Zhou Z Abstract Decrements in metabolic health elevate disease risk, including type 2 diabetes, heart disease, and certain cancers. Thus, treatment strategies to combat metabolic dysfunction are needed. Reduced ESR1 (estrogen receptor, ERα) expression is observed in muscle from women, men, and animals presenting clinical features of the metabolic syndrome. Human studies of natural expression of ESR1 in metabolic tissues show that muscle expression of ESR1...
Source: Trends in Molecular Medicine - Category: Molecular Biology Authors: Tags: Trends Mol Med Source Type: research
Food labels contain a wealth of information: calories, serving size, and the amounts of fat, sugar, vitamins, and fiber contained in a food, among other things. But do consumers know how to effectively use this information? A recent study showed that some consumers are struggling, especially when it comes to understanding whole grains. Recent study highlights consumer confusion For the study, published in Public Health Nutrition, researchers conducted two experiments to examine consumer understanding of whole grains on food labels. The research, which focused on food labels on bread, cereal, and crackers, was done online a...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Healthy Eating Nutrition Source Type: blogs
Conclusions/interpretationLoneliness is a risk factor for type 2 diabetes. The mechanisms underlying this relationship remain to be elucidated.Graphical abstract
Source: Diabetologia - Category: Endocrinology Source Type: research
The objective of this study was to investigate the association between theACE gene polymorphism and CHD among male Iraqi patients with and without type2 diabetes mellitus (T2DM).MethodsA case-control study of total 217 male subjects participated in this study, divided into three groups; Group 1 including 86 CHD patients with T2DM, group 2 including 78 CHD patients without T2DM, and group 3 including 53 age and sex-matched healthy individuals (as a control group). Genotyping ofACE (I/D) gene was performed using polymerase chain reaction (PCR) technique.ResultsThe II allele was significantly more frequent in CHD patients wit...
Source: Journal of Diabetes and Metabolic Disorders - Category: Endocrinology Source Type: research
Abstract Metrnl, a secreted protein expressed in white adipose tissue, has been identified as a novel adipokine. It is also highly expressed in barrier tissues, including the skin, intestinal and respiratory tract epithelium in both mice and humans. Research shows that its expression is upregulated by inflammation, chronic high-fat diets, exercise, cold exposure, etc., and it plays important roles in promoting neurite extension, enhancing white fat browning, improving insulin sensitivity, modulating lipid metabolism and regulating inflammatory response, the latter implying Metrnl is a new cytokine. These studies s...
Source: Acta Pharmacologica Sinica - Category: Drugs & Pharmacology Authors: Tags: Acta Pharmacol Sin Source Type: research
Ceramides are bioactive lipids that have an important role in many cellular functions such as apoptosis and inflammation. During the past decade emerging clinical data have shown that ceramides are not only of great biochemical interest but may also have diagnostic utility. Ceramides have shown independent predictive value for negative cardiovascular outcomes as well as for the onset of type 2 diabetes. Based on abundant published data, risk score using the concentrations of circulating ceramides have been developed and adapted for routine clinical practice. Currently serum ceramides are used clinically as efficient risk s...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
SGLT2 inhibitors and GLP-1 receptor agonists should be considered in people with type 2 diabetes and chronic kidney disease to protect against heart disease and kidney disease progression, the AHA says.Medscape Medical News
Source: Medscape Cardiology Headlines - Category: Cardiology Tags: Cardiology News Source Type: news
Indeed, the science now suggests that inflammation is the single biggest risk factor for serious health problems such as type 2 diabetes, heart disease, arthritis and dementia.
Source: the Mail online | Health - Category: Consumer Health News Source Type: news
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