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Specialty: General Medicine
Source: LANCET
Condition: Heart Attack
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Total 16 results found since Jan 2013.
Comment Secondary prevention shifts into second gear
Aspirin has been a mainstay in the secondary prevention of cardiovascular events since the 1990s.1 In the mid-1990s, the antiplatelet clopidogrel was tested against aspirin in patients with atherosclerotic vascular disease and was found to reduce vascular death, ischaemic stroke, and myocardial infarction by 8 ·7%.2 The combination of clopidogrel and aspirin for secondary prevention to reduce cardiovascular events was tested in patients with symptomatic atherothrombosis; however, no benefit was observed.
Source: LANCET - November 10, 2017 Category: General Medicine Authors: E Magnus Ohman Tags: Comment Source Type: research
Comment Antithrombotic therapy in peripheral artery disease
Peripheral artery disease is a systemic atherothrombotic disease in which plaque builds up in the arteries that carry blood to the limbs. If severe enough, impaired blood flow can cause critical limb ischaemia, which presents as resting pain, ulceration, or gangrene, and might require a limb amputation in the most extreme cases.1 People with peripheral artery disease often have plaque in other arterial beds, and thus are at increased risk for myocardial infarction, ischaemic stroke, and cardiovascular death.
Source: LANCET - November 10, 2017 Category: General Medicine Authors: Jeffrey S Berger Tags: Comment Source Type: research
Articles Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Among elderly patients who have PCI, a DES and a short duration of DAPT are better than BMS and a similar duration of DAPT with respect to the occurrence of all-cause mortality, myocardial infarction, stroke, and ischaemia-driven target lesion revascularisation. A strategy of combination of a DES to reduce the risk of subsequent repeat revascularisations with a short BMS-like DAPT regimen to reduce the risk of bleeding event is an attractive option for elderly patients who have PCI.
Source: LANCET - November 1, 2017 Category: General Medicine Authors: Olivier Varenne, St éphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Jos Tags: Articles Source Type: research
Comment Circadian rhythm and ischaemia –reperfusion injury
Every day, thousands of patients are exposed to ischaemia-reperfusion injury, either in uncontrolled circumstances (eg, acute myocardial infarction or ischaemic stroke) or under controlled conditions (eg, heart, kidney, or liver surgery, or transplantation). Whatever the clinical setting is, the extent of final tissue damage (ie, infarct size) is mainly determined by the duration of the ischaemic phase and the amount of jeopardised tissue.1 Experimental and proof-of-concept clinical trials have shown that infarct size results from the addition of an ischaemia-induced injury plus a reperfusion-induced injury, and that timel...
Source: LANCET - October 26, 2017 Category: General Medicine Authors: Thomas Bochaton, Michel Ovize Tags: Comment Source Type: research
Articles Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study
High carbohydrate intake was associated with higher risk of total mortality, whereas total fat and individual types of fat were related to lower total mortality. Total fat and types of fat were not associated with cardiovascular disease, myocardial infarction, or cardiovascular disease mortality, whereas saturated fat had an inverse association with stroke. Global dietary guidelines should be reconsidered in light of these findings.
Source: LANCET - August 29, 2017 Category: General Medicine Authors: Mahshid Dehghan, Andrew Mente, Xiaohe Zhang, Sumathi Swaminathan, Wei Li, Viswanathan Mohan, Romaina Iqbal, Rajesh Kumar, Edelweiss Wentzel-Viljoen, Annika Rosengren, Leela Itty Amma, Alvaro Avezum, Jephat Chifamba, Rafael Diaz, Rasha Khatib, Scott Lear, Tags: Articles Source Type: research
Articles Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials
Mean achieved SBP less than 120 mm Hg during treatment was associated with increased risk of cardiovascular outcomes except for myocardial infarction and stroke. Similar patterns were observed for DBP less than 70 mm Hg, plus increased risk for myocardial infarction and hospital admission for heart failure. Very low blood pressure achieved on treatment was associated with increased risks of several cardiovascular disease events. These data suggest that the lowest blood pressure possible is not necessarily the optimal target for high-risk patients, although it is not possible to rule out some effect of reverse causality.
Source: LANCET - April 5, 2017 Category: General Medicine Authors: Michael B öhm, Helmut Schumacher, Koon K Teo, Eva M Lonn, Felix Mahfoud, Johannes F E Mann, Giuseppe Mancia, Josep Redon, Roland E Schmieder, Karen Sliwa, Michael A Weber, Bryan Williams, Salim Yusuf Tags: Articles Source Type: research
Editorial Atrial fibrillation and stroke: unrecognised and undertreated
When did you or your primary care physician last palpate your wrist to check for a regular heart rate? This simple action, followed by an electrocardiogram if the heart rate is irregular, might be crucial in preventing death and disability from ischaemic stroke, heart failure, or myocardial infarction. In this week's issue, we publish a clinical Series of three papers on atrial fibrillation ahead of the annual European Society of Cardiology (ESC) meeting held in Rome, Italy, Aug 27 –31. Atrial fibrillation is estimated to affect 33 million people worldwide.
Source: LANCET - August 19, 2016 Category: Journals (General) Authors: The Lancet Tags: Editorial Source Type: research
Comment Stroke and mortality after atrial fibrillation —a global struggle
Atrial fibrillation is a widely recognised health-care challenge with increasing prevalence across the world. Epidemiological observations mainly attribute this increase to an ageing population and better prognosis in distinguishing it from other cardiac disorders such as myocardial infarction.1 Research into atrial fibrillation has focused on antithrombotic management for stroke prevention and mortality, in the era of non-vitamin K antagonist oral anticoagulants.2 However, although these large, phase 3 trials enrolled patients from many centres in different countries and included broad populations, regional differences an...
Source: LANCET - August 7, 2016 Category: Journals (General) Authors: Torben Bjerregaard Larsen, Peter Br ønnum Nielsen Tags: Comment Source Type: research
Obituary Philip Majerus
Physician and biochemist who showed small doses of aspirin reduce the risk of heart attack and stroke. Born on July 10, 1936, in Chicago, IL, USA, he died with prostate cancer on June 8, 2016, in University City, MO, USA, aged 79 years.
Source: LANCET - July 29, 2016 Category: Journals (General) Authors: Alison Snyder Tags: Obituary Source Type: research
Articles Outcomes after thrombus aspiration for ST elevation myocardial infarction: 1-year follow-up of the prospective randomised TOTAL trial
Routine thrombus aspiration during PCI for STEMI did not reduce longer-term clinical outcomes and might be associated with an increase in stroke. As a result, thrombus aspiration can no longer be recommended as a routine strategy in STEMI.
Source: LANCET - October 13, 2015 Category: Journals (General) Authors: Sanjit S Jolly, John A Cairns, Salim Yusuf, Michael J Rokoss, Peggy Gao, Brandi Meeks, Sasko Kedev, Goran Stankovic, Raul Moreno, Anthony Gershlick, Saqib Chowdhary, Shahar Lavi, Kari Niemela, Ivo Bernat, Warren J Cantor, Asim N Cheema, Philippe Gabriel S Tags: Articles Source Type: research
Comment Long working hours: an avoidable cause of stroke?
William Osler, in an article about atherosclerosis published 100 years ago, wrote that the main cause of myocardial infarction was “wear and tear of life”.1 Although we now have more detailed theories regarding the causal mechanisms, there is still some kinship between modern studies of work-related determinants of cardiovascular diseases and Osler's broad approach to the cause of disease.2
Source: LANCET - August 19, 2015 Category: Journals (General) Authors: Urban Janlert Tags: Comment Source Type: research
Comment Alteplase in acute ischaemic stroke: the need for speed
Doctors treating patients who have had an acute ischaemic stroke must feel the need for speed more feverishly than a racing driver. Stroke does not hurt. There is none of the pain that might be registered on the face of a patient with acute myocardial infarction or the visceral sight of blood in the case of trauma to evoke a sense of immediacy. Yet stroke is exactly like acute myocardial infarction and acute trauma in the need for very fast treatment.
Source: LANCET - November 28, 2014 Category: Journals (General) Authors: Michael D Hill, Shelagh B Coutts Tags: Comment Source Type: research
Comment Do we need to know whether nitrous oxide harms patients?
In The Lancet, Paul Myles and colleagues investigate the association between nitrous oxide exposure and cardiovascular complications such as non-fatal myocardial infarction, stroke, pulmonary embolism, cardiac arrest, and death, within 30 days of surgery, in patients with known or suspected coronary artery disease having major non-cardiac surgery under general anaesthesia. The rationale for this large, multicentre study, which involved more than 7000 patients from 45 centres, was the observation that short-term exposure to nitrous oxide led to significant increases in plasma homocysteine.
Source: LANCET - October 18, 2014 Category: Journals (General) Authors: Martin R Tramèr Tags: Comment Source Type: research
Comment NAVIGATOR: physical activity for cardiovascular health?
In The Lancet, Thomas Yates and colleagues report new findings from the NAVIGATOR trial, a multicentre, international, randomised, placebo-controlled trial that examined the effect of nateglinide, valsartan, or both, on cardiovascular events in patients with impaired glucose tolerance and either existing cardiovascular disease or at least one additional risk factor. The results of this cohort analysis of the association between daily ambulatory activity, as assessed by pedometer, and a composite of death from cardiovascular causes, non-fatal myocardial infarction, and non-fatal stroke, show a graded and independent inverse...
Source: LANCET - March 21, 2014 Category: Journals (General) Authors: Giuseppe Pugliese, Stefano Balducci Tags: Comment Source Type: research
Correspondence Refining the American guidelines for prevention of cardiovascular disease
The recent American Heart Association (AHA) and American College of Cardiology (ACC) guidelines recommend that more people are offered treatment to prevent heart attacks and strokes; they do this by lowering the risk cutoff from a 20% 10-year risk to 7·5% (the approximate risk of a person aged 60 years). Paul Ridker and Nancy Cook state that the risk calculator in the guidelines overestimates risk about two-fold. This variation, however, has little effect on discriminating between who will and will not have a heart attack or stroke (ie, on screening performance).
Source: LANCET - February 15, 2014 Category: Journals (General) Authors: Nicholas Wald, Joan Morris Tags: Correspondence Source Type: research
