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Improved outcomes in patients with ST-elevation myocardial infarction during the last 20  years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995–2014
ConclusionGradual implementation of new and established evidence-based treatments in STEMI patients during the last 20  years has been associated with prolonged survival and lower risk of recurrent ischaemic events, although a plateauing is seen since around 2008.
Source: European Heart Journal - August 29, 2017 Category: Cardiology Source Type: research

Clinical outcomes of state-of-the-art percutaneous coronary revascularization in patients with de novo three vessel disease: 1-year results of the SYNTAX II study
ConclusionAt one year, clinical outcomes with the SYNTAX-II strategy were associated with improved clinical results compared to the PCI performed in comparable patients from the original SYNTAX-I trial. Longer term follow-up is awaited and a randomized clinical trial with contemporary CABG is warranted.ClinicalTrials.gov IdentifierNCT02015832
Source: European Heart Journal - August 26, 2017 Category: Cardiology Source Type: research

Insomnia and myocardial infarction
Insomnia associated with increased risk of infarction and stroke according to study 
Source: European Heart Journal - July 14, 2017 Category: Cardiology Source Type: research

Modern prevention: genetic testing, vascular imaging, machine learning, and drug safety
Traditionally, prevention has been divided into primary and secondary prevention. While the former focused on individuals considered healthy, the latter was designed to avoid future events in those who already had coronary artery disease, myocardial infarction, or stroke.1 However, this distinction is no longer useful, as many asymptomatic individuals do have atherosclerotic lesions such as plaques and calcifications upon modern imaging, and not all subjects with suspected symptoms have atherosclerotic vascular disease.2 –4 This Focus Issue on Prevention addresses these important issues. In a firstCurrent Opinion entitle...
Source: European Heart Journal - June 13, 2017 Category: Cardiology Source Type: research

NSAIDs and cardiac arrest Non-steroidal anti-inflammatory drug use is associated with increased risk of Out-of-hospital Cardiac Arrest: A nationwide Case-Time-Control study
Non-steroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used drugs worldwide. However, during the last 10  years, accumulating evidence of an increased cardiovascular risk associated with use of NSAIDs has emerged, and NSAIDs have been linked to several cardiovascular adverse events, such as myocardial infarction, heart failure, and stroke. Cardiac arrest is the ultimate and most dreaded adverse drug event… We aimed to assess the association between NSAID use and the risk of out-of-hospital cardiac arrest.
Source: European Heart Journal - June 13, 2017 Category: Cardiology Source Type: research

Visit-to-visit variability of blood pressure and cardiovascular outcomes in patients with stable coronary heart disease. Insights from the STABILITY trial
ConclusionIn patients with stable coronary heart disease, higher visit-to-visit variabilities of both systolic and diastolic BP are strong predictors of increased risk of cardiovascular events, independently of mean BP.
Source: European Heart Journal - May 27, 2017 Category: Cardiology Source Type: research

Impact of the SYNTAX scores I and II in patients with diabetes and multivessel coronary disease: a pooled analysis of patient level data from the SYNTAX, PRECOMBAT, and BEST trials
ConclusionsDifferences in 5 years outcomes following PCI and CABG for patients with MVD and diabetes were influenced by anatomic complexity as measured by the SYNTAX score. The SYNTAX score II mortality prediction model showed similar performance regardless of the diabetes status.
Source: European Heart Journal - April 18, 2017 Category: Cardiology Source Type: research

Low-density lipoprotein cholesterol targeting with pitavastatin + ezetimibe for patients with acute coronary syndrome and dyslipidaemia: the HIJ-PROPER study, a prospective, open-label, randomized trial
ConclusionAlthough intensive lowering with standard pitavastatin plus ezetimibe showed no more cardiovascular benefit than standard pitavastatin monotherapy in ACS patients with dyslipidaemia, statin plus ezetimibe may be more effective than statin monotherapy in patients with higher cholesterol absorption; further confirmation is needed.Trial NoUMIN000002742, registered as an International Standard Randomized Controlled Trial.
Source: European Heart Journal - April 18, 2017 Category: Cardiology Source Type: research

Radial versus femoral access in patients with acute coronary syndromes with or without ST-segment elevation
Conclusion</div>Radial as compared with femoral access provided consistent benefit across the whole spectrum of patients with ACS, without evidence that type of presenting syndrome affected the results of the random access allocation.</span>
Source: European Heart Journal - February 28, 2017 Category: Cardiology Source Type: research

Personalising the decision for prolonged dual antiplatelet therapy: development, validation and potential impact of prognostic models for cardiovascular events and bleeding in myocardial infarction survivors
Conclusion</div>Prognostic models for cardiovascular events and bleeding using population-based EHRs may help to personalise decisions for prolonged DAPT 1-year following acute MI.</span>
Source: European Heart Journal - February 27, 2017 Category: Cardiology Source Type: research

Gut microbiota-dependent trimethylamine N-oxide in acute coronary syndromes: a prognostic marker for incident cardiovascular events beyond traditional risk factors
Conclusion</div>Plasma TMAO levels among patients presenting with chest pain predict both near- and long-term risks of incident cardiovascular events, and may thus provide clinical utility in risk stratification among subjects presenting with suspected ACS.</span>
Source: European Heart Journal - January 10, 2017 Category: Cardiology Source Type: research

Comparative efficacy of coronary artery bypass surgery vs. percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease with or without chronic kidney disease
Conclusions Compared to PCI, the effects of CABG on long-term risks for MACCE observed in the FREEDOM trial are preserved among patients with mild to moderate CKD.
Source: European Heart Journal - December 29, 2016 Category: Cardiology Authors: Baber, U., Farkouh, M. E., Arbel, Y., Muntner, P., Dangas, G., Mack, M. J., Hamza, T. H., Mehran, R., Fuster, V. Tags: Clinical trial update Source Type: research

Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry
Conclusion Ticagrelor vs. clopidogrel post-ACS was associated with a lower risk of death, MI, or stroke, as well as death alone. Risk of bleeding was higher with ticagrelor. These real-world outcomes are consistent with randomized trial results.
Source: European Heart Journal - December 21, 2016 Category: Cardiology Authors: Sahlen, A., Varenhorst, C., Lagerqvist, B., Renlund, H., Omerovic, E., Erlinge, D., Wallentin, L., James, S. K., Jernberg, T. Tags: Acute coronary syndromes Source Type: research

Sodium-glucose cotransporter-2 inhibition for the reduction of cardiovascular events in high-risk patients with diabetes mellitus
Patients with type 2 diabetes mellitus (T2D) exhibit an increased risk for cardiovascular (CV) events. Hyperglycaemia itself contributes to the pathogenesis of atherosclerosis and heart failure (HF) in these patients, but glucose-lowering strategies studied to date have had little to no impact on reducing CV risk, especially in patients with a long duration of T2D and prevalent CV disease (CVD). Sodium glucose cotransporter-2 (SGLT2) inhibitors are a novel class of anti-hyperglycaemic medications that increase urinary glucose excretion, thus improving glycaemic control independent of insulin. The recently published CV outc...
Source: European Heart Journal - November 16, 2016 Category: Cardiology Authors: Marx, N., McGuire, D. K. Tags: Clinical update Source Type: research

Randomized trial of switching from prescribed non-selective non-steroidal anti-inflammatory drugs to prescribed celecoxib: the Standard care vs. Celecoxib Outcome Trial (SCOT)
This study excluded an increased risk of the primary endpoint of more than two events per 1000 patient-years associated with switching to prescribed celecoxib.Clinical Trial Registrationhttps://clinicaltrials.gov/show/NCT00447759; Unique identifier: NCT00447759.
Source: European Heart Journal - October 4, 2016 Category: Cardiology Source Type: research

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