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Condition: Heart Attack

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Total 79 results found since Jan 2013.

Obesity and atrial fibrillation: can adipokines help to solve this puzzle
Obesity is a major public health problem increasing risk for hypertension, diabetes mellitus, cardiovascular diseases, heart failure, stroke, left atrial enlargement and obstructive sleep apnoea. Conventionally, body mass index (BMI) is used in many studies to diagnose and classify obesity. However, epidemiological studies have shown that waist:hip ratio is a better predictor for myocardial infarction and sudden cardiac death compared with BMI. Nevertheless, some subjects who have ‘healthy obese phenotype’ have a benign cardiometabolic profile due to greater deposition of the fat tissue in the subcutaneous area...
Source: Heart - August 10, 2016 Category: Cardiology Authors: Güngör, B. Tags: Drugs: cardiovascular system, Hypertension, Acute coronary syndromes, Epidemiology, Diabetes, Metabolic disorders Editorials Source Type: research

Cardiovascular disease risk assessment in HIV: navigating data-sparse zones
Persons with HIV are surviving longer than ever before due to effective antiretroviral therapy (ART) and are increasingly at risk for chronic, non-communicable diseases.1–3 Data from large cohorts in North America and Europe have demonstrated that HIV-infected persons have roughly 50% greater risks for myocardial infarction (MI) than uninfected persons, as well as greater risks for other cardiovascular diseases such as heart failure and stroke.4 5 These elevated risks for MI persist even after accounting for cardiovascular risk factors and ART regimens and are thought to result from HIV-associated inflammation, immun...
Source: Heart - July 10, 2016 Category: Cardiology Authors: Feinstein, M. J. Tags: Drugs: cardiovascular system, Acute coronary syndromes Editorials Source Type: research

Effect of prior clopidogrel use on outcomes in medically managed acute coronary syndrome patients
Conclusions Patients receiving clopidogrel before admission for ACS and subsequently treated only medically are at higher risk for CV events versus those not previously receiving clopidogrel. More potent antiplatelet inhibition with prasugrel versus clopidogrel did not significantly reduce this risk. Trial registration number NCT00699998.
Source: Heart - July 10, 2016 Category: Cardiology Authors: Chin, C. T., Boden, W. E., Roe, M. T., Neely, B., Neely, M. L., Leiva-Pons, J. L., Corbalan, R., Gottlieb, S., Dalby, A. J., Armstrong, P. W., Prabhakaran, D., Fox, K. A. A., White, H. D., Ohman, E. M., Winters, K. J., Schiele, F. Tags: Drugs: cardiovascular system, Acute coronary syndromes Special populations Source Type: research

All types of atrial fibrillation in the setting of myocardial infarction are associated with impaired outcome
Conclusions AF is common in the setting of MI and is associated with a higher risk of composite cardiovascular outcome and the individual components; mortality, reinfarction and ischaemic stroke, respectively. No major difference in outcome was observed between AF subtypes. No difference in outcome for AF was observed between the NSTEMI and STEMI cohort.
Source: Heart - June 5, 2016 Category: Cardiology Authors: Batra, G., Svennblad, B., Held, C., Jernberg, T., Johanson, P., Wallentin, L., Oldgren, J. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Coronary artery disease Source Type: research

Non-vitamin K antagonist oral anticoagulants (NOACs) for the management of venous thromboembolism
Learning objectives Understand the importance of venous thrombosis in cardiovascular medicine. Appreciate the mode of action of different oral anticoagulants. Recall the uses, risks and benefits of each non-vitamin K antagonist oral anticoagulants. Introduction Thrombosis is the common pathophysiology responsible for ischaemic heart disease, ischaemic stroke and venous thromboembolism (VTE), and a major contributor to the global disease burden.1 This effect is markedly more pronounced by considering the view that cancer is also a thrombotic disease.2 3 Cardiovascular disease (CVD, manifesting as acute coronary syndromes, m...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Blann, A. D., Lip, G. Y. H. Tags: Education in Heart, Drugs: cardiovascular system, Acute coronary syndromes, Venous thromboembolism, Epidemiology Source Type: research

Cardiovascular highlights from non-cardiology journals
Pre-operative aspirin does not influence CABG outcomes Aspirin is a common therapy for risk reduction among patients with coronary artery disease. However, among patients undergoing coronary artery bypass surgery, the benefits of aspirin on the risk of myocardial infarction and stroke may be outweighed by perioperative bleeding risk. To address this question, the ATACAS trial randomized 2100 patients to either receive 100 mg aspirin daily or matching placebo for 4 days immediately prior to the operation with all patients resuming aspirin within 24 hours of their bypass surgery. The primary outcome was a composite of d...
Source: Heart - June 5, 2016 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research

Using electronic health records to predict costs and outcomes in stable coronary artery disease
Conclusions Existing EHRs may be used to estimate lifetime healthcare costs and outcomes of patients with stable-CAD. The stable-CAD model developed in this study lends itself to informing decisions about commissioning, pricing and reimbursement. At current prices, to be cost-effective some established as well as future stable-CAD treatments may require stratification by patient risk.
Source: Heart - April 24, 2016 Category: Cardiology Authors: Asaria, M., Walker, S., Palmer, S., Gale, C. P., Shah, A. D., Abrams, K. R., Crowther, M., Manca, A., Timmis, A., Hemingway, H., Sculpher, M. Tags: Health policy, Open access, Drugs: cardiovascular system, Acute coronary syndromes Coronary artery disease Source Type: research

Ticagrelor and aspirin for the prevention of cardiovascular events after coronary artery bypass graft surgery
Conclusions Ticagrelor added to aspirin after CABG reduced the proportion of patients with graft occlusion, and was a significant univariate and multivariable predictor of graft occlusion. These results are hypothesis-generating and should be confirmed in larger studies. Trial registration number NCT01373411: Results.
Source: Heart - April 24, 2016 Category: Cardiology Authors: Saw, J., Wong, G. C., Mayo, J., Bernstein, V., Mancini, G. B. J., Ye, J., Skarsgard, P., Starovoytov, A., Cairns, J. Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Clinical diagnostic tests, Epidemiology Coronary artery disease Source Type: research

Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis
Conclusions Data from observational studies suggests a possible association between prolonged PR interval and significant increases in atrial fibrillation, heart failure and mortality. Future prospective studies are needed to confirm the relationships reported, consider possible mechanisms and define the optimal monitoring strategy for such patients.
Source: Heart - April 11, 2016 Category: Cardiology Authors: Kwok, C. S., Rashid, M., Beynon, R., Barker, D., Patwala, A., Morley-Davies, A., Satchithananda, D., Nolan, J., Myint, P. K., Buchan, I., Loke, Y. K., Mamas, M. A. Tags: Bradyarrhythmias and heart block, Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Arrhythmias and sudden death Source Type: research

Safety and efficacy of ticagrelor and clopidogrel in primary percutaneous coronary intervention
Conclusions In the subset of patients with STEMI treated with primary PCI, ticagrelor compared with clopidogrel was safe, and efficacy outcomes were consistent with the overall PLATO trial. Trial registration number NCT00391872; Results.
Source: Heart - March 22, 2016 Category: Cardiology Authors: Velders, M. A., Abtan, J., Angiolillo, D. J., Ardissino, D., Harrington, R. A., Hellkamp, A., Himmelmann, A., Husted, S., Katus, H. A., Meier, B., Schulte, P. J., Storey, R. F., Wallentin, L., Gabriel Steg, P., James, S. K., on behalf of the PLATO Investi Tags: Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Percutaneous intervention, Venous thromboembolism Coronary artery disease Source Type: research

Biomarkers of inflammation and risk of cardiovascular events in anticoagulated patients with atrial fibrillation
Conclusions In patients with AF on anticoagulation, after accounting for clinical risk factors and other biomarkers, biomarkers of inflammation were significantly associated with an increased risk of mortality. However, there were no associations with the risk of stroke or major bleeding. Trial registration number ClinicalTrials.gov identifier: NCT00412984 post-results.
Source: Heart - March 11, 2016 Category: Cardiology Authors: Hijazi, Z., Aulin, J., Andersson, U., Alexander, J. H., Gersh, B., Granger, C. B., Hanna, M., Horowitz, J., Hylek, E. M., Lopes, R. D., Siegbahn, A., Wallentin, L., on behalf of the ARISTOTLE Investigators Tags: Editor's choice, Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Arrhythmias and sudden death Source Type: research

Ischaemic stroke after ST-elevation myocardial infarction
Clinical introduction A 67-year-old Hispanic man presented with 5-h history of typical chest pain and an ECG consistent with inferior ST-elevation myocardial infarction (STEMI). Coronary angiography revealed an occluded proximal right coronary artery, and a percutaneous intervention with drug eluting stent was performed. He was started on aspirin and clopidogrel. Two weeks later, he was admitted with loss of consciousness, tonic-clonic seizure and urinary incontinence. On physical examination, he was unresponsive to tactile stimuli. Cardiac examination revealed a prominent left ventricular heave. Neurological examination s...
Source: Heart - December 11, 2015 Category: Cardiology Authors: Al-Ansari, Y., Otalvaro, L., Damluji, A. A. Tags: Drugs: cardiovascular system, Echocardiography, Image challenges, Acute coronary syndromes, Clinical diagnostic tests Source Type: research

Cost-effectiveness of percutaneous coronary intervention versus bypass surgery from a Dutch perspective
Conclusions For the broad population with three-vessel or left main disease who are candidates for either CABG or PCI, we found that CABG is a clinically and economically attractive revascularisation strategy compared with DES-PCI from a Dutch healthcare perspective. The cost-effectiveness of CABG versus PCI differed according to several anatomic factors, however. The newly developed SYNTAX Score II provides enhanced prognostic discrimination in this population, and may be a useful tool to guide resource allocation as well. Trial registration number Clinical trial unique identifier: NCT00114972 (http://www.clinical-trials.gov)
Source: Heart - November 26, 2015 Category: Cardiology Authors: Osnabrugge, R. L., Magnuson, E. A., Serruys, P. W., Campos, C. M., Wang, K., van Klaveren, D., Farooq, V., Abdallah, M. S., Li, H., Vilain, K. A., Steyerberg, E. W., Morice, M.-C., Dawkins, K. D., Mohr, F. W., Kappetein, A. P., Cohen, D. J., on behalf of Tags: Health policy, Drugs: cardiovascular system, Interventional cardiology, Acute coronary syndromes, Percutaneous intervention, Epidemiology Coronary artery disease Source Type: research

Consistency of benefit from an early invasive strategy after fibrinolysis: a patient-level meta-analysis
Conclusions Benefit from an early invasive strategy after fibrinolysis for ST-elevation myocardial infarction is similar across patient subgroups stratified by these clinical characteristics. Therefore, prediction of risk and benefit from an early invasive strategy after fibrinolysis for ST-elevation myocardial infarction is best achieved by global risk evaluation rather than specific patient characteristics.
Source: Heart - September 10, 2015 Category: Cardiology Authors: Abdel-Qadir, H., Yan, A. T., Tan, M., Borgia, F., Piscione, F., Di Mario, C., Halvorsen, S., Cantor, W. J., Westerhout, C. M., Scheller, B., Le May, M. R., Fernandez-Aviles, F., Sanchez, P. L., Lee, D. S., Goodman, S. G. Tags: Drugs: cardiovascular system, Acute coronary syndromes, Epidemiology Coronary artery disease Source Type: research

Cardiovascular highlights from non-cardiology journals
Antiplatelet therapy in long-term risk reduction after myocardial infarction The activated platelet is central to development of ischemic cardiovascular events. Guidelines recommend treatment with a P2Y12 receptor antagonist for 1-year after myocardial infarction (MI) to reduce the risk of recurrent events. The PEGASUS trial sought to determine the impact of using the P2Y12 antagonist ticagrelor as part of long-term therapy after MI. In this trial, a total of 21,162 clinically stable patients with a MI in the prior 1 to 3 years (median 18 months) were randomized in a 1:1:1 fashion to either placebo, ticagrelor 90mg twice d...
Source: Heart - June 10, 2015 Category: Cardiology Authors: Bradley, S. M. Tags: Journal scan Source Type: research