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Specialty: Internal Medicine
Condition: Heart Disease
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Total 371 results found since Jan 2013.
The Pooled Cohort Equations for Predicting Risk of Myocardial Infarction and Stroke: Validated in Representative Natural History Populations
The American College of Cardiology (ACC)/American Heart Association (AHA) Pooled Cohort equations (PCEs) were introduced in late 2013 and published in mid-2014.1 Unlike the Framingham score used to determine coronary heart disease (CHD) risk in the National Cholesterol Education Program Adult Treatment Panel III guidelines,2 the new PCEs focused on estimating risk of CHD and stroke and additionally provided specific risk assessment for African American individuals. Because stroke may occur before CHD, particularly in women and African Americans, the PCEs were seen as a major advance in disease prognostication.
Source: Mayo Clinic Proceedings - May 10, 2016 Category: Internal Medicine Authors: Neil J. Stone, Donald M. Lloyd-Jones Tags: Editorial Source Type: research
The Kinetics of Circulating Monocyte Subsets and Monocyte-Platelet Aggregates in the Acute Phase of ST-Elevation Myocardial Infarction: Associations with 2-Year Cardiovascular Events
In conclusion, our data show the expansion of the CD14++CD16+ monocyte subset during acute phase of STEMI has predictive values for 2-year adverse cardiovascular outcomes in patients treated with primary PCI. Future studies will be warranted to elucidate whether CD14++CD16+ monocytes may become a target cell population for new therapeutic strategies after STEMI.
Source: Medicine - May 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
The Association Between Peptic Ulcer Disease and Ischemic Stroke: A Population-Based Longitudinal Study
Abstract: Stroke is a common cause of death worldwide, but about 30% of ischemic stroke (IS) patients have no identifiable contributing risk factors. Because peptic ulcer disease (PUD) and vascular events share some common risk factors, we conducted a population-based study to evaluate the association between PUD and IS.
We followed up a representative sample of 1 million residents of Taiwan using the National Health Insurance Research Database from 1997 to 2011. We defined patients who received medications for PUD and had related diagnosis codes as the PUD group, and a reference group matched by age and sex was sampled f...
Source: Medicine - May 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Comparative Effectiveness of Blood Pressure-lowering Drugs in Patients who have Already Suffered From Stroke: Traditional and Bayesian Network Meta-analysis of Randomized Trials
Abstract: Hypertension is the most important risk factor for stroke and stroke recurrence. However, the preferred blood pressure (BP)-lowering drug class for patients who have suffered from a stroke has yet to be determined.
To investigate the relative effects of BP-lowering therapies [angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blockers (ARB), β blockers, calcium channel blockers (CCBs), diuretics, and combinations of these drugs] in patients with a prior stroke history, we performed a systematic review and meta-analysis using both traditional frequentist and Bayesian random-effects models and m...
Source: Medicine - April 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Reviewand Meta-Analysis Source Type: research
Effect of prestroke antiplatelets use on first‐ever ischaemic stroke severity and early outcome
ConclusionsOur findings provide further evidence supporting modest benefit of AP therapy on the course and outcome of first‐ever ischaemic stroke. Further large studies are needed to confirm this effect.
Source: International Journal of Clinical Practice - March 31, 2016 Category: Internal Medicine Authors: J. P. Bembenek, M. Niewada, M. Karlinski, A. Czlonkowska Tags: Original Paper Source Type: research
Complete revascularisation in patients with ST-segment elevation myocardial infarction and multivessel disease: contemporary data in context
Commentary on: Engstrøm T, Kelbæk H, Helqvist S, et al.. DANAMI-3—PRIMULTI Investigators. Complete revascularisation versus treatment of the culprit lesion only in patients with ST-segment elevation myocardial infarction and multivessel disease (DANAMI-3—PRIMULTI): an open-label, randomised controlled trial. Lancet 2015;386:665–71. Context Primary percutaneous coronary intervention is recommended in patients presenting with ST-segment Elevation Myocardial infarction (STEMI).1 In 40–60% of STEMI patients there is disease in non-infarct-related arteries (IRAs).2 Such patients have higher ...
Source: Evidence-Based Medicine - March 21, 2016 Category: Internal Medicine Authors: Banning, A. S., Gershlick, A. H. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research
Diabetes and new-onset atrial fibrillation in a hypertensive population.
Conclusion Diabetes was modestly associated with new-onset AF in hypertensive patients with no ischemic vascular disease. Among diabetic patients, only obesity reached significance in its association with this arrhythmia. Key Messages Diabetes modestly associated with new-onset atrial fibrillation in hypertensive patients with no ischemic vascular disease. In the subgroup of patients with diabetes, only obesity reached significance in its association with atrial fibrillation.
PMID: 26939743 [PubMed - as supplied by publisher]
Source: Annals of Medicine - March 6, 2016 Category: Internal Medicine Tags: Ann Med Source Type: research
Obstructive sleep apnea risk and psychological health among non-Hispanic blacks in the Metabolic Syndrome Outcome (MetSO) cohort study.
Conclusion Our results suggest that non-Hispanic blacks with metabolic syndrome who experience anxiety and/or depression should be screened for OSA. Key messages This study assessed associations of moderate to severe depression and anxiety with risk of obstructive sleep apnea (OSA) among non-Hispanic blacks with metabolic syndrome. Patients with depression had nearly two-fold increased odds of being at risk for OSA. Patients with anxiety had three-fold increased odds of being at risk for OSA.
PMID: 26593384 [PubMed - in process]
Source: Annals of Medicine - February 18, 2016 Category: Internal Medicine Tags: Ann Med Source Type: research
Significant interactions between traditional risk factors affect cardiovascular risk prediction in healthy general population.
CONCLUSIONS: There are significant effect modifications between major risk factors, and accounting for them leads to significantly more accurate estimation of cardiovascular risk.
PMID: 25405541 [PubMed - indexed for MEDLINE]
Source: Annals of Medicine - February 18, 2016 Category: Internal Medicine Tags: Ann Med Source Type: research
Increased Risk of Stroke in Patients With Fibromyalgia: A Population-BASED Cohort Study
Abstract: Neuropsychiatric diseases might enhance stroke development, possibly through inflammation and atherosclerosis. Approximately 25% to 40% of patients with stroke, largely younger patients, are not associated with any conventional stroke risk factors. In this research, we explored whether fibromyalgia (FM), a neuropsychosomatic disorder, increases stroke risk.
From a claims dataset with one million enrollees sourced of the Taiwan National Health Insurance database, we selected 47,279 patients with FM and randomly selected 189,112 age- and sex-matched controls within a 3-year period from January 1, 2000 to December ...
Source: Medicine - February 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
ACE inhibitors in African Americans with hypertension associated with worse outcomes as compared to other antihypertensives
Commentary on: Bangalore S, Ogedegbe G, Gyamfi J, et al.. Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks. Am J Med 2015;128:1195–203. Context Hypertension affects one-third of the world's population and remains a leading cause of myocardial infarction, stroke, heart failure, renal failure and death. Although hypertension control has improved,1 the prevalence is increasing due to an ageing population, rising obesity and a shift towards western lifestyles and disease patterns in low-income and middle-income countries. Hypertension is now also a major contr...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Lund, L. H. Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Obesity (nutrition), Ischaemic heart disease, Renal medicine, Drugs: musculoskeletal and joint diseases, Health education Source Type: research
Observational studies are compatible with an association between saturated and trans fats and cardiovascular disease
Commentary on: de Souza RJ, Mente A, Maroleanu A, et al.. Intake of saturated and trans unsaturated fatty acids and risk of all-cause mortality, cardiovascular disease, and type 2 diabetes: systematic review and meta-analysis of observational studies. BMJ 2015;351:h3978. Context What is the relationship between saturated or trans fats in our food and cardiovascular risk? To find out we must examine the totality of interventional and observational evidence and all appropriate outcomes. The WHO Nutrition Guidance Advisory Group (WHO NUGAG) recently commissioned systematic reviews of randomised controlled trials (RCTs) which ...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Hooper, L., Mann, J. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Diet, Ischaemic heart disease, Diabetes Aetiology/Harm Source Type: research
Elucidating the use of enoxaparin in non-ST-elevation acute coronary syndromes (NSTE-ACS)
The guidelines The new joint guidelines from the American Heart Association (AHA) and the American College of Cardiology (ACC) for non-ST-elevation acute coronary syndromes (NSTE-ACS) represent the culmination of a massive undertaking to synthesise a large body of evidence, and the guideline writing committee is to be applauded for their efforts in preparing these guidelines.1 2 As is the current standard, the online version of these guidelines was published ahead of print, and review of the electronic publication ahead of print revealed that the handling of enoxaparin was problematic.1 The problem concerned the discussion...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Mayer, M. Tags: Clinical trials (epidemiology), Editor's choice, Drugs: cardiovascular system, Stroke, Ischaemic heart disease Perspective Source Type: research
Longer dual antiplatelet therapy (DAPT) after percutaneous coronary intervention has higher anti-ischaemic efficacy than shorter DAPT but is associated with more frequent bleeding
Commentary on: Spencer FA, Prasad M, Vandvik PO, et al.. Longer- versus shorter-duration dual-antiplatelet therapy after drug-eluting stent placement: a systematic review and meta-analysis. Ann Intern Med 2015;163:118–26. Context Dual antiplatelet therapy (DAPT) with aspirin plus a P2Y12 receptor antagonist is recommended after drug eluting stent implantation (DES) for at least 12 months by the American College of Cardiology/American Heart Association1 and for 6–12 months by European guidelines. Recent randomised controlled trials (RCT) suggested comparable efficacy of short-term DAPT versus therapy o...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Navarese, E. P. Tags: Journalology, Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Venous thromboembolism, Radiology, Clinical diagnostic tests, Ethics Therapeutics/Prevention Source Type: research
Supplemental oxygen in patients without hypoxia in ST segment elevation myocardial infarction increases myocardial injury and infarct size
Commentary on: Stub D, Smith K, Bernard S, et al.. AVOID Investigators. Air versus oxygen in ST-segment-elevation myocardial infarction. Circulation 2015;131:2143–50. Context In patients with ST segment elevation myocardial infarction (STEMI), timely reperfusion, best obtained with primary percutaneous coronary intervention (pPCI), is a mainstay to reduce infarct size (IS) and improve clinical outcome. Routine oxygen administration in normoxic patients with STEMI before pPCI, while mentioned by international guidelines,1 is not supported by randomised evidence. Stub and colleagues performed the AVOID study to compare...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Crimi, G. Tags: Clinical trials (epidemiology), Drugs: cardiovascular system, Pain (neurology), Stroke, Interventional cardiology, Ischaemic heart disease, Drugs: respiratory system Therapeutics/Prevention Source Type: research
