Heart Disease
20 Mar NSAIDS Diclofenac and Ibuprofen Associated with Increased Risk of Cardiac Arrest
MedicalResearch.com Interview with: [caption id="attachment_33131" align="alignleft" width="133"]
Dr. Søndergaard[/caption]
Kathrine Bach Søndergaard MD, Research Fellow
Gentofte University Hospital
Department of Cardiology
Hellerup
MedicalResearch.com: What is the background for this study?
Response: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used and have in previous studies been associated with an increased risk of cardiovascular adverse events, such as myocardial infarction and heart failure. Cardiac arrest is the ultimate adverse event; however, no research exists of the association between cardiac arrest and use of NSAIDs, which we aimed to assess in this study.
20 Mar Instantaneous Wave-Free Ratio To Evaluate Coronary Artery Disease
MedicalResearch.com Interview with: [caption id="attachment_32970" align="alignleft" width="200"]
Dr. Matthias Götberg[/caption]
Matthias Götberg, MD, PhD
Director Cardiac Cath Lab
Department of Coronary Heart Disease
Skane University Hospital- Lund
Lund, Sweden
MedicalResearch.com: What is the background for this study?
Response: Cardiologists encounter patients with narrowing of the coronary arteries on a daily basis. They typically use visual estimation of the severity of narrowing when performing coronary angiography, but it is difficult to accurately assess, based on a visual estimation alone, whether a stent is needed to widen the artery and allow the blood to more freely.
FFR (Fractional Flow Reserve) is more precise tool and results in better outcomes than using angiography alone to assess narrowing of the coronary arteries. With FFR, the doctor threads a thin wire through the coronary artery and measures the loss of blood pressure across the narrowed area. To acquire an accurate measurement, the patient must be given adenosine, which is a drug that dilates the blood vessels during the procedure. This drug causes discomfort; patients describe having difficulty breathing or feeling as if someone is sitting on their chest. The drug also adds to the cost of the procedure and can have other rare but serious side effects.
iFR (Instantaneous Wave-Free Ratio) is also based on coronary blood pressure measurements using a thin wire, but unlike FFR, it uses a mathematical algorithm to measure the pressure in the coronary artery only when the heart is relaxed and the coronary blood flow is high. As a result, a vasodilator drug is not needed.
iFR has been validated in smaller trials and have been found to be equally good as FFR to detect ischemia, but larger randomized outcome trials are lacking.
iFR-Swedeheart is a Scandinavian Registry-based Randomized Clinical Trial (RRCT) in which 2000 patients were randomized between iFR and FFR as strategies for performing assessment of narrowed coronary vessels. The primary composite endpoint at 12 months was all-cause death, non-fatal myocardial infarction, and unplanned revascularization.
RRCT is a new trial design originating from Scandinavia using existing web-based national quality registries for online data entry, randomization and tracking of events. This allows for a very high inclusion rate and low costs to run clinical trials while ensuring robust data quality.
19 Mar Valvular Heart Disease: Edoxaban vs Warfarin in the ENGAGE AF-TIMI 48 Trial
MedicalResearch.com Interview with: Raffaele De Caterina MD, PhD Professor of Cardiology and Director of the University Cardiology Division 'G d'Annunzio' University in Chieti MedicalResearch.com: What is the background for this study? What are the main findings? Response: The widely used term “valvular atrial fibrillation” encompasses a variety of conditions in which atrial fibrillation and valvular heart disease coexist. Since most trials of the non-vitamin K antagonist oral anticoagulants (NOACs) have variably excluded “valvular atrial fibrillation”, in more or less restrictive terms, there has been uncertainty whether NOACs can be used in such varied conditions. While atrial fibrillation in the presence of a mechanical valve or rheumatic mitral stenosis has to be a true contraindication (unfavorable data with one NOAC in the former setting; no data in the latter setting), patients with valvular diseases such as mitral insufficiency, aortic stenosis, aortic insufficiency, or with the presence of a bioprosthesis, have been variably included in the phase III trials of NOACs, but had not been extensively and conclusively studied before.19 Mar TAVR for Bicuspid Vs. Tricuspid Aortic Valve Stenosis
MedicalResearch.com Interview with: Sung-Han Yoon MD Clinical Trials, Cardiology, Developmental Biology Cedars-Sinai Medical Center, Los Angeles MedicalResearch.com: What is the background for this study? What are the main findings? Response: Transcatheter aortic valve replacement (TAVR) has become the standard treatment in inoperable patients in high surgical risk patients with symptomatic severe aortic stenosis (AS). However, major randomized trials excluded congenital bicuspid AS due to its unique morphological features. The indication of TAVR is expanding into a younger population, in which the frequency of bicuspid AS is higher. Therefore, we will encounter TAVR for bicuspid AS more frequently. However, the experience of TAVR in bicuspid AS is limited to small series. Therefore, we aim to evaluate the clinical outcomes of TAVR in bicuspid AS and compare them to tricuspid AS.19 Mar iFR Can Assess Need For Coronary Revascularization Without Adenosine
Posted at 23:13h
in Author Interviews, Heart Disease, Imperial College, Medical Imaging, Surgical Research
MedicalResearch.com Interview with:
[caption id="attachment_33035" align="alignleft" width="149"]
Dr. Davies[/caption]
Dr. Justin Davies PhD
Senior Reserch Fellow and Hononary Consultant Cardiologist
National Heart and Lung Institute,
Imperial College London
MedicalResearch.com: What is the background for this study?
Response: We know from the FAME study that compared to angiography alone, FFR guided revascularization improves long-term clinical outcomes for our patients. Despite this, adoption of FFR into everyday clinical practice remains stubbornly low. One major factor for this is the need for adenosine (or other potent vasodilator medications) in order to perform an FFR measurement. Adenosine is expensive, unpleasant for the patient, time consuming and even potentially harmful.
iFR is a newer coronary physiology index that does not require adenosine for its measurement. In the prospective, multi center, blinded DEFINE FLAIR study, 2492 patients were randomly assigned to either FFR guided revascularisation or iFR guided revascularization and followed up for a period of 1 year.
19 Mar Cannabis Users Have Increased Risk of Stroke and Heart Failure
MedicalResearch.com Interview with: [caption id="attachment_33103" align="alignleft" width="140"]
Dr. Aditi Kalla[/caption]
Aditi Kalla, MD
Cardiology Research Fellow
Einstein Medical Center
Philadelphia
MedicalResearch.com: What is the background for this study?
Response: As of the recent 2016 election, decriminalization of cannabis passed in several states bringing the total count up to 28 states and D.C. where cannabis is now legal for medicinal and/or recreational purposes. From a physician’s perspective, it is rare that a drug has “hit the market” so to speak without undergoing clinical trials to determine safety and efficacy. Hence, we sought out to study if cannabis had any effects (positive or negative) on the cardiovascular system.
19 Mar Radiation Exposure and Vascular Access in Acute Coronary Syndromes: The RADMatrix Trial
[caption id="attachment_32906" align="alignleft" width="200"]
Dr. Marco Valgimigli[/caption]
MedicalResearch.com Interview with:
Dr. Marco Valgimigli, MD, PhD
Interventional Cardiology
Sandro Pertini Hospital, ASL RM2, Rome, Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Every year millions of people with coronary artery disease are treated worldwide with percutaneous coronary intervention (PCI). Radial access as compared to femoral access reduces bleeding and mortality in patients with acute coronary syndrome (ACS) undergoing invasive management. However, prior studies have raised concerns over the increased risk of radiation exposure for both patients and operators with radial instead of femoral access and it remains still unclear whether radial access increases the risk of operator or patient radiation exposure in contemporary practice when performed by expert operators.
The MATRIX (Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX) trial is the largest randomized trial comparing radial versus femoral access in ACS patients undergoing invasive management. In this radiation sub-study (RAD-MATRIX), we collected fluoroscopy time and dose area product (DAP) and equipped radial operators consenting to participate with dedicated dosimeters, each wearing a thorax (primary endpoint), wrist and head (secondary endpoints) lithium fluoride thermo luminescent dosimeter, during study conduct to establish non-inferiority of radial versus femoral access.
Among eighteen operators, performing 777 procedures in 767 patients, the non-inferiority primary endpoint was not achieved. Operator equivalent dose at the thorax was significantly higher with radial than femoral access. After normalization of operator radiation dose by fluoroscopy time or DAP, the difference remained significant. Radiation dose at wrist or head did not differ between radial and femoral access. Thorax operator dose did not differ in the right radial compared to the left radial access. In the overall MATRIX population, fluoroscopy time and DAP were higher with radial as compared to femoral access.
19 Mar Cardiovascular Procedures That Push the Line: High-Risk or Futility of Care?
MedicalResearch.com Interview with: [caption id="attachment_33090" align="alignleft" width="200"]
Dr. Adam Skolnick[/caption]
Adam Skolnick, MD
Cardiologist
Associate professor of medicine
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: I am privileged to serve on the ACC Program Planning Committee and helped to design this important session that seeks to determine the line between when a cardiovascular procedure is high risk and when it is futile. I am co-chairing the session with the incoming chair of the section on Geriatric Cardiology for the ACC, Dr. Karen Alexander from Duke.
We are practicing medicine at one of the most extraordinary times when there are so many devices and procedures to prolong and improve quality of life. It is critical to assess a patient's goals of care for a given intervention. In some patients, particularly those who are multiple degenerative chronic conditions, are frail and/or have cognitive impairment it is difficult to know when a given procedure multiple medical conditions will achieve a patient's goals. When is a procedure high risk, and when is it simply futile? This is the fine line upon which many cardiologists often find themselves.
The speakers present case examples of high risk patients considering TAVI, high risk PCI or CABG and mechanical support devices and with interaction from the audience work through when each procedure is high risk and when it is unlikely to achieve a patient's goals of care. We also have a dedicated talk on high risk procedures in patients with cognitive impairment, such as advanced dementia.
19 Mar ST-Segment Elevation and Cardiac MRI in MI With Non-Obstructive Coronary Arteries
MedicalResearch.com Interview with: [caption id="attachment_33084" align="alignleft" width="133"]
Dr. Reynolds[/caption]
Harmony Reynolds, MD
Cardiologist
Saul J. Farber Associate Professor of Medicine
NYU Langone Medical Center
MedicalResearch.com: What is the background for this study?
Response: Some patients with heart attack have open, rather than severely narrowed, coronary arteries when they have a heart attack. This type of heart attack, known as myocardial infarction with non-obstructive coronary arteries or MINOCA, can be caused by a number of different problems. Cardiac MRI is useful because it can help physicians to find the underlying cause of MINOCA.
MINOCA patients with ST elevation on the ECG are at higher risk of death than those without ST elevation but it is not known whether ST elevation correlates with any specific underlying cause of MINOCA.
19 Mar Effect of Moderate-Intensity Exercise Training on Peak Oxygen Consumption in Patients With Hypertrophic Cardiomyopathy
Posted at 00:33h
in Author Interviews, Exercise - Fitness, Genetic Research, Heart Disease, JAMA, University of Michigan
MedicalResearch.com Interview with:
[caption id="attachment_33068" align="alignleft" width="200"]
Dr. Sara Saberi[/caption]
Sara Saberi, MD
Assistant Professor
Inherited Cardiomyopathy Program
Frankel Cardiovascular Center
University of Michigan Hospital and Health Systems
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Patients with hypertrophic cardiomyopathy are often told not to exercise or to significantly curb their exercise due to concern over the potential risk of increased ventricular arrhythmias and sudden cardiac death. There is no data regarding risks/benefits of exercise in HCM though. There is, however, data that shows that patients with HCM are less active and more obese than the general population AND a majority feel that exercise restrictions negatively impact their emotional well-being.
So, we devised a randomized clinical trial of a 16-week moderate-intensity aerobic exercise program versus usual activity with the primary outcome being change in peak VO2 (oxygen consumption). This exercise intervention resulted in a 1.27 mL/kg/min improvement in peak VO2 over the usual activity group, a statistically significant finding. There were no major adverse events (no death, aborted sudden cardiac death, appropriate ICD therapies, or sustained ventricular tachycardia). There was also a 10% improvement in quality of life as measured by the Physical Functioning scale of the SF-36v2.
19 Mar Instantaneous Wave-free Ratio vs Fractional Flow Reserve to Guide PCI
MedicalResearch.com Interview with: [caption id="attachment_33059" align="alignleft" width="200"]
Dr. Matthias Götberg[/caption]
Dr. Matthias Götberg MD PhD
Department of Cardiology, Clinical Sciences
Lund University, Skåne University Hospital
Lund, Sweden
MedicalResearch.com: What is the background for this study?
Response: Cardiologists encounter patients with narrowing of the coronary arteries on a daily basis. They typically use visual estimation of the severity of narrowing when performing coronary angiography, but it is difficult to accurately assess, based on a visual estimation alone, whether a stent is needed to widen the artery and allow the blood to more freely.
FFR (Fractional Flow Reserve) is more precise tool and results in better outcomes than using angiography alone to assess narrowing of the coronary arteries. With FFR, the doctor threads a thin wire through the coronary artery and measures the loss of blood pressure across the narrowed area. To acquire an accurate measurement, the patient must be given adenosine, which is a drug that dilates the blood vessels during the procedure. This drug causes discomfort; patients describe having difficulty breathing or feeling as if someone is sitting on their chest. The drug also adds to the cost of the procedure and can have other rare but serious side effects.
iFR (Instantaneous Wave-Free Ratio) is also based on coronary blood pressure measurements using a thin wire, but unlike FFR, it uses a mathematical algorithm to measure the pressure in the coronary artery only when the heart is relaxed and the coronary blood flow is high. As a result, a vasodilator drug is not needed.
iFR has been validated in smaller trials and have been found to be equally good as FFR to detect ischemia, but larger randomized outcome trials are lacking.
iFR-Swedeheart is a Scandinavian Registry-based Randomized Clinical Trial (RRCT) in which 2000 patients were randomized between iFR and FFR as strategies for performing assessment of narrowed coronary vessels. The primary composite endpoint at 12 months was all-cause death, non-fatal myocardial infarction, and unplanned revascularization.
RRCT is a new trial design originating from Scandinavia using existing web-based national quality registries for online data entry, randomization and tracking of events. This allows for a very high inclusion rate and low costs to run clinical trials while ensuring robust data quality.
15 Mar Does Stress Raise Risk of Atrial Fibrillation?
MedicalResearch.com Interview with: [caption id="attachment_32976" align="alignleft" width="133"]
Dr. Simon Graff[/caption]
Simon Graff MD
Department of Public Health
Research Unit for General Practice
Aarhus University
Aarhus C, Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The presented study is a continuation of our interest in the role of stress and the possible causes of atrial fibrillation. We published a study that showed that spousal bereavement were followed by a transiently increased risk of new onset of atrial fibrillation. With spousal bereavement being one of the most stressful life-event, we wanted to know whether minor and differentiated stress exposures had an effect as well. Therefore we used register based data on perceived stress as a new measure of exposure.
14 Mar Appropriate Anticoagulation Underutilized in Atrial fibrillation
MedicalResearch.com Interview with: Dr. Ying Xian MD PhD Department of Neurology, Duke Clinical Research Institute Duke University Medical Center Durham, North Carolina MedicalResearch.com: What is the background for this study? Response: Atrial fibrillation (AF) is the most common arrhythmia. AF increases the risk for stroke and accounts for 10% to 15% of all ischemic strokes. While the burden of AF-related stroke is high, AF is a potentially treatable risk factor. Numerous studies have demonstrated that vitamin K antagonists, such as warfarin, or non-vitamin K antagonist oral anticoagulants (NOACs), reduce the risk of ischemic stroke. Based on these data, current guidelines recommend adjusted-dose warfarin or NOACs over aspirin for stroke prevention in high-risk patients with Atrial fibrillation.13 Mar Association of Intensive Blood Pressure Control and Kidney Disease Progression in Nondiabetic Patients With CKD
MedicalResearch.com Interview with: Hon-Yen Wu, MD, PhD, on behalf of all authors Attending Physician and Assistant Professor, Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Assistant Professor, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan. Assistant Professor, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan. Assistant Professor, School of Medicine, National Yang-Ming University, Taipei, Taiwan. MedicalResearch.com: What is the background for this study? What are the main findings? Response: The effect of intensive blood pressure (BP) control in nondiabetic patients with chronic kidney disease (CKD) has long been a topic of debate. We summarized the published information comparing intensive BP control (< 130/80 mmHg) with standard BP control (< 140/90 mmHg) on major renal outcomes in CKD patients without diabetes. We pooled data from 9 randomized clinical trials with more than 8000 patients and over 800 events of kidney disease progression. We found that targeting blood pressure below the current standard did not provide additional benefit for renal outcomes compared with standard BP control, but may benefit nonblack patients or those with heavy proteinuria. MedicalResearch.com: What should readers take away from your report? Response: For the optimal blood pressure target in CKD patients without diabetes, an individually tailored treatment rather than a general rule to control hypertension is suggested.13 Mar Failed Fertility Therapy Linked To Increased Risk of Heart Disease
MedicalResearch.com Interview with: [caption id="attachment_32860" align="alignleft" width="200"]
Dr. Jacob Udell[/caption]
Jacob A. Udell MD MPH FRCPC
Cardiovascular Division
Women's College Hospital
Toronto General Hospital
University of Toronto
MedicalResearch.com: What is the background for this study?
Response: We’ve noticed for a long time that fertility drug treatment can cause short-term complications such as high blood pressure or diabetes in pregnancy. We recently started wondering whether there may be long term consequences for these women years after a baby was or was not born. To do this, we looked at all women who were treated with fertility therapy in Ontario for the last 20 years, from what we could determine this amounted to more than 28,000 women. We then followed up years later to examine every woman’s cardiovascular health.
09 Mar Time-Related Microcirculatory Dysfunction in Patients With Takotsubo Cardiomyopathy
MedicalResearch.com Interview with: Dr. Fernando Alfonso Cardiac Department H.U de la Princesa Madrid. Spain MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tako-Tsubo Cardiomyopathy is, unfortunately, a “black hole” in current cardiology knowledge. We have a large background about its epidemiology and clinical course but, conversely, cardiology research have...
07 Mar Using Post-Resuscitation ECG To Predict Need For Brain CT
MedicalResearch.com Interview with: [caption id="attachment_32752" align="alignleft" width="200"]
Dr. Won Young Kim[/caption]
Won Young Kim, MD
Department of Emergency Medicine
Ulsan University College of Medicine
Asan Medical Center
Seoul, Korea
MedicalResearch.com: What is the background for this study?
Response: The current advanced cardiac life support guidelines recommended emergent percutaneous intervention for out-of-hospital cardiac arrest (OHCA) survivors with ST-segment elevation and suspected cardiac origin without ST-segment elevation. However, spontaneous subarachnoid hemorrhage (SAH) is a well-known cause of cardiac arrest, and its electrocardiogram may mimic myocardial infarction or ischemia. The need and timing for brain computed tomography in non-traumatic OHCA remain controversial.
The present study aimed at determining the role of the post-resuscitation ECG in patients with significant ST-segment changes on initial ECG to investigate the difference in post-resuscitation ECG characteristics between OHCA patients with SAH and those with suspected cardiac origin of OHCA.
02 Mar Many Eligible Groups Not Receiving Recommended Statin Therapy
MedicalResearch.com Interview with: Dr. Yashashwi Pokharel MD, MSCR Department of Cardiovascular Research Saint Luke’s Mid-America Heart Institute Kansas City, Missouri and Salim S. Virani, MD PhD, FACC, FAHA Associate Professor, Section of Cardiovascular Research Associate Director for Research, Cardiology Fellowship Training Program Baylor College of Medicine Investigator, Health Policy, Quality and Informatics Program Michael E. DeBakey Veterans Affairs Medical Center HSR&D Center of Innovation Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center Houston, TX MedicalResearch.com: What is the background for this study? What are the main findings? Response: Unlike the previous cholesterol management guideline that recommended use of either statin and non-statin therapy to achieve low density lipoprotein cholesterol (LDL-C) target, the 2013 American College of Cardiology/American Heart Association cholesterol management guideline made a major paradigm shift by recommending statin focused treatment in 4 specific patient groups and replaced LDL-C target with fixed statin intensity treatment (moderate to high intensity statin therapy). With this change, it was speculated that a large number of patients would be eligible for statin treatment (in one study, up to 11.1% additional patients were expected to be eligible for statin therapy). Our study provided the real world trends in the use of statin and non-statin lipid lowering therapy (LLT) from a national sample of cardiology practices in 1.1 million patients 14 months before and 14 months after the release of the 2013 guideline. We found a modest, but significant increasing trend in the use of statin therapy in only 1 of the 4 patient groups eligible for statin therapy (i.e., 4.3% increase in the use of moderate to high intensity statin therapy in patients with established atherosclerotic cardiovascular disease). We did not find any significant change in non-statin LLT use. Importantly, about a third to half of patients in statin eligible groups were not receiving moderate to high intensity statin therapy even after the publication of the 2013 guideline.01 Mar Ischemic Postconditioning During Primary PCI for Patients With STEMI Heart Attack
MedicalResearch.com Interview with: [caption id="attachment_32483" align="alignleft" width="200"]
Dr. Engstrøm[/caption]
Thomas Engstrøm MD, PhD
The Heart Center | Rigshospitalet | University of Copenhagen | Denmark
Professor in cardiology | University of Lund | Sweden
Adjunct professor in cardiology | University of Aalborg | Denmark
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Timely reperfusion by primary angioplasty (primary PCI) in patients with ST-elevation myocardial infarction is mandatory. However reperfusion it self can harm the myocardium - so called reperfusion injury. During a number of years ischemic postconditioning (iPOST) by repetitive interruptions of blood flow after reperfusion has been a promising technique to address reperfusion damage.
The trial investigated the effect of iPOST in 1200 patients treated with primary PCI and in addition either iPOST or conventional angioplasty.
01 Mar Metabolic Syndrome Severity Confers Greater Cardiovascular Risk
MedicalResearch.com Interview with: [caption id="attachment_32345" align="alignleft" width="176"]
Dr. DeBoer[/caption]
Mark D. DeBoer, MD
Associate Professor of Pediatrics
Division of Pediatric Endocrinology
University of Virginia
Charlottesville, VA 22908
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Worldwide there remains a need for accurate prediction of cardiovascular disease. One such predictor is the metabolic syndrome, a cluster of individual risk factors including central obesity, high blood pressure, high triglycerides, low HDL cholesterol, and high fasting glucose. Metabolic Syndrome is usually diagnosed using set criteria, where a person is diagnosed if he or she has abnormalities in at least 3 of the individual components. Using these criteria, someone with MetS (compared to without MetS) has a >50% greater chance of developing cardiovascular disease over the ensuing 10 years. The problem is that prior studies showed that having MetS did not increase risk above that seen for having the abnormalities in the individual risk factors themselves.
Our study used a continuous MetS severity score that we derived previously and assessed this score as a predictor of future cardiovascular disease in two large cohorts. We found that even when analyzed with abnormalities in the individual Metabolic Syndrome components, higher levels of the MetS severity score conferred higher risk for cardiovascular disease. This suggests the potential for following this score in individuals over time to identify those at higher risk for future cardiovascular disease.
01 Mar Health Lifestyle Could Cut Cardiovascular Disease 50% in Chinese
Posted at 17:53h
in Author Interviews, Heart Disease, JACC, Lifestyle & Health, Race/Ethnic Diversity
MedicalResearch.com Interview with:
[caption id="attachment_32341" align="alignleft" width="200"]
Dr. Lu Qi[/caption]
Lu Qi, MD, PhD, FAHA
HCA Regents Distinguished Chair and Professor
Director, Tulane University Obesity Research Center
Department of Epidemiology
Tulane University
School of Public Health and Tropical Medicine
New Orleans, LA 70112
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Adherence to healthy lifestyle (high physical activity, less smoking, moderate alcohol consumption, healthy diet, and low adiposity) has been related to substantially reduced risk of cardiovascular diseases in large cohorts from the US and Europe, however, similar evidence in Asians such as Chinese is lacking.
27 Feb New Recording System Enables Identification of Complex Cardiac Arrhythmias
MedicalResearch.com Interview with: [caption id="attachment_32456" align="alignleft" width="200"]
Jay Millerhagen[/caption]
MedicalResearch.com: What is the background for this study?
Response: Journal of the American College of Cardiology (JACC): Clinical Electrophysiology (JACC CEP) publication entitled, “Novel Electrophysiology Recording System Enables Specific Visualization of the Purkinje Network and Other High-Frequency Signals” reports important findings obtained using BioSig Technologies’ PURE EP System during a series of pre-clinical studies conducted at Mayo Clinic in Rochester, Minnesota. These studies are part of a company-funded Advanced Research Program announced on March 28, 2016. The JACC CEP manuscript provides an excellent example of the PURE EP System’s ability to record challenging high frequency signals known as Purkinje potentials. These signals are of great interest to electrophysiologists when assessing arrhythmia syndromes dependent on the Purkinje network.
27 Feb Aspirin Desensitization in Patients With Coronary Artery Disease
MedicalResearch.com Interview with: [caption id="attachment_32432" align="alignleft" width="133"]
Dr. Rossini[/caption]
Dr. Roberta Rossini, MD, PhD
USC Cardiologia, Cardiovascular Department
Bergamo, Italy
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Aspirin (ASA) is stilll the cornerstone of antithrombotic therapy in patients with coronary artery disease, especially after PCI, both
in the acute and the chronic phase of treatment. However, ≈2% of patients have hypersensitivity to ASA. ASA desensitization may represent a valid approach. Desensitization protocols generally involve gradual increases in patient exposure to ASA with the goal of mitigating or abolishing immune-mediated reaction. However, many desensitization protocols require several days to be completed, making them unpractical. This may also contribute to the limited experience with applying ASA desensitization protocols in real-world practice in patients with CAD.
We previously reported the results of a pilot investigation supporting the feasibility of performing a rapid (<6 hours)
Aspirin desensitization protocol in patients undergoing PCI with stent implantation (Rossini R, Angiolillo DJ, Musumeci G, Scuri P, Invernizzi P, Bass TA, Mihalcsik L, Gavazzi A. Aspirin desensitization in patients undergoing percutaneous coronary interventions with stent implantation. Am J Cardiol. 2008;101:786–789. doi: 10.1016/j.amjcard.2007.10.045). The encouraging findings from our pilot feasibility investigation prompted the design of a larger scale multicenter investigation aimed to assess the safety and efficacy of a rapid aspirin desensitization protocol in patients with a history of ASA hypersensitivity undergoing coronary angiography.
26 Feb Stopping Warfarin in Dementia Patients with Atrial Fib Associated With Increased Risk of Stroke and Death
Posted at 17:36h
in Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Geriatrics, Heart Disease, Stroke
MedicalResearch.com Interview with:
[caption id="attachment_32407" align="alignleft" width="200"]
Dr. Ariela Orkaby[/caption]
Ariela Orkaby, MD, MPH
Geriatrics & Preventive Cardiology
Associate Epidemiologist
Division of Aging, Brigham and Women's Hospital
Instructor in Medicine, Harvard Medical School
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Atrial Fibrillation is a common heart rhythm that affects 1 in 25 adults over age 60 and 1 in 10 adults over age 80. The feared consequence of atrial fibrillation is stroke, leading to the prescription of blood thinning medications (anticoagulants such as warfarin) to prevent strokes. However, there is an underutilization of these life-saving medications in older adults, and particularly in those who have dementia. In part, this is due to a lack of research and inclusion of older adults with dementia in prior studies.
In this study, we used clinical Veterans Administration data, linked to Medicare, to follow 2,572 individuals over age 65 who had atrial fibrillation and until a diagnosis of dementia. The average age was 80 years, and 99% were male. We found that only 16% remained on warfarin. We used statistical methods to account for reasons why a patient would or would not be treated with warfarin and found that those who continued to take warfarin had a significantly lower risk of stroke (HR 0.74, 95% Confidence interval 0.54- 0.99, p=0.47) and death (HR 0.72, 95% CI 0.60-0.87, p<0.01) compared to those who did not continue to take warfarin, without an increased risk of bleeding.
25 Feb Enrollment in Heart Failure Registry Associated With Improved Survival
MedicalResearch.com Interview with: Lars H. Lund, MD Phd, Assoc. Prof., FESC Department of Medicine, Karolinska Institutet, and Department of Cardiology, Karolinska University Hospital Sweden MedicalResearch.com: What is the background for this study? What are the main findings? Response: Registries are accepted for quality reporting but it is actually unknown whether in heart failure they directly improve outcomes. Here, enrollment in SwedeHF was strongly associated with reduced mortality.25 Feb Increase In Subdural Hematomas Associated With Increase Use of Antithrombotic Drugs
MedicalResearch.com Interview with: [caption id="attachment_32393" align="alignleft" width="200"]
Dr. David Gaist[/caption]
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The incidence of subdural hematoma (SDH; a bleed located within the skull, but outside the brain) has been reported to be on the increase. Previous studies have shown an association between use of antithrombotic drugs and SDH. However, studies with updated estimates of this risk and with focus on current more complex and aggressive regimens of antithrombotic treatment are scarce.
We therefore performed this study, where we identified 10,010 patients aged 20-89 years that were admitted with SDH in Denmark in 2000 through 2015. Preadmission use of antithrombotic drugs (low-dose aspirin, clopidogrel, vitamin K antagonist, e.g. warfarin, and direct oral anticoagulants) of these cases was compared to that of 400,380 individuals from the general population with no history of SDH (controls).
We found that use of antithrombotic drugs was associated with an increased risk of subdural hematoma . The magnitude of this risk varied by type of antithrombotic, and was, e.g., low for use of low-dose aspirin, and highest for warfarin. Further, with a single exception (low-dose aspirin and dipyridamole), concurrent use of more than one antithrombotic drug was associated with higher risk of SDH, particularly if warfarin was taken along with an antiplatelet drug, e.g., low-dose aspirin or clopidogrel. Increasing use of antithrombotic drugs was observed in the study period. The incidence of subdural hematomas in the Danish population also increased markedly in the years 2000-2015, particularly among those aged 75+ years. Our study indicates that this increased incidence, can, at least partly, be explained by increased use of antithrombotic drugs.
25 Feb Can Patients With A Pacemaker or Defibrillator Get An MRI?
MedicalResearch.com Interview with: [caption id="attachment_32206" align="alignleft" width="200"]
Dr. Robert Russo[/caption]
Robert Russo, MD, PhD, FACC
The Scripps Research Institute
The La Jolla Cardiovascular Research Institute
MedicalResearch.com: What is the background for this study?
Response: For an estimated 2 million people in the United States and an additional 6 million people worldwide, the presence of a non-MRI-conditional pacemaker or implantable cardioverter defibrillator (ICD) is considered a contraindication to magnetic resonance imaging. This creates a dilemma for at least half of these patients, who are predicted to require an MRI scan during their lifetime after a cardiac device has been implanted. Safety concerns for patients with an implanted cardiac device undergoing MRI are related to the potential for magnetic field-induced cardiac lead heating resulting in myocardial thermal injury, and a detrimental change in pacing properties. As a result, patients with an implanted device have long been denied access to MRI, although it may have been the most appropriate diagnostic imaging modality for their clinical care. Despite the development of MRI-conditional cardiac devices, a strategy for mitigating risks for patients with non MRI-conditional devices and leads will remain an enduring problem for the foreseeable future due to an ever increasing demand for MRI and the large number of previously and currently implanted non-MRI-conditional devices.
25 Feb Which AFib Patients Should Resume Warfarin After Intracranial Hemorrhage?
MedicalResearch.com Interview with: Peter Brønnum Nielsen MD PhD Aalborg Thrombosis Research Unit Department of Clinical Medicine Faculty of Health Department of Cardiology, Atrial Fibrillation Study Group Aalborg University Hospital Aalborg, Denmark MedicalResearch.com: What is the background for this study? What are the main findings? Response: Patients who sustain an intracranial hemorrhage (ICH) event are often excluded from randomized trials investigating stroke prevention in atrial fibrillation (AF) by use of oral anticoagulant treatment.24 Feb Long Telomeres May Be Good For Heart Disease, Bad For Cancer Risk
MedicalResearch.com Interview with: [caption id="attachment_32371" align="alignleft" width="134"]
Dr. Philip Haycock[/caption]
Philip C. Haycock, PhD
MRC Integrative Epidemiology Unit
University of Bristol
Bristol, England
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The direction and causal nature of the association of telomere length with risk of cancer and other diseases is uncertain. In a Mendelian randomization study of 83 non-communicable diseases, including 420,081 cases and 1,093,105 controls, we found that longer telomeres were associated with increased risk for several cancers but reduced risk for some other diseases, including cardiovascular diseases.