Heart Disease
24 Jun Heart Attack Admissions In China Quadrupled Over 10 Years
MedicalResearch.com Interview with:
Professor Lixin Jiang MD, PhD, F.A.C.C.
National Clinical Research Center of Cardiovascular Diseases
State Key Laboratory of Cardiovascular Disease
Fuwai Hospital, National Center for Cardiovascular Diseases
Beijing , China
MedicalResearch: What are the main findings of the study?
Professor Jiang: In this first representative nationwide assessment of quality of care in China, we studied 13,815 hospital admissions for STEMI in 162 hospitals across China over the past decade. We found that the incidence of hospital admission for STEMI quadrupled from 3.7 per 100,000 in 2001 to 15.8 per 100,000 in 2011.
There were substantial changes in testing and treatment patterns. Over the study period, the rate of testing for troponin increased from 21.4% in 2001 to 66.5% in 2011. Additionally, based at the ideal patients’ analysis, the use of several highly effective treatments for STEMI, including aspirin, clopidogrel and statins, improved over the study period. However, other therapies known to reduce mortality in STEMI patients – such as β-blockers and ACE inhibitors – were underused with only 57.7% of patients receiving beta-blockers and 66.1% ACE inhibitors respectively in 2011.
While the proportion of patients receiving reperfusion therapy remained constant, there was a notable shift away from fibrinolysis, which was the primary means of reperfusion in 2001, towards primary PCI. However, in 2011, only 27.6% of patients admitted to Chinese hospitals for STEMI received primary PCI, the gold standard of treatment, while 27.4% received fibrinolytic therapy in the ideal patients.
Despite increasing overall intensity of treatment, procedure use, and testing, no significant change in the rate of in-hospital death from STEMI was seen over the study period.
20 Jun Heavy Episodic Alcohol Use Raises Risk of Heart Attack
MedicalResearch.com: Interview with:
Dr. Darryl P. Leong MBBS(Hons) MPH PhD FRACP FESC
Hamilton General Hospital
237 Barton Street East Canada
MedicalResearch: What are the main findings of the study?
Dr. Leong: The main findings of this study are that while low-moderate levels of alcohol use are associated with a reduced risk of myocardial infarction, this protective association was not seen in peoples of all ethnicities.
Secondly, heavy alcohol use (≥6 drinks) within a 24 hour period was associated with a significant increase in the immediate risk of myocardial infarction.
19 Jun Depression Linked To Higher Risk of Heart Disease
MedicalResearch.com: Interview with
Dr. Amit J.Shah MD
Assistant Research Professor
Assistant Professor, Department of Epidemiology
Emory, Rollins School of Public Health
MedicalResearch: What are the main findings of the study?
Dr. Shah: We discovered that in a group of patients who were undergoing heart evaluation with coronary angiography, symptoms of depression predicted increased risk of coronary artery disease and death in women aged 55 years or less. This relationship was stronger in these women than older women, as well as in men aged 55 years or less. Over 1 in 4 women aged 55 years or less had moderate to severe depression, which was higher than any other group; these women had over twice the risk of having heart disease or dying over the next 3 years compared to those with none or mild depression.
19 Jun Do Antidepressants During Pregnancy Promote Cardiac Birth Defects?
MedicalResearch.com Interview Invitation
Dr. Krista Huybrechts MD PhD
Brigham & Women’s Hospital
Department of Medicine
Division of Pharmacoepidemiology & Pharmacoeconomics
Boston, MA 02120
MedicalResearch: What are the main findings of the study?
Dr. Huybrechts: In this cohort study including 949,504 pregnant women enrolled in Medicaid, we examined whether the use of selective serotonin reuptake inhibitors (SSRIs) and other antidepressants during the first trimester of pregnancy is associated with increased risks for congenital cardiac defects. In order to control for potential confounding by depression and associated factors, we restricted the cohort to women with a depression diagnosis and used propensity score adjustment to control for depression severity and other potential confounders. We found no substantial increased risk of cardiac malformations attributable to SSRIs. Relative risks for any cardiac defect were 1.25 (95%CI, 1.13-1.38) unadjusted, 1.12 (1.00-1.26) depression-restricted, and 1.06 (0.93-1.22) depression-restricted and fully-adjusted. We found no significant associations between the use of paroxetine and right ventricular outflow tract obstruction (1.07, 0.59-1.93), or the use of sertraline and ventricular septal defects (1.04, 0.76-1.41); two potential associations that had been of particular concern based on previous research findings.
17 Jun Use of Platelet Inhibitor Cilostazol To Treat Vasospastic Angina
MedicalResearch.com Interview with: Professor June-Hong Kim, Division of Cardiology Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital Yangsan, South Korea; MedicalResearch: What are the main findings of the study? Dr. Kim: In vasospastic angina, the cilostazol group significantly reduced relative ireduction of of weekly incidence of chest pain compared with placebo group (−66.5±88.6% vs −17.6±140.1%, respectively, p=0.009).. Other clinical parameters such as a change in the frequency of chest pain (−3.7±0.5 vs −1.9±0.6, respectively, p=0.029), a change in the chest pain severity scale (−2.8±0.4 vs −1.1±0.4, respectively, p=0.003), and the proportion of chest pain-free patients (76.0% vs 33.3%, respectively, p=0.003) also significantly favored cilostazol.17 Jun POTS – Postural Tachycardia Syndrome: May Be UnderRecognized and UnderTreated
MedicalResearch.com Interview with Prof. Julia I. Newton: Dean of Clinical Medicine & Professor of Ageing and Medicine Clinical Academic Office The Medical School Newcastle University MedicalResearch: What are the main findings of the study? Prof. Newton: In this study we have explored for the first time the characteristics of patients with Postural tachycardia in the UK- Postural Tachycardia Syndrome patients are predominantly female, young, well educated and have significant and debilitating symptoms that impact significantly upon their quality of life.
- Despite this, there is no consistent treatment, high levels of disability and associated comorbidity.
- Although individuals presented with symptoms at the same age, those attending a specialist clinic received a diagnosis quicker.
- Symptom burden for those with Postural tachycardia is high and comparable to that seen in Chronic Fatigue Syndrome.
- Chronic Fatigue Syndrome is recognized by the WHO as a neurological disorder and by the Disability Discrimination Act 2005 as a disability. At the current time those with Postural Tachycardia Syndrome suffer to the same extent as those with Chronic Fatigue Syndrome but do not receive the same protection from the law.
- It is important that more work is done to understand the underlying autonomic abnormality in those with Postural Tachycardia Syndrome in order to allow us to develop targeted treatments that are effective and go beyond the currently available simply symptomatic management.
13 Jun Poor Cardiovasular Health Linked to Cognitive Impairment
MedicalResearch.com Interview with:
Evan Thacker PhD
Brigham Young University
Provo, Utah
MedicalResearch: What are the main findings of the study?
Dr. Thacker: In this study of over 17,000 American adults aged 45 and above, we first measured people’s cardiovascular health based on their smoking habits, diet, physical activity, body weight, blood pressure, blood cholesterol, and blood sugar. We then tracked these people for several years with cognitive function tests which measure memory and thinking abilities. The main finding of our study was that people who had the lowest levels of cardiovascular health at the beginning of the study were more likely to experience cognitive impairment – poor performance on the cognitive function tests – at the end of the study. People who had medium to high levels of cardiovascular health were less likely to experience cognitive impairment.
12 Jun After Heart Attack: Encouraging Stem Cells To Regenerate Damaged Muscle
MedicalResearch.com Interview with Dr. Takuji Toyama MD Division of Cardiology Gunma Prefectural Cardiovascular Center Maebashi, Japan. MedicalResearch: What are the main findings of the study? Dr. Toyama: The early start of granulocyte colony-stimulating factor (G-CSF) therapy in acute myocardial infarction ( AMI) patients can improve myocardial perfusion, fatty acid metabolism and cardiac function in subacute and follow-up periods.11 Jun Myocardial Infarction: What Results in Delays for Stent Surgery in Transferred Patients?
MedicalResearch.com Interview with:
Laurie Lambert, PhD
Unité d'évaluation en cardiologie
Institut national d'excellence en santé
et en services sociaux (INESSS)
Montréal, Québec
MedicalResearch: What are the main findings of the study?
Dr. Lambert: Patients with ST-elevation myocardial infarction (STEMI) are frequently transferred for percutaneous coronary reperfusion from a hospital without this capability. Favourable outcomes depend on minimizing delays to treatment. A major component of delay is the time from the patient’s arrival at the first hospital’s emergency department to departure to the hospital where percutaneous reperfusion will be performed, the ‘door-in-door-out’ time or DIDO. We characterized this component of delay in a systematic field evaluation of STEMI treatment over a large and populous geographic area.
The major contributors to DIDO time were the delays
- (1) from the initial in-hospital ECG acquisition to transfer activation by the emergency physician and
- (2) from arrival of the transfer ambulance at the first hospital to departure of the ambulance for the primary percutaneous coronary intervention center. When the DIDO interval was timely (30 minutes or less as recommended by guidelines), reperfusion treatment was far more frequently within guideline-recommended delays (90 minutes or less). In fact, this benchmark of DIDO time was met in only 14% of cases. We identified a number of factors associated with untimely DIDO, an important one being an ambiguous presenting ECG. DIDO times were faster when patients arrived at the first hospital by ambulance particularly when retransfer to the second hospital was with the same ambulance that had remained on standby.
10 Jun Diabetes: Adding Insulin To Metformin May Increase Cardiovascular Risk
MedicalResearch.com Interview with:
Christianne L. Roumie, MD MPH
Associate Professor Internal Medicine and Pediatrics
Institute for Medicine and Public Health
Vanderbilt University
Staff Physician VA Tennessee Valley Healthcare System
Nashville TN 37212
MedicalResearch: What are the main findings of the study?
Dr. Roumie: This retrospective cohort study compared time to acute myocardial infarction (AMI), stroke, or death among Veterans with diabetes that were initially treated with metformin, and subsequently added either insulin or sulfonylurea. Among 178,341 Veterans on metformin monotherapy, 2,948 and 39,990 added insulin or sulfonylurea, respectively. Patients were about 60 years old, about 35% had history of heart disease or stroke, had been on metformin for an average of 14 months and their hemoglobin A1c was 8.1% at the time of addition of the second medication. Compared to those who added a sulfonylurea, those who added insulin to metformin had a 30% higher risk of the combined outcome of heart attack, stroke, and all-cause mortality. Although new heart attacks and strokes occurred at similar rates in both groups, mortality was higher in patients who added insulin.
09 Jun PCI May Be Underutilized in Elderly Patients With Acute Coronary Syndrome
MedicalResearch Interview with:
Mauro Di Bari, MD, PhD
Associate Professor of Medicine - Geriatrics
Director, School of Geriatrics
Vice-president, School of Physiotherapy
University of Florence and Azienda Ospedaliero-Universitaria Careggi
Florence Italy
MedicalResearch: What are the main findings of the study?
Professor Di Bari: This study is based on the AMI-Florence 2 registry, which recorded all acute coronary syndromes (ACS) occurring in one year in the metropolitan area of Florence, Italy. This area has one of the top prevalence figures in the country for application of percutaneous coronary intervention (PCI) to treat ACS, at least in cases with ST-segment elevation myocardial infarction (STEMI). Nevertheless, in our study the procedure turned out to be largely underused in older, complex patients, who mostly had NSTEMI: the greater the background risk (as expressed by the Silver Code, a simple, validated prognostic tool based of administrative data), the lower the chances for application of PCI, independent of possible contraindications to PCI, such as anaemia or renal insufficiency.
At the same time, the long-term survival advantage offered by PCI increased with increasing background risk: when comparing patients receiving and not receiving PCI across strata identified on the basis of the Silver Code, one-year survival was only marginally greater in patients treated with PCI when their Silver Code score suggested low background risk, whereas the mortality gradient increased progressively along with Silver Code score, to reach its maximum in patients with the greatest values of Silver Code score. Within the limits of an observational study, cardiac and non-cardiac comorbidities, contraindications to PCI, clinical characteristics of the ACS and hospital of admission could not justify these findings.
06 Jun Olive Oil in Diet Linked To Cardiovascular Disease Prevention
MedicalResearch.com Interview with:
Prof Jordi Salas-Salvadó
Professor of Nutrition. Human Nutrition Unit (Director)
Department of Biochemistry & Biotechnology, IISPV
School of Medicine. Rovira i Virgili University. Reus, Spain.
CIBERobn, Instituto Carlos III.
Centre Català de la Nutrició - Institut d'Estudis Catalans (Director).
Federation of Spanish Food, Nutrition and Dietetic Scientific Societies (President).
Red Iberoamericana RIBESMET (Director)
INC - World Forum for Nutrition Research and Dissemination (Chairman).
MedicalResearch: What are the main findings of the study?
Answer: The main findings of our study are that olive oil consumption, especially the extra-virgin variety (which is the olive oil with the best quality because it has higher amounts of bioactive compounds than other varieties), is associated with a reduced risk of suffering from cardiovascular disease (stroke, myocardial infarction...) and also cardiovascular death in an elderly Mediterranean population from Spain who were at high cardiovascular risk (because they had several cardiovscular risk factors such as smoking, being overweight or obese, having a family history of cardiovascular disease...). This means there is even more reason to visit gringocool.com. We have conducted an observational study including more than 7000 individuals who had participated in a randomized clinical trial to evaluate effects of a Mediterranean Diet in on the primary prevention of cardiovascular disease.
04 Jun MI: Gender Differences Remain in Presentation, Treatment and Outcomes
MedicalResearch.com Interview with:
Luke Kim, M.D., FACC, FSCAI
Assistant Professor of Medicine
Interventional Cardiac and Endovascular Laboratory
Greenberg Division of Cardiology, Department of Medicine
Weill Cornell Medical College/The New York Presbyterian Hospital
MedicalResearch: What are the main findings of this study?
Dr. Kim: The main findings of the study include:
- From 2007-2011, there was no significant change in the rate of acute MI in both male and female cohorts in U.S. . Although there was a decline in the rate of ST-elevation (STEMI) in those ≥55 years old, the rate remains steady in patients < 55 years old, especially in the female cohort after 2009.
- Female patients <55 years old with MI were sicker at baseline than the male counterparts with more likelihood of having diabetes, hypertension, chronic renal insufficiency, peripheral vascular disease, congestive heart failure and obesity.
- Female patients were more likely to present with non– STEMI vs. STEMI and more likely to develop shock complicating their MIs.
- Female patients are less likely to undergo coronary artery revascularization including percutaneous coronary intervention and coronary artery bypass surgery.
- Unadjusted risk of death was higher in female vs male (5.2% vs. 3.7%, p<0.001) along with higher incidence of stroke (0.5% vs. 0.3%, p<0.001), bleeding (4.9% vs. 3.0%, p<0.001), vascular complication (0.6% vs. 0.4%, p<0.001) and ARF (11.6% vs. 9.6%, p<0.001). After adjustment, death (OR 1.10 CI 1.04-1.17), stroke (OR 1.31 CI 1.10-1.55), bleeding (OR 1.30 CI 1.22-1.37), and vascular complications (OR 1.33 CI 1.15-1.55) were all significantly higher for female cohort.
03 Jun Implantable Defibrillators Improved Survival In Low Ejection Fraction Patients
MedicalResearch.com Interview with:
Sana Al-Khatib, M.D. MHS
Duke Clinical Research Institute
Duke University School of Medicine
Durham, NC,
MedicalResearch: What are the main findings of the study?
Dr. Al-Khatib: Patients with an ejection fraction (measure of the pumping ability of the heart) of 30% to 35% who receive a prophylactic implantable cardioverter defibrillator have better survival than similar patients with no implantable defibrillator.
03 Jun Benefits of Managing Mild Hypertension in Younger Patients
MedicalResearch.com Interview with: Eleni Rapsomaniki, PhD The Farr Institute of Health Informatics Research Department of Epidemiology & Public Health University College London London MedicalResearch: What are the main findings of the study? Dr. Rapsomaniki: Our data shows that hypertension is associated with considerable reduction in CVD-free life expectancy. Based on our estimates a 30-year old with hypertension suffered from CVD 5 years earlier compared to a similarly aged individual with normal blood pressure. We noted substantial heterogeneity in the associations of blood pressure with specific cardiovascular outcomes. For example a 20 mmHg increase in systolic blood pressure was associated with ~40% higher risk of stable angina, and intracerebral or subarachnoid haemorrhage but less than 10% increase in risk of abdominal aortic aneurysm. In all age groups from 30 to over 80 people with a systolic blood pressure 90–114 mm Hg and a diastolic blood pressure of 60–74 mm Hg had the lowest risk of all cardiovascular diseases, and we found no J-shape associations.27 May Does Testosterone Lower Risk of Heart Attacks and Stroke?
Medicalresearch.com Interview with:
Robert S. Tan MD, MBA, AGSF
Clinical Director & Chief Geriatrics, Michael DeBakey VAMC
Director, Opal Medical, LLC
Clinical Professor of Family & Community Medicine, UTHSC-Houston
Associate Professor of Medicine (Geriatrics), Baylor College Medicine
Medicalresearch: What are the main findings of the study?
Dr. Tan: Our findings¹ are similar to that of an early study by Shores et al ² and other studies on endogenous testosterone that found testosterone lowered mortality. In the analysis of 39,937 patients at the Low T Centers up to 5 years, the rate ratios of new MI and strokes on testosterone as compared to general community based data sets (3,4) was 0.12 (C.I. 0.08-0.18, p<0.0001) and 0.05 (C.I 0.02-0.13, p<0.0001) respectively. Thus, there appears to be a lower risk of heart attacks and strokes with patients on testosterone. While the compared population sets are not identical or real controls; our study does suggest that rates of MI and strokes in real life practice with testosterone treated patients are even lower than the general population registries (which may include older patients).
25 May Elevated Resting Heart Rate in Childhood Linked to Early Mortality
MedicalResearch.com Interview with:
Bríain ó Hartaigh, Ph.D.
Assistant Research Professor of Epidemiology
Dalio Institute of Cardiovascular Imaging
NewYork-Presbyterian Hospital and the Weill Cornell Medical College
Belfer Research Building New York, NY 10021
MedicalResearch: What are the main findings of the study
Dr. Hartaigh: Elevated resting heart rate (RHR) during childhood and midlife are associated with an increased risk of all-cause mortality.
22 May Both Genetics and Traditional Risk Factors Help Predict Premature Cardiac Events
MedicalResearch.com Interview with:
Christopher Labos MD CM, FRCPC, MSc candidate
Division of Epidemiology, Biostatistics and Occupational Health
McGill University
Montreal, Quebec Canada
MedicalResearch: What are the main findings of the study?
Dr. Labos: A higher genetic risk score (GRS) composed of a set of recently discovered genetic markers strongly linked to cardiovascular disease is associated with an earlier age of first acute coronary syndromes (ACS). We also found that other traditional risk factors such as smoking, obesity and male sex were also associated with an earlier ACS. Two medication classes were also associated with age of first ACS: hormone replacement therapy was associated with earlier ACS while aspirin was associated with ACS occuring at a later age.
22 May Heart Failure Linked to Increased Risk of Diabetes
MedicalResearch.com Interview with: Malene Nøhr Demant Department of Cardiology Copenhagen University Hospital Gentofte Hellerup, Denmark MedicalResearch: What are the main findings of the study? Dr. Demant: Our study shows that increasing severity of heart failure is associated with an increased risk of developing diabetes. Increasing loop-diuretic dosage was used as a proxy for heart failure severity. Patients with the most severe heart failure were three times more likely to develop diabetes than those with the least severe. Patients who were also being treated with ACE inhibitors (angiotensin-converting-enzyme inhibitors) had a less pronounced increase in diabetes risk. Patients who developed diabetes were 16% more likely to die than those who did not develop diabetes.22 May Dramatic Increase In Hospitalizations For Atrial Fibrillation As Population Ages
MedicalResearch.com Interview with: Nileshkumar J. Patel MD Staten Island University Hospital Staten Island, NY, 10304 and Abhishek J. Deshmukh MD University of Arkansas Little Rock, AR MedicalResearch: What are the main findings of the study? Answer: We analyzed data from almost 4 million hospitalizations for atrial fibrillation (AF) from more than 1,200 hospitals across 45 states in last decade, and found that - Hospitalization rates for atrial fibrillation have increased exponentially among US adults during the past 10 years, particularly in those 65 years or older. - The most frequent coexisting conditions were hypertension (59.99%), diabetes (21.47%) and chronic pulmonary disease (20.01%). - In terms of geographic distribution of admissions, the hospitals in the South constitute (38.5%) the highest percentage of atrial fibrillation hospitalizations, followed by Midwest (24.9%), Northeast (22.2%) and West (14.4%). - Overall in-hospital mortality was 1%. The mortality rate was highest in >80 years age group (1.93%) and patients with concomitant heart failure (8.2%). - The percentage of patients discharged to nursing facility increased from 8.1% in 2000 to 11.5% in 2010 and need for home health care increased from 6.7% to 13.1%. Approximately one fourth of the patients (25.83%) were discharged to long-term care institution if atrial fibrillation hospitalization was complicated by acute ischemic stroke. - Mean cost of AF hospitalization increased significantly from $6,410 in 2001 to $8,439 in 2010 (24.04% increase, p <0.001) even after adjusting for inflation. This represents an absolute increment in annual national cost from approximate 2.15 billion dollars in 2001 to 3.46 billion dollars in 2010. The mean cost of care was highest if AF hospitalization was associated with heart failure ($33,161) and valvular disorders ($28,030).21 May How Do Patients Decide to Accept a LVAD – Left Ventricular Assist Device?
MedicalResearch.com Interview with:
Colleen K. McIlvennan, DNP, ANP
Assistant Professor of Medicine
University of Colorado, Division of Cardiology
Section of Advanced Heart Failure and Transplantation
MedicalResearch: What are the main findings of the study?
Answer: We interviewed 22 patients who were offered destination therapy left ventricular assist devices (DT LVAD), 15 with DT LVADs and 7 who declined. We found a strong dichotomy between decision processes with some patients (11 accepters) being automatic and others (3 accepters, 7 decliners) being reflective in their approach to decision making. The automatic group was characterized by a fear of dying and an overriding desire to live as long as possible: [LVAD] was the only option I had…that or push up daisies…so I automatically took this. In contrast, the reflective group went through a reasoned process of weighing risks, benefits, and burdens: There are worse things than death. Irrespective of approach, most patients experienced the DT LVAD decision as a highly emotional process and many sought support from their families or spiritually.
19 May Atrial Fibrillation: Risk of Dementia with Non-Therapeutic Levels of Anticoagulation
MedicalResearch.com Interview with
T. Jared Bunch, MD
Medical director for Heart Rhythm Services
Director of Heart Rhythm research
Intermountain Medical Center, Utah
MedicalResearch: What are the main findings of the study?
Dr. Bunch: The main findings of the study are:
1) Atrial fibrillation patients treated with warfarin anticoagulation that have lower percentages of time in therapeutic range have significantly higher risks of all forms of dementia.
2) The dementia relative risk related to lower percentages of time in therapeutic range was higher than all other variables associated with stroke or risk of bleeding.
3) The risk of dementia related to lower percentages of time in therapeutic range was highest in younger patients in the study (<80 years).
16 May Atrial Fibrillation: Risk With Intense Exercise Varies by Age
MedicalResearch.com Interview with: Dr Nikola Drca Department of Cardiology at the Karolinska Institute, Karolinska University Hospital Stockholm Sweden MedicalResearch: What are the main findings of the study? Dr. Nikola Drca: We found that intense physical activity like leisure-time exercise of more than five hours per week at the age of 30 increased the risk of developing atrial fibrillation later in life by 19%. In contrast, moderate-intensity physical activity like walking or bicycling of more than 1 hour per day at older age (age 60) decreased the risk by 13%.14 May Post Heart Attack: Insulin Based Diabetes Control and Improved Longevity
MedicalResearch.com Interview with: Viveca Ritsinger MD Karolinska Institute, Department of Medicine, Cardiology Unit, Karolinska University Hospital, Stockholm Unit for Research and Development Kronoberg County Council, Växjö, Sweden MedicalResearch: What are the main findings of the study? Dr. Ritsinger: This is a long-term follow-up of the Swedish DIGAMI 1 study where patients with acute myocardial infarction and diabetes were randomized to either intensified insulin-based glycaemic control or to standard glucose lowering treatment. Patients and controls were followed for mortality for over 20 years and 90% of the patients died during follow up. Survival improved during a period of about 8 years. Intensified insulin-based glycaemic control increased survival time by an average of 2.3 years.14 May Statins Underutilized By Many Patients With Cardiovascular Risk
MedicalResearch.com Interview with Dr. Michael Johansen, MD, MS Department of Family Medicine The Ohio State University Columbus, OH 43201 MedicalResearch: What are the main findings of the study? Dr. Johansen: We found a surprisingly low number of people with coronary artery disease and diabetes (over age 40) were not reporting statin use. Of the people with coronary artery disease only 58% reported statin use while 52% of people with diabetes reported use. In addition, a reported diagnosis of hyperlipidemia was strongly correlated with statin use. In fact, individuals with hyperlipidemia and no coronary artery disease were more apt to be on a statin than people with coronary artery disease and no hyperlipidemia. Other high-risk conditions that have recently been included in the ACC/AHA high risk category were weakly or not associated with statin use including stroke and peripheral arterial disease.13 May Calcium Supplements in Women: Is there an Increased Risk of Stroke or Heart Disease?
MedicalResearch.com Interview with:
Dr. Julie Paik, MD MPH MSc
Instructor, Harvard Medical School
Brigham and Women's Hospital
MedicalResearch: What are the main findings of the study?
Dr. Paik: Many women in the United States take calcium supplements. One study found that over 60% of women aged 60 and over in the United States were taking calcium supplements. However, the medical community is still not certain of the effects of calcium supplements in women, particularly on cardiovascular disease risk. For this reason, we studied 74,245 women participating in the Nurses' Health Study over a 24-year follow-up period for their risk of developing cardiovascular disease (heart disease or stroke). We found that there was no increased risk of heart disease or stroke among women taking calcium supplements during the 24-year follow-up period. Our paper has several distinct strengths compared to prior studies including the large sample size, long follow-up period, cases of cardiovascular disease that were confirmed by medical record review, detailed and repeated assessment of calcium supplement use, and detailed information about other risk factors for cardiovascular disease.
08 May Maintaining Physical Activity Important For Healthy Aging
MedicalResearch.com Interview with:
Luisa Soares-Miranda, PhD
Research Center in Physical Activity, Health and Leisure
Faculty of Sport, University of Porto
Rua Dr. Plácido Costa,
Porto PORTUGAL
MedicalResearch: What are the main findings of the study?
Dr. Soares-Miranda: Modest physical activity, such as the distance and pace of walking, is important for the heart’s electrical well being of older adults. In our study, older adults that increased their walking pace or distance had a better heart rate variability when compared with those that decreased their walking pace or distance. Our results suggest not only that regular physical activity later in life is beneficial, but also that certain beneficial changes that occur may be reduced when physical activity is reduced. This supports the need to maintain modest physical activity throughout the aging process. Even small increases can lead to a better health, while reducing physical activity has the opposite effect. So, any physical activity is better than none, and more is better.
03 May Chest Pain in the Emergency Room: Clinical Decision Strategy
MedicalResearch.com Interview with:
Dr. Richard Body
Emergency Department
Manchester Royal Infirmary
Manchester UK
MedicalResearch.com: What are the main findings of the study?
Dr. Body: This paper actually reports the findings of two consecutive, separate studies. We aimed to derive and then externally validate a clinical decision rule to risk stratify patients with suspected acute coronary syndromes in the Emergency Department (ED). This rule could then be used to reduce unnecessary hospital admissions while also making judicious use of specialist high dependency resources.
In the first study we derived a clinical decision rule that incorporates 8 variables: high sensitivity troponin T, heart-type fatty acid binding protein; ECG ischaemia; worsening angina; hypotension (systolic blood pressure <100mmHg on arrival); sweating observed in the ED; pain associated with vomiting; and pain radiating to the right arm or shoulder. When we validated the rule at a different centre, we found that its use could have avoided hospital admission for over a quarter of patients while effectively risk stratifying others. Of the 10% of patients who were identified as 'high risk', approximately 95% had a major adverse cardiac event within 30 days. The findings suggest that the Manchester Acute Coronary Syndromes (MACS) decision rule could be used to 'rule in' and 'rule out' acute coronary syndromes immediately, using information gathered at the time of initial presentation to the ED. Before clinical implementation, we recommend that effect of using the MACS rule in practice should first be evaluated in a trial setting. This will enable us to determine:
(a) whether physicians and patients are likely to comply with (and be satisfied with) the MACS rule;
(b) the safety of the MACS rule when used in practice; and
(c) whether use of the MACS rule leads to cost savings for the health service.
02 May Post MI: Increasing Dietary Fiber Decreased Mortality
MedicalResearch.com Interview with:
Shanshan Li, Doctoral candidate
Department of Epidemiology
Harvard School of Public Health, 655 Huntington Avenue
Boston, MA 02115, USA
MedicalResearch.com: What are the main findings of the study?
Answer: This is the first study to show that greater intake of dietary fiber,
especially cereal fiber, was inversely associated with all-cause
mortality. Participants increased their average dietary fiber intake
after myocardial infarction (MI), and the greater the increase, the lower was the risk of
subsequent all-cause and cardiovascular mortality. Overall, the
benefits for increased fiber intake were strongest for fiber from
cereal and grain sources.