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Author Interviews, Blood Pressure - Hypertension, Heart Disease, Lancet / 03.06.2014

​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. (more…)
Baylor College of Medicine Houston, Heart Disease, Testosterone / 27.05.2014

Robert S. Tan MD, MBA, AGSFMedicalresearch.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). (more…)
Author Interviews, Heart Disease / 25.05.2014

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 10021MedicalResearch.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. (more…)
Author Interviews, BMJ, Genetic Research, Heart Disease / 22.05.2014

Christopher Labos MD CM, FRCPC, MSc candidate Division of Epidemiology, Biostatistics and Occupational Health McGill University Montreal, Quebec CanadaMedicalResearch.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. (more…)
Author Interviews, Diabetes, Diabetologia, Heart Disease / 22.05.2014

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. (more…)
AHA Journals, Author Interviews, Cost of Health Care, Heart Disease, JACC / 22.05.2014

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). (more…)
Author Interviews, End of Life Care, Heart Disease / 21.05.2014

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 TransplantationMedicalResearch.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. (more…)
Cognitive Issues, Heart Disease / 19.05.2014

T. Jared Bunch, MD Medical director for Heart Rhythm Services Director of Heart Rhythm research Intermountain Medical Center, UtahMedicalResearch.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). (more…)
Author Interviews, Exercise - Fitness, Heart Disease, Karolinski Institute / 16.05.2014

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%. (more…)
Author Interviews, Diabetes, Heart Disease, Karolinski Institute, Lancet / 14.05.2014

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. (more…)
Author Interviews, General Medicine, Heart Disease, Statins / 14.05.2014

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. (more…)
Author Interviews, Brigham & Women's - Harvard, Calcium, Heart Disease / 13.05.2014

Dr. Julie Paik, MD MPH Instructor, Harvard Medical School Brigham and Women's Massachusetts GeneralMedicalResearch.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. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Geriatrics, Heart Disease / 08.05.2014

Luisa Soares-Miranda, PhD Research Center in Physical Activity, Health and Leisure Faculty of Sport, University of Porto Rua Dr. Plácido Costa, Porto PORTUGALMedicalResearch.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. (more…)
Author Interviews, BMJ, Emergency Care, Heart Disease / 03.05.2014

Dr. Richard Body Emergency Department Manchester Royal Infirmary Manchester UKMedicalResearch.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. (more…)
Author Interviews, BMJ, Heart Disease, Nutrition / 02.05.2014

Shanshan Li, Doctoral candidate Department of Epidemiology Harvard School of Public Health, 655 Huntington Avenue Boston, MA 02115, USAMedicalResearch.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. (more…)
AHA Journals, Author Interviews, Heart Disease / 02.05.2014

Yoshikazu Goto, MD, PhD Kanazawa University Hospital, Section of Emergency Medicine Takaramachi 13-1, Kanazawa 920-8640, JapMedicalResearch.com Interview with: Yoshikazu Goto, MD, PhD Kanazawa University Hospital, Section of Emergency Medicine Takaramachi 13-1, Kanazawa 920-8640, Japan MedicalResearch.com: What are the main findings of the study? Dr. Goto: The main findings were as follows. Dispatcher-assisted bystander cardiopulmonary resuscitation for children with out-of-hospital cardiac arrest, increased bystander CPR provision rate, and was associated with improved favorable neurological outcomes compared to no bystander CPR. Conventional bystander CPR (chest compression plus rescue breathing) was associated with greater likelihood of neurologically intact survival, compared to chest-compression-only CPR irrespective of cardiac arrest etiology. (more…)
Heart Disease, Vitamin D / 01.05.2014

Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner HospitalMedicalResearch.com Interview with: Joshua Lewis, Ph.D Raine Foundation / Alan Robson Fellow Bone and Vascular Research Group School of Medicine and Pharmacology University of Western Australia Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital MedicalResearch.com: What are the main findings of the study? Dr. Lewis: We tested the hypothesis raised by others that calcium supplementation with or without vitamin D increases coronary heart disease and mortality risk in elderly women. To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women. Importantly all events included in this large meta-analysis were verified by clinical review, hospital record or death certificate. We did not observe any significant increase in all-cause mortality or coronary heart disease events that included myocardial infarction, angina pectoris and acute coronary syndromes and chronic coronary heart disease. (more…)
Author Interviews, Diabetes, Heart Disease / 24.04.2014

Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K.MedicalResearch.com Interview with: Prof. Simon R. Heller Professor of Clinical Diabetes Department of Human Metabolism University of Sheffield, Sheffield, U.K. MedicalResearch.com: What are the main findings of the study? Prof. Heller: We explored the potential to hypoglycaemia to cause cardiac arrhythmias since we have previously shown that a low glucose can alter the electrocardiogram.  We had a hypothesis that alterations in heart rhythm or ectopic beats might contribute to cardiac mortality and in part explain the association between intensive diabetic therapy and increased mortality.  We therefore undertook continuous glucose monitoring and 12 lead EKG monitoring for a period of 5 days in individuals with Type 2 diabetes at increased CV risk.  We found that hypoglycaemia was fairly common and that nocturnal episodes in particular, were generally marked by a pattern whereby glucose levels dropped to low levels for some hours during which patients slept.  These periods of hypoglycemia were associated with a high risk of marked slow heart rates (bradycardia) accompanied by ectopic beats.  Our data suggest that this was due to overactivity of the vagus nerve.  We have therefore identified a mechanism which might contribute to increased mortality in individuals with Type 2 diabetes and high CV risk during intensive insulin therapy. (more…)
AHA Journals, Author Interviews, Cannabis, Heart Disease / 23.04.2014

Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France.MedicalResearch.com Interview with: Emilie Jouanjus, PharmD, PhD Risques, maladies chroniques et handicaps Facult_e de M_edecine, Guesde, Toulouse 31073, France. MedicalResearch.com: What are the main findings of the study? Dr. Jouanjus: Our study emphasizes that cardiovascular complications make up 1.8 percent of cannabis-related health complications reported in France. These were cases of peripheral arteriopathies, and cardiac and cerebrovascular disorders, some of which resulted in the death. These findings conducted us to conclude that marijuana is a possible risk factor for cardiovascular disease in young adults. (more…)
Heart Disease, JACC / 16.04.2014

Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com Interview with: Rine Nakanishi, MD, PhD Los Angeles Biomedical Research Institute MedicalResearch.com: What are the main findings of the study? Dr. Nakanishi: With growing evidence that a measurement of the buildup of calcium in coronary arteries can predict heart disease risk, Los Angeles Biomedical Research Institute (LA BioMed) researchers found that the process of "calcium scoring" was also accurate in predicting the chances of dying among adults with little or no traditional risk factor of heart disease. The study conducted by LA BioMed researchers examined 5,593 adults with no known heart disease and zero or minimal risk factor of heart disease -- including hypertension, dyslipidemia, diabetes, current smoking and family history of heart disease -- who had undergone coronary artery calcium screening by non-contrast cardiac computed tomography from 1991-2011. Among the adults in the study, even those with low coronary artery calcium scores of 1-99 were 50% more likely to die of heart disease than adults with a calcium score of zero. Adults with moderate scores of 100-399 were 80% more likely to die from heart disease than those with a score of zero, and those with scores of 400 or more were three times more likely to die from heart disease, when compared to adults with no calcified plaque buildup, or a score of zero. (more…)
Author Interviews, Heart Disease, JAMA, Mental Health Research / 15.04.2014

https://archinte.jamanetwork.com/article.aspx?articleid=1860496MedicalResearch.com Interview with: Dr. Jeffery  C. Huffman, M.D. Harvard Medical School Department of Psychiatry Massachusetts General Hospital, Boston MedicalResearch.com: What are the main findings of the study? Dr. Huffman: Depression and anxiety in cardiac patients are associated with adverse cardiac outcomes.  We completed a very low-intensity care management intervention to identify depression and anxiety disorders during a cardiac admission and then to assist in the monitoring and management of the condition over the next 24 weeks. There have been other care management trials in cardiac patients, but ours was the first to co-manage depression and anxiety, the first to initiate treatment in the hospital, the first to take a broad population of cardiac patients rather than a single diagnosis, and the first to use such a low-resource strategy with only a single part-time social worker to coordinate care. We found that the care management intervention was associated with significant improvements in mental health treatment, mental health related quality of life, depression, and function at 24 weeks compared to enhanced treatment as usual.  We did not find differences in anxiety, adherence, or cardiac readmissions. (more…)
Dental Research, Heart Disease / 12.04.2014

Dr Ola Vedin University of Uppsala, SwedenMedicalResearch.com Interview with: Dr Ola Vedin University of Uppsala, Sweden   MedicalResearch.com: What are the main findings of the study? Dr. Vedin: That self-reported tooth loss as a marker of periodontal disease is common in patients with established coronary heart disease and is associated with higher levels of LDL cholesterol, glucose levels, systolic blood pressure and waist circumference as well as diabetes and smoking, i.e. risk factors for coronary heart disease. Gum bleeding, another marker of periodontal disease, was associated with higher levels of LDL cholesterol and systolic blood pressure. In summary, patients with few remaining teeth and gum bleeding demonstrated a heavier burden of cardiovascular risk factors. (more…)
Author Interviews, Heart Disease, NEJM / 11.04.2014

Marc A. Pfeffer, M.D., Ph.D. Dzau Professor of Medicine Harvard Medical School Cardiovascular Division Brigham and Women's HospitalMedicalResearch.com Interview with: Marc A. Pfeffer, M.D., Ph.D. Dzau Professor of Medicine Harvard Medical School Cardiovascular Division Brigham and Women's Hospital MedicalResearch.com: What are the main findings of the study? Dr. Pfeffer: We randomized 3445 patients with symptomatic heart failure and a left ventricular ejection fraction greater than or equal to 45% (heart failure with preserved ejection fraction or diastolic heart failure) to spironolactone or placebo and followed them for over 3 years. Our primary outcome the composite of death from cardiovascular causes, aborted cardiac arrest, or hospitalization for management of heart failure was not significantly reduced in the group randomized to spironolactone. We did, however, observe that fewer patients in the spironolactone group were hospitalized for the management of heart failure following randomization. Spironolactone therapy was associated with higher incidence of  hyperkalemia and rises in serum creatinine. (more…)
Author Interviews, Heart Disease, Kidney Disease / 06.04.2014

Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The NetherlandsMedicalResearch.com Interview with: Judith Kooiman Department of Thrombosis and Hemostasis Leiden University Medical Center Leiden, The Netherlands   MedicalResearch.com: What are the main findings of the study? Dr. Kooiman: The main finding of our study is that trans radial PCI (TRI) is associated with a significantly lower risk of AKI compared with trans femoral PCI (TFI), after adjustment for confounding factors. (more…)
Author Interviews, BMJ, Heart Disease / 06.04.2014

Professor Ben He Department of Cardiology Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai China.MedicalResearch.com Interview with: Professor Ben He Department of Cardiology Renji Hospital, School of Medicine Shanghai Jiao Tong University, Shanghai China. MedicalResearch.com: What are the main findings of the study? Professor He: Elimination of PVCs by catheter ablation can improve LVEF and reverse LV dimensions. The pooled mean change in LVEF post-ablation meets the prespecified borderline (5%) and can be considered clinically effective. Beneficial effects of ablation of frequent PVCs in improving LV function are more significant in patients with reduced LVEF at baseline. (more…)
Author Interviews, Biomarkers, Emergency Care, Heart Disease, JACC, Karolinski Institute / 04.04.2014

Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, HuddingeMedicalResearch.com Interview with: Martin J. Holzmann, MD, PHD Department of Emergency Medicine Karolinska University Hospital, Huddinge   MedicalResearch.com: What are the main findings of the study? Dr. Holzmann: In a cohort of 8900 consecutive patients who sought medical attention for chest pain, we found that an undetectable high-sensitivity cardiac troponin level (<5 ng/l), and an ECG with no ischemic changes has a negative predictive value of 99.8% (95%, 99.7-99.9%). Thus, this will rule out MI with nearly 100% accuracy, and independent of when the troponin was measured in relation to onset of chest pain, and independent of any risk factors for cardiovascular disease. (more…)
Author Interviews, Heart Disease, NEJM / 04.04.2014

Professor Harvey White MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service Auckland City Hospital Victoria St West Auckland 1142 NEW ZEALANDMedicalResearch.com Interview with: Professor Harvey White MB ChB DSc FRACP FACC FESC FAHA FHKCC (Hon) FCSANZ FRSNZ La'auli (matai); Prince Mahidol Laureate; John Neutze Scholar, Director of Coronary Care & Green Lane Cardiovascular Research Unit, Green Lane Cardiovascular Service Auckland City Hospital NEW ZEALAND MedicalResearch.com: What are the main findings of the study? Prof. White:   During follow-up (median 3.7 years), the composite primary end point (cardiovascular death, myocardial infarction or stroke) occurred in 9.7% of the 7,924 patients randomly assigned to darapladib and 10.4% of the 7,904 patients in the placebo group (HR 0.94, 95% CI 0.85-1.03 p=0.199). In the first prespecified secondary endpoint of major coronary events (CHD death, MI or urgent revascularization) compared with placebo, darapladib reduced the rate (9.3% vs. 10.3%; HR=0.9; 95% CI, 0.82-1 p=0.045). Total coronary events (14.6% vs. 16.1%; HR = 0.91; 95% CI, 0.84-0.98,p=0.019). (CHD death, MI, any coronary revascularization, hospitalization for unstable angina) were also reduced. No major safety concerns arose during the trial. (more…)
Heart Disease / 01.04.2014

Mary E. Arthur, MD Cardiothoracic and ICU Anesthesia Department of Anesthesiology and Perioperative Medicine Georgia Regents University, Augusta, GAMedicalResearch.com interview with: Mary E. Arthur, MD Cardiothoracic and ICU Anesthesia Department of Anesthesiology and Perioperative Medicine Georgia Regents University, Augusta, GA   MedicalResearch.com: What made this cardiac case challenging? Dr. Arthur: The left ventricle of our patient’s heart was functioning very poorly, and he required maximum pharmacologic support after he was weaned from cardiopulmonary bypass at the end of a 4-vessel coronary artery bypass graft procedure. His blood pressure and cardiac output were extremely low and his heart was not pumping well and so we put him back on bypass. Under routine circumstances, using an intra-aortic balloon pump is the next logical step, however it was inadvisable in this patient because he had moderate aortic insufficiency (a leaky aortic valve). (more…)
Author Interviews, Heart Disease, Kidney Disease, McGill / 27.03.2014

Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill UniversityMedicalResearch.com Interview with: Louise Pilote, MD, MPH, PhD Department of Medicine, McGill University Department of Epidemiology and Biostatistics, McGill University MedicalResearch.com: What are the main findings of the study? Dr. Pilote: Our study found that in patients with atrial fibrillation (AF) undergoing dialysis, warfarin use, compared to no-warfarin use, did not reduce the risk for stroke (adjusted hazard ratio (HR): 1.14, 95% confidence interval (CI): 0.78 to 1.67) but it was associated with a 44% higher risk for bleeding event (adjusted HR: 1.44, 95% CI: 1.13 to 1.85). However, warfarin use in non-dialysis patients with AF was associated with a 13% lower risk for stroke (adjusted HR: 0.87, 95% CI: 0.85 to 0.90) and only a 19% higher risk for bleeding event (adjusted HR: 1.19, 95% CI: 1.16 to 1.22). (more…)