Heart 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.
02 May Bystander CPR: Dispatcher Assistance Improves Outcomes
MedicalResearch.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.
01 May Calcium – Vitamin D Supplementation: Effect on Heart Disease and Mortality?
MedicalResearch.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.
24 Apr Diabetes: Nocturnal Hypoglycemia and Risk of Cardiac Arrhythmias
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.
23 Apr Cannabis Associated Cardiovascular Complications Increase
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.
16 Apr Calcium Scores: Predictive Of Heart Disease Death Even In Low Risk Adults
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.
15 Apr Collaborative Treatment of Depression and Anxiety Feasible in Hospitalized Cardiac Patients
MedicalResearch.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.
12 Apr Tooth Loss Associated with Risk Factors for Coronary Heart Disease
MedicalResearch.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.
11 Apr Heart Failure Treatment with Diuretic Spironolactone
MedicalResearch.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.
09 Apr NSAIDS Associated with Atrial Fibrillation
MedicalResearch.com Interview with: Bruno Stricker, MB PhD Professor of Pharmaco-epidemiology Professor of Pharmacoepidemiology Erasmus MC MedicalResearch.com: What are the main findings of the study? Dr. Stricker: NSAIDs/painkillers may cause atrial fibrillation. MedicalResearch.com: What should patients and provider take away from this study? Dr. Stricker: Atrial fibrillation is the main risk factor of stroke. Patients with cardiovascular disease should...
06 Apr Acute Kidney Injury Risk From PCI Surgery Lower With Radial Approach
MedicalResearch.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.
06 Apr Frequent PVCs: Catheter Ablation Improved Left Ventricular Function
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.
04 Apr Heart Attack Diagnosis in the Emergency Room: How Accurate in Cardiac Troponin?
Posted at 22:54h
in Author Interviews, Biomarkers, Emergency Care, Heart Disease, JACC, Karolinski Institute
MedicalResearch.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.
04 Apr Coronary Artery Disease: Evaluation of Darapladib for Atherosclerotic Plaques
MedicalResearch.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.
01 Apr Balloon Pump: May Be Option for Patients with Mild to Moderate Aortic Insufficiency
Posted at 19:54h
in Heart Disease
MedicalResearch.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).
27 Mar Dialysis Patients with Atrial Fibrillation: Warfarin and Risk of Stroke and Bleeding
MedicalResearch.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).
20 Mar Military Combat Increases Risk of Subsequent Coronary Heart Disease
MedicalResearch.com Interview with:
Dr. Nancy Crum-Cianflone MD
Deployment Health Research Department, Naval Health Research Center, San Diego, CA
MedicalResearch.com: What are the main findings of the study?
Dr. Nancy Crum-Cianflone: There have been several studies examining the health outcomes of service members who recently deployed to the conflicts in Iraq and Afghanistan. However, none of these studies to date had examined the potential role of military deployment experiences and PTSD on coronary heart disease (CHD) among young US service members. We believed that this would be an important study to undertake since these data would not only be useful to the US military, but may also have implications regarding job-related stressors on the health of young adults in the general population.
After studying over 60,000 current and former US military personnel, we found that those who deployed and experienced combat were at a 60%-90% increased risk of subsequently developing CHD. This finding was noted when we examined both self-reported CHD and medical record validated coronary heart disease. These data suggest that experiences of intense stress may increase the risk for coronary heart disease over a relatively short period among young, previously healthy adults.
20 Mar Heart Attack: Feminine Traits May Delay Cardiac Treatment
Posted at 11:55h
in Author Interviews, CMAJ, Emergency Care, Gender Differences, Heart Disease, McGill
MedicalResearch.com Interview with:
Roxanne Pelletier, PhD
Postdoctoral Fellow
Division of Clinical Epidemiology
McGill University Health Centre (MUHC)
687 Pine Avenue West, V Building, Room V2.17
Montreal, Qc
MedicalResearch.com: What made you want to study this disparity between men and women and heart attacks?
Dr. Pelletier: Despite enhanced medical treatment and decrease in the incidence of heart diseases, important sex disparities persist in the risk of mortality following a cardiac event: the risk of mortality is higher in women compared to men, and this sex difference is even more important in younger adults. Therefore, we aimed to investigate potential mechanisms underlying this sex difference in mortality.
19 Mar No Cardiovascular Benefit Found With Omega 3 Fatty Acids or Macular Xanthophylls Supplementation
MedicalResearch.com Interview with: Denise Bonds, MD, MPH National Heart, Lung, and Blood Institute (NHLBI) MedicalResearch.com: What are the main findings of the study? Dr.Bonds: We found no cardiovascular benefit to supplementation of the diet with either omega-3 fatty acids or with the macular xanthophyll’s lutein and zeaxanthin.18 Mar Gestational Diabetes Increases Risk of Future Heart Disease
MedicalResearch.com Interview with:
Erica P. Gunderson, PhD, MS, MPH
Senior Research Scientist, Cardiovascular and Metabolic Section
Division of Research, Kaiser Permanente Northern California
Oakland, CA 94612-2304
MedicalResearch.com: What are the main findings of the study?
Dr. Gunderson: The study found that:
- Gestational diabetes is a pregnancy complication that reveals a woman’s greater risk of future heart disease.
- Women who experience gestational diabetes face an increased risk of subclinical atherosclerosis (early heart disease) even if they do not develop type 2 diabetes or the metabolic syndrome years after pregnancy.
- Study participants with a history of gestational diabetes who did not develop diabetes or metabolic syndrome showed a greater carotid artery wall thickness (marker of early atherosclerosis) compared to those who never experienced gestational diabetes. The vessel narrowing also could not be attributed to obesity or other risk factors for heart disease that were measured before pregnancy.
- Weight gain and blood pressure elevations in women with gestational diabetes were responsible for these differences in the artery wall thickness.
17 Mar Saturated Fatty Acid Not Associated with Coronary Artery Disease?
MedicalResearch.com Interview with:
Rajiv Chowdhury MD, PhD
Cardiovascular Epidemiologist
Department of Public Health and Primary Care
University of Cambridge
MedicalResearch.com: What are the main findings of the study?
Dr. Chowdhury: Total saturated fatty acid, whether measured as a dietary intake variable or in the bloodstream as a biomarker, was not associated with coronary disease risk in combining all available prospective observational studies. Similarly, there were non-significant overall associations in the prospective studies that involved assessments of total monounsaturated fatty acids, long-chain omega-3 and omega-6 polyunsaturated fatty acids.
However, we found diversity in the observational associations between specific circulating long-chain omega-3 and omega-6 fatty acids with coronary risk, with some evidence that circulating levels of eicosapentaenoic and docosahexaenoic acids (ie, the two main types of long-chain omega-3 polyunsaturated fatty acids), and arachidonic acid are each associated with lower coronary risk. Similarly, within saturated fatty acids, there were positive, however, non-significant associations observed for circulating blood composition of palmitic and stearic acids (found largely in palm oil and animal fats, respectively), whereas circulating margaric acid (a milk fat) had a significant inverse association.
Additionally, when we investigated the randomised controlled trials that reported on the effects of omega-3 and omega-6 fatty acids on reducing coronary outcomes, there was no significant overall association observed.
17 Mar Do patients Need to Fast Prior to Coronary Interventions?
MedicalResearch.com Interview with:
Dr Tahir Hamid MRCP (UK), FESC
Department of Cardiology, Royal Albert Edward Infirmary
NHS Trust, Wigan, UK
MedicalResearch.com: What are the main findings of the study?
Dr. Hamid: Traditionally patients undergoing diagnostic and interventional coronary artery procedures are kept Nil-by-mouth, but until yet there exists neither evidence nor clear guidance about the benefits of this practice in such patients. In our study performed at two National Health Services (NHS) institutes, we demonstrated in our 1916 patients, that such procedures could be undertaken without the need for being 4-6 hours fasting. None of our patients had major complications leading to pulmonary aspiration or emergency cardiac surgery.
16 Mar Osteoarthritis: Total Hip, Knee Replacements Reduce Cardiovascular Risk
MedicalResearch.com Interview with:
Bheeshma Ravi, MD
Orthopedic Surgery
University of Toronto Medical Center
MedicalResearch.com: What are the main findings of the study?
Dr. Ravi: This study suggests that in persons with moderate-severe osteoarthritis of the hip or knee, total joint replacement is associated with a significant reduction in the risks for serious cardiovascular events.
13 Mar CABG Surgery in Patients with Acute Coronary Syndromes and Chronic Kidney Disease
MedicalResearch.com Interview with:
Martin Holzmann, MD, PhD
Department of Emergency Medicine,
Karolinska University Hospital
Stockholm Sweden.
MedicalResearch.com: What are the main findings of the study?
Dr. Holzmann: The main finding is that patients with renal dysfunction are at increased risk of cardiovascular events after undergoing CABG for acute coronary syndromes.
04 Mar Atrial Fibrillation, Warfarin and Kidney Function after Heart Attack
MedicalResearch.com Interview with:
Juan Jesus Carrero PhD (Pharm and Med)
Associate Professor in Renal Medicine
Karolinska Institutet, Sweden.
MedicalResearch.com: Why did you choose to study this particular question?
Answer: We chose this question because there is currently an important knowledge gap regarding safety and effectiveness of common drugs in individuals with chronic kidney disease. Because kidney dysfunction interferes with drug metabolism and drug elimination, patients with kidney dysfunction have traditionally been excluded from randomized controlled trials. Yet, practice guidelines are afterwards extrapolated to those in the absence of formal evaluation.
01 Mar Should Dental Extractions Be Done Prior to Heart Surgery?
Posted at 01:18h
in Annals Thoracic Surgery, Author Interviews, Dental Research, Heart Disease, Infections, Mayo Clinic
MedicalResearch.com Interview with:
Dr. Kendra J. Grim
Department of Anesthesiology
Mayo Clinic, Rochester, MN 55905
MedicalResearch.com: What are the main findings of the study?
Dr. Grim: “The current guidelines say that if possible, treating the dental problems that patients have before heart surgery is best, to try to prevent both early and late heart infections. But the data is very unclear, because it’s very difficult to study. We found in our study that their risk of serious complications after having teeth removed may be higher than we thought. We were primarily looking at stroke, heart attack, renal failure and death. We found that actually the incidence of having one of those major morbidities was 8 percent. Of that 8 percent, we had six patients, or 3 percent, of the total group who died between their dental surgery and scheduled heart surgery, so these patients never made it to their heart surgery. An additional 3 percent of patients died after heart surgery. “