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All Blog Posts (117)

COX-2 inhibitors blunt "preconditioning" effect of statin

Objectives: The purpose of this study was to determine whether single-dose rosuvastatin (40 mg) protects against ischemia and reperfusion (IR)–induced endothelial dysfunction in humans and whether this effect is cyclooxygenase (COX)-2 dependent.

Background: Animal studies have demonstrated that rosuvastatin can limit damage and improve recovery after IR.

Methods: In a double-blind, parallel design, 20 volunteers were randomized to a single dose of oral rosuvastatin (40 mg) or placebo.

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Added by Cardiology Rounds Team on March 8, 2010 at 1:26pm — No Comments

Aspirin as Preventive Therapy in Patients With Asymptomatic Vascular Disease

Cardiovascular disease (CVD) is the leading cause of death in the western world and a leading cause of death worldwide. Assessing patients' cardiovascular risk may be used to target preventive treatments to asymptomatic individuals at high risk for future CVD events. For these high-risk individuals, strategies including medication, diet, and comprehensive lifestyle approaches have been shown to improve cardiovascular morbidity and morta… Continue

Added by Cardiology Rounds Team on March 5, 2010 at 7:00am — No Comments

Aspirin for Prevention of Cardiovascular Events in a General Population Screened for a Low Ankle Brachial Index

Context A low ankle brachial index (ABI) indicates atherosclerosis and an increased risk of cardiovascular and cerebrovascular events. Screening for a low ABI can identify an asymptomatic higher risk group potentially amenable to preventive treatments.

Objective To determine the effectiveness of aspirin in preventing events in people with a low ABI iden

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Added by Cardiology Rounds Team on March 5, 2010 at 7:00am — No Comments

Effects of the Cyclooxygenase Inhibiting Nitric Oxide Donator Naproxcinod Versus Naproxen on Systemic Blood Pressure in Patients With Osteoarthritis

Traditional nonsteroidal anti-inflammatory drugs are associated with the destabilization of blood pressure (BP) control, particularly in hypertensive patients treated with blockers of the renin-angiotensin system. To assess the potential impact of nitric oxide donation, the effects of naproxcinod with naproxen and placebo on changes in BP were compared in a randomized clinical trial of 916 patients with osteoarthritis after 13 weeks of therapy. In addition, the effects of naproxcinod versus napr… Continue

Added by Cardiology Rounds Team on February 17, 2010 at 4:38pm — No Comments

Clinical relevance of echocardiography in acute severe dyspnea.

BACKGROUND: The aim of this study was to assess the most relevant echocardiographic parameter for the clinical diagnosis of acute dyspnea due to left-heart dysfunction. METHODS: Transthoracic echocardiography was performed in 88 patients in sinus rhythm admitted for respiratory distress. Two experts determined the cause of dyspnea as cardiogenic (26 patients) or noncardiogenic (62 patients). RESULTS: The feasibility was 100% for the E/A ratio and the E/E deceleration time (EDT) ratio but 97%, 89… Continue

Added by Cardiology Rounds Team on February 17, 2010 at 4:36pm — No Comments

A Universal Definition of Myocardial Infarction for the Twenty-First Century

As recently as 40 years ago, biomarkers used for the diagnosis of acute myocardial infarction (MI) were nonspecific and assays were not highly reproducible from one laboratory to another. This led to intense scientific efforts to develop a highly reproducible, sensitive, and specific biomarker to identify myocardial necrosis. More than 30 years ago, the World Health Organization (WHO) sought a standardized definition of MI for use by physicians throughout the world. The criteria employed in this… Continue

Added by Cardiology Rounds Team on February 17, 2010 at 4:35pm — No Comments

Key Articles Related to Complementary and Alternative Medicine in Cardiovascular Disease: Part 1

Complementary and alternative medicine (CAM) therapy has gained popularity in America over the past several years, reflected in the increased utilization of these agents. Given the abundance of nontraditional products available to the public, clinicians should be made aware of the existing evidence relating to CAM therapy to better provide patient care in a meaningful manner. This bibliography article compiled key articles specific to CAM therapy and cardiovascular disease, which include primary… Continue

Added by Cardiology Rounds Team on February 17, 2010 at 4:34pm — No Comments

an online guide for cardiology trainees, pg students, interns, young fellows to prepare for clinical exams, viva voce

http://www.cardiologytips.blogspot.com Continue

Added by Dr Shilpi Mohan on February 11, 2010 at 11:21pm — No Comments

Thrombosis The atrial septal pouch—a new source of thrombus? January 29, 2010 | Sue Hughes link - theheart.org

Orange, CA - A pouchlike structure, commonly found in the left atrium of the heart, has the potential to be a potent generator of thrombus and might be the cause of many ischemic events, particularly strokes in younger individuals, a new paper reports [1]. The paper, published in the January 2010 issue of the Journal of the American College of Cardiology: Cardiovascular Interventions, was written by Drs Subramaniam Krishnan and Miguel Salazar (University of California at Irvine Medical Center,… Continue

Added by Dr Shilpi Mohan on February 3, 2010 at 12:46pm — No Comments

Same weight loss, better BP with low-carb diet vs drug/diet combo

Durham, NC - A new randomized trial comparing a low-carbohydrate diet with a low-fat diet in combination with the weight-loss drug orlistat has found that both strategies produced meaningful weight loss among hospital outpatients over a one-year period [1]. Strikingly, however, the low-carb diet appeared to produce significant improvements in blood pressure. According to Dr William S Yancy Jr (Duke University, Durham, NC), lead author on the study, this is the first time the low-carb diet has b… Continue

Added by Dr Shilpi Mohan on January 27, 2010 at 9:19pm — No Comments

Incidence of and Risk Factors for Skin Cancer After Heart Transplant

bjective To examine the incidence, tumor burden, and risk factors for nonmelanoma and other skin cancer types in this heart transplant cohort. Design Retrospective review of patient medical records. Setting Tertiary care center. Patients All heart transplant recipients at Mayo Clinic from 1988 to 2006. Main Outcome Measures Cumulative incidence of skin cancer and tumor burden, with Cox proportional hazards regression models used to evaluate risk factors for posttransplant primary and seconda… Continue

Added by Cardiology Rounds Team on January 27, 2010 at 12:03pm — No Comments

Comorbidity Affects the Relationship Between Glycemic Control and Cardiovascular Outcomes in Diabetes A Cohort Study

Background: Recent studies have shown mixed results regarding the effectiveness of intensive glucose-lowering therapy in reducing risk for cardiovascular events. Objective: To determine whether attaining hemoglobin A1c (HbA1c) targets of 6.5% or less or 7.0% or less for glycemic control at baseline provides differential benefits for patients with high versus low-to-moderate levels of comorbidity. Design: 5-year longitudinal observational study of patients with type 2 diabetes. Patients were ca… Continue

Added by Cardiology Rounds Team on January 27, 2010 at 12:03pm — No Comments

Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark

Background Combinations of aspirin, clopidogrel, and vitamin K antagonists are widely used in patients after myocardial infarction. However, data for the safety of combinations are sparse. We examined the risk of hospital admission for bleeding associated with different antithrombotic regimens. Methods By use of nationwide registers from Denmark, we identified 40 812 patients aged 30 years or older who had been admitted to hospital with first-time myocardial infarction between 2000 and 2005. Cl… Continue

Added by Cardiology Rounds Team on January 20, 2010 at 9:13pm — No Comments

Strength of Study Evidence Examined by the FDA in Premarket Approval of Cardiovascular Devices

Context Medical devices are common in clinical practice and have important effects on morbidity and mortality, yet there has not been a systematic examination of evidence used by the US Food and Drug Administration (FDA) for device approval. Objectives To study premarket approval (PMA)—the most stringent FDA review process—of cardiovascular devices and to characterize the type and strength of evidence on which it is based. Data Sources and Study Selection Systematic review of 123 summaries of… Continue

Added by Cardiology Rounds Team on January 20, 2010 at 9:11pm — No Comments

Systematic Review: Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II–Receptor Blockers for Ischemic Heart Disease

Background: Patients with ischemic heart disease and preserved ventricular function experience considerable morbidity and mortality despite standard medical therapy. Purpose: To compare benefits and harms of using angiotensin-converting enzyme (ACE) inhibitors, angiotensin II–receptor blockers (ARBs), or combination therapy in adults with stable ischemic heart disease and preserved ventricular function. Data Sources: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cochrane… Continue

Added by Cardiology Rounds Team on January 20, 2010 at 8:26am — No Comments

obesity : an epidemic?

Most Americans overweight, and one-third are obese: NHANES January 13, 2010 | Michael O'Riordan Hyattsville, MD - Two new studies this week draw attention to the alarming number of individuals in the US considered overweight or obese [1,2]. Based on the latest surveys, more than two-thirds of US adults are overweight or obese, one-third are considered obese, and more than 10% of children and adolescents are also considered too heavy for their age. The good news, however, is that the increasing… Continue

Added by Dr Shilpi Mohan on January 18, 2010 at 4:29pm — No Comments

statin induced myopathy: cause?

The exact reason for statin-induced myopathy is not known. The reasons postulated are- Statin blocks the production of Farnesyl Pyrophosphate, an intermediate in the synthesis of Ubiqunone or co-enzyme CQ 10. CQ10 is responsible for mitocondrial energy production. CQ 10 decreases with Statin which leads to myopathy variation in SLCO1B1 gene which participates in the absorption of Statins cause increase in the risk of myopathy Statin reduces production of regulatory proteins important for myo… Continue

Added by Dr Shilpi Mohan on January 18, 2010 at 4:15pm — No Comments

High Residual Platelet Reactivity After Clopidogrel Loading and Long-Term Clinical Outcome After Drug-Eluting Stenting for Unprotected Left Main Coronary Disease

Background— No data exist about the impact of high residual platelet reactivity (HRPR) after clopidogrel loading on long-term clinical outcome in patients undergoing drug-eluting stent (DES) implantation for unprotected left main disease (ULMD). Methods and Results— Consecutive patients who underwent percutaneous coronary intervention for ULMD had prospective platelet reactivity assessment by light transmittance aggregometry after a loading dose of 600 mg of clopidogrel. The primary end point o… Continue

Added by Cardiology Rounds Team on January 13, 2010 at 9:10pm — No Comments

Impact of a Single High Loading Dose of Atorvastatin on Periprocedural Myocardial Infarction

Objectives: Atorvastatin administered at least 7 days before the percutaneous coronary intervention (PCI) reduces the rate of periprocedural myocardial infarction (MI). It is unknown whether a single, high (80 mg) loading dose of atorvastatin may reduce the rate of periprocedural MI. Background: Periprocedural MI is a prognostically important complication of PCI. Methods: The day before the elective PCI, 668 statin-naive patients were randomly assigned to atorvastatin 80 mg (atorvastatin group… Continue

Added by Cardiology Rounds Team on January 13, 2010 at 9:09pm — No Comments

Contraindicated Medication Use in Dialysis Patients Undergoing Percutaneous Coronary Intervention

Context The US Food and Drug Administration guides clinicians through drug labeling of medications that are contraindicated or not recommended for use in specific patient groups. Little is known about the use of such medications and their effects on outcomes in clinical practice. Objective To investigate the use of the contraindicated/not-recommended agents enoxaparin and eptifibatide among dialysis patients undergoing percutaneous coronary intervention (PCI) and their association with outcomes… Continue

Added by Cardiology Rounds Team on January 13, 2010 at 9:08pm — No Comments