The HCPLive Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...
May 9th 2024
Compass Pathways reports positive results for psilocybin in PTSD treatment, showing safety and symptom improvement in an open-label phase 2 study.
Elevating Care for PAH: Applying Recommended Management Approaches to Maximize Outcomes
View More
‘REEL’ Time Patient Counseling™: Navigating the Complex Journey of Diagnosing and Managing Fabry Disease
View More
Expert Illustrations & Commentaries™: Envisioning Novel Therapeutic Approaches to Managing ANCA-associated Vasculitis
View More
Diabetic patients with acute coronary syndromes are at higher risk for mortality, even if they have ST-segment elevation myocardial infarction. Diabetic patients with unstable angina/non–Q-wave infarction have impaired platelet responsiveness to nitric oxide, a physiological anti-aggregating autocoid. The extent of this impairment depends on the degree of hyperglycemia. Rapid correction of hyperglycemia with infused insulin restores responsiveness to nitric oxide, thus ameliorating platelet dysfunction.
Significance of hyperglycemia and platelet function in diabetic patients
Glucose-insulin-potassium (GIK) was initially advocated as a treatment of acute myocardial infarction (MI) to promote electrical stability.
To evaluate the interactions between the weight loss drug, sibutramine, and different antihypertensive treatments, we randomly assigned 171 subjects taking 3 antihypertensive treatment regimens to receive sibutramine or placebo. Our study showed for the first time that combination therapy with an angiotensin-converting enzyme inhibitor and a calcium channel blocker is more advantageous than a ß blocker/diuretic-based-regimen with regard to supporting the weight-reducing actions and metabolic changes induced by sibutramine.
Multislice computed tomography coronary angiography: A study in search of a clinical niche
September 8th 2008The study presented in this issue of Cardiology Review by Schuijf and colleagues investigated various aspects of what is rapidly becoming an accepted imaging modality for the assessment of coronary artery disease.
Cardiac magnetic resonance stress tests in coronary heart disease
September 8th 2008We evaluated the prognostic value of cardiac magnetic resonance (CMR) stress testing with direct comparison of adenosine stress first-pass perfusion and dobutamine stress wall motion imaging among 513 subjects with known or suspected coronary heart disease over a median follow-up period of 2.3 years. Positive results on CMR stress testing identified subjects at high risk for subsequent cardiac events (nonfatal myocardial infarction or cardiac death), whereas normal CMR stress test results were associated with a very low annual cardiac event rate.
Cardiovascular morbidity in hypertensive patients with persistent atrial fibrillation
We conducted a substudy of the Rate Control Versus Electrical Cardioversion (RACE) study to evaluate cardiovascular morbidity, mortality, and the outcome of rate and rhythm control treatment in subjects with and without hypertension with persistent atrial fibrillation.
So when should sinus rhythm be restored?
September 8th 2008This review summarizes an important substudy of the Rate Control Versus Electrical Cardioversion (RACE) trial, which randomized 522 patients with atrial fibrillation (AF) to rate versus rhythm control treatment strategies and followed them for up to 2.3 years with a primary composite endpoint that included cardiovascular mortality, heart failure, thromboembolic complications, bleeding, severe adverse effects of anti-arrhythmic agents, and pacemaker implantation.
Anticoagulation for atrial fibrillation-trends in the United States
The use of anticoagulation therapy for atrial fibrillation has slowly increased in the last decade, yet many patients at relatively high risk for thromboembolic events are still not receiving anticoagulants. Patients receiving therapy that is intended to maintain sinus rhythm may be at higher risk for underuse of anticoagulation therapy than those receiving rate control therapies. In addition, the increase in the use of anticoagulation therapy appears to have been particularly notable among patients for whom it may not be indicated and in whom safer, less expensive antithrombotic therapies would suffice.
Creatine kinase-MB elevation after coronary artery bypass graft surgery in acute coronary syndromes
September 8th 2008We evaluated more than 26 000 subjects from 4 large trials that included subjects with non–ST-segment elevation acute coronary syndromes to determine the prognostic importance of creatine kinase-myocardial band (CK-MB) elevation after coronary artery bypass graft (CABG) surgery during the index hospitalization. Results showed that mortality at 6 months increased with increasing peak CK-MB ratios (CK-MB value post-CABG/CK-MB upper limit of normal), and peak CK-MB ratio was an independent predictor of 6-month outcome.
Acute aortic occlusion: Common presentation of an uncommon catastrophe
September 5th 2008There is scant systematic literature available on acute aortic occlusion. A review of 46 cases in a single center found 2 primary causes, including embolism (65%) or thrombosis (35%).1 Smoking and diabetes were found to be the risk factors for thrombotic occlusion and pre-existing cardiac disease and female gender risk factors for embolism. Acute aortic occlusion due to embolization of a large thrombus from left atrial appendage occurred in a patient with atrial fibrillation at our institution recently (Radha Sharma,MD, personal communication, February 2008). Case reports have described embolization of atrial myxoma to the abdominal aorta resulting in aortoiliac occlusion.2,3
Late mortality with sirolimus-eluting stents in diseased saphenous vein grafts
September 5th 2008In a secondary post-hoc analysis of the Reduction of Restenosis in Saphenous Vein Grafts with Cypher (RRISC) trial, we compared the long-term safety of sirolimus-eluting stents (SES) with bare-metal stents (BMS) in diseased saphenous vein grafts
Drug-eluting stents and diseased saphenous vein grafts: Long-term risk in RRISC
Progressive disease in saphenous vein grafts remains a major short-term and long-term clinical challenge after surgical revascularization.
Can corticosteroids prevent atrial fibrillation after cardiac surgery?
September 5th 2008We conducted a prospective, double-blind, randomized, multicenter study among 241 patients who underwent their first on-pump coronary artery bypass graft (CABG) surgery, aortic valve replacement (AVR), or combined CABG and AVR surgery to determine whether the use of hydrocortisone prevents atrial fibrillation after cardiac surgery. Results showed that the incidence of postoperative atrial fibrillation was significantly lower in the hydrocortisone group compared with the placebo group.
Prevention of postoperative atrial fibrillation
Atrial fibrillation (AF) is common after cardiac surgery, occurring in 11% to 40% of patients after coronary artery bypass grafting (CABG)1-8 and in more than 50% of patients after valvular heart surgery.
Nonfasting triglycerides and ischemic heart disease in men and women
Triglyceride levels are usually measured after the patient has fasted, and then exclude remnant lipoproteins. Except for the first few hours of the morning, individuals are usually in a nonfasting state for most of the day. We investigated whether nonfasting triglyceride levels predicted the risk of myocardial infarction (MI), ischemic heart disease, and death in the general population. Results showed that increased nonfasting triglyceride levels were associated with an increased risk of MI, ischemic heart disease, and death.
Serial biomarker measurements in chronic heart failure
September 5th 2008Cardiac troponin T (cTnT) and B-type natriuretic peptide (BNP) have been used to estimate prognosis in heart failure. However, most studies have evaluated decompensated patients using single measurements. To determine the value of serial measurements, we evaluated 190 stable chronic heart failure patients every 3 months during 2 years.
Biomarkers in heart failure: Work in progress
Assessing prognosis in heart failure poses a challenge in clinical practice.