Cardiology

Mortality in patients with type 1 diabetes mellitus (T1DM) is higher than in the general population, and whether mortality improves or alters with glycemic control is unknown.

Refractory angina is a loosely defined term generally referring to the persistence of life-impacting angina despite maximal antianginal medications and, when possible, coronary revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]). Numerous novel pharmacotherapies and mechanical interventions have been proposed, and studies conducted, to treat patients with refractory angina.

Atrial fibrillation (AF) and heart failure (HF) often coexist. The use of beta-blockers in HF patients has a class 1A recommendation in both the European and American guidelines. In current guidelines for heart failure therapy, the recommendation for beta-blockers is not restricted to patients with sinus rhythm, and includes all HF patients.

In the era of progressive technology, the diagnostic modalities for stable coronary artery disease are various. The original cardiac stress test has been used in the past for many purposes, including diagnosis of obstructive coronary artery disease in a patient with chest pain as well as risk stratification for ischemia. More recently, coronary computed tomographic angiography (CCTA) has emerged as a great tool to diagnose anatomically obstructive coronary lesions. However, for the past few years, obtaining functional and physiologic data such as comparative fractional flow reserve (FFR) has become the gold standard for evidence of ischemia on CCTA similar to invasive angiography.

The primary objectives of treating acute ischemic stroke are to prevent death and limit functional disability. Similar to acute myocardial infarction (AMI), timely reperfusion using systemic thrombolysis has been shown to improve outcome of acute stroke, namely functional neurologic recovery, but not mortality. But unlike AMI, the role of intra-arterial or endovascular therapy in acute stroke has not been clearly established.

As P4P strategies gain popularity, the need for accurate assessment tools becomes more and more apparent-many physicians support PCP but believe that current measures are inaccurate. A common problem is that physicians appear to be penalized if they treat the elderly or patients who have reduced access to care or drug treatment.

This study was a randomized, controlled trial of 240 adults with metabolic syndrome who were assigned to follow either the single-component dietary recommendation of increased fiber consumption (≥30g/d), or the multi-component American Heart Association (AHA) dietary guidelines. The primary outcome measure was weight loss at 12 months.

A 51 year-old man with a history of well-controlled hypertension presents to his primary physician's office for an acute care visit with chest discomfort that would come and go.

As new medications and agents are developed organizations like the American College of Cardiology and the American Heart Association update their guidelines on treating a variety of conditions. Recently work was completed to help doctors treating acute coronary syndromes.

Sometimes even the most routine appearing patients can have results on their EKG that that can catch even the most veteran cardiologists off guard. This can be especially true for people who have had relatives suffer an unexpected cardiac fatality.

With primary care physicians treating such a broad spectrum of conditions they also have a number of medications they can prescribe to help their patients. While some of these are more beneficial than others it is important to consider which might be more effective for patients.

Individuals with chronic obstructive pulmonary disease are more likely to experience sudden cardiac death, according to a team of Dutch researchers.

In a multicenter observational study reported April 29 at the Asian Pacific Society of Cardiology Congress 2015, held in Abu Dhabi, researchers examined the relationship between the severity and presence of coronary artery disease in male patients and the number of wives they have. The more wives, the more heart disease.

Huntington's Disease (HD) is an autosomal dominant progressive neurodegenerative disorder. In addition to the central nervous system disturbance the ailment causes, there is increasing evidence the genetic abnormality also affects peripheral organs and tissues.

Albumin -- the most abundant protein in the human body -- has many roles. It transports hormones, fatty acids, and other compounds. It buffers serum pH, and maintains osmotic pressure. Now, it appears that albumin may be a tool that could be used in diabetes management.

Analysis of a large patient cohort indicates that "isolated" events of atrial fibrillation precipitated by temporary secondary conditions tend to become chronic long-term cases of atrial fibrillation.

FDA approval of the left atrial appendage closure device after a long review process provides a potentially useful alternative to warfarin.

Lack of sleep and chronic kidney disease (CKD) independently lead to hypertension, diabetes mellitus, lower quality of life, and shorter life expectancy. Severity of CKD and sleep disturbances may also worsen diabetes and hypertension synergistically.

A 28-year old man comes in who recently arrived in southern California from South America and suddenly developed a "cold." His symptoms included productive cough, shortness of breath, chest pain, fever, weakness and malaise. He also reported unexplained weight loss. Sputum and blood specimens were obtained for acid-fast smear examination and culture. A single posterior-anterior chest radiograph was obtained as part of his initial evaluation.

In this edition of Clinical Forum, we asked three Cardiology Review editorial board members to comment on multivessel versus culprit-vessel-only PCI in patients with acute myocardial infarction, considering perspectives from the PRAMI and CvLPRIT trials.