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...
October 25th 2024
New research indicates semaglutide reduced albuminuria and body weight in CKD patients without diabetes, highlighting its potential renal benefits.
Elevating Care for PAH: Applying Recommended Management Approaches to Maximize Outcomes
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‘REEL’ Time Patient Counseling™: Navigating the Complex Journey of Diagnosing and Managing Fabry Disease
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Expert Illustrations & Commentaries™: Envisioning Novel Therapeutic Approaches to Managing ANCA-associated Vasculitis
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Asystole during sleep in a 46-year-old male athlete
September 10th 2008A number of electrocardiographic abnormalities have been described in athletes.1 Among these are sinus bradycardia and varying degrees of atrioventricular (AV) block. These findings have been attributed to the "athlete's heart," and are felt to be due to enhanced vagal tone seen with excellent physical conditioning. Secondarily it has also been suggested that there are intrinsic changes within the sinoatrial and AV nodes themselves, including prolonged sinus node recovery time and AV nodal Wenckebach, and these abnormalities persist following autonomic blockade.
Radiofrequency ablation vs medical therapy after a first episode of symptomatic atrial flutter
Atrial flutter is an arrhythmia that occurs less commonly than atrial fibrillation and is often resistant to rate control and termination.
Increased risk of major clinical events late after treatment with drug-eluting stents
September 10th 2008We compared the incidence of late clinical events after withdrawal of clopidogrel between subjects treated with drug-eluting stents (DES) and those treated with bare-metal stents. Death and myocardial infarction occurred more frequently among DES-treated subjects during the follow-up period. The results of this study indicate that there may be a penalty for the lower rate of restenosis and reinterventions after DES implantation, in particular, an increased rate of late stent thromboses.
A total of 114 patients with an intermediate pretest likelihood of coronary artery disease were evaluated with both multislice computed tomography (MSCT) and myocardial perfusion imaging (MPI). Results showed that in the majority of cases, a normal MSCT scan was associated with normal perfusion. However, only half of patients with significant stenoses showed abnormal perfusion. Accordingly, MPI and MSCT are intrinsically different techniques and appear to be complementary rather than overlapping as they provide information on atherosclerosis versus ischemia, respectively.
Different means to the same end, or just different?
September 10th 2008The study by Schuijf and Bax, which compares multislice computed tomography (CT) versus myocardial perfusion imaging, is very timely, as this new cardiac imaging modality has gained rapid acceptance by cardiologists for managing patients.
Intensive statin therapy in acute coronary syndrome
September 10th 2008We conducted a meta-analysis of 13 randomized controlled trials involving 17 963 subjects to determine the effect of intensive statin therapy instituted within 14 days of hospitalization for acute coronary syndrome. Results showed that early, intensive statin therapy is safe and significantly decreases cardiovascular death and recurrent ischemia following acute coronary syndrome after 6 months of treatment.
Coronary artery disease in asymptomatic diabetic patients
We evaluated the effectiveness of the current American Diabetes Association guidelines for the detection of coronary artery disease (CAD) in asymptomatic patients with type 2 diabetes and assessed whether a more aggressive diagnostic strategy would permit detection of silent CAD at an earlier stage. The prevalence of myocardial perfusion defects and CAD in asymptomatic diabetic patients was high independent of risk factor profile, and an aggressive diagnostic approach in patients who would normally be excluded from screening permitted identification of CAD at an earlier stage, when coronary anatomy is more likely to respond to treatment.
A 67-year-old man with positive results on a stress myocardial perfusion test was found to have isolated anomalous origin of the left anterior descending coronary artery from a separate coronary ostium of the right sinus of Valsalva. This anomalous artery was not stenotic and coursed over the anterior free wall of the right ventricle, in front of the pulmonary artery. It did not appear to have an intra-arterial or intramyocardial course.
Chronic diuretic use and increased mortality and hospitalization in heart failure
Diuretic use is associated with activation of neurohormones and disease progression in heart failure. Yet, diuretics are commonly prescribed, although little is known about their long-term effects. We performed a study based on propensity score matching, which indicated that in subjects with ambulatory, chronic, mild-to-moderate heart failure, diuretic use was associated with increased mortality and hospitalization. These findings call into question the wisdom of using long-term diuretic therapy in heart failure patients who are asymptomatic or minimally symptomatic.
Long-term diuretic use and increased mortality and hospitalization in heart failure
Diuretic use has long been a mainstay in the management of symptomatic heart failure with pulmonary or systemic congestion, or both.
Atrial fibrillation after cardiac surgery
We assessed preoperative cardiac physiology using echocardiography in patients undergoing cardiac surgery to identify predictors of postoperative atrial fibrillation. Subjects with enlarged left atrial volume had a 5-fold greater risk of postoperative atrial fibrillation, independent of age and other risk factors, than those without enlarged left atrial volume. Left atrial volume appears to be a powerful tool to stratify patients according to risk before surgery and to effectively target preventive therapy.
Left atrial volume and the risk of postoperative atrial fibrillation
Atrial fibrillation that occurs after cardiac surgery remains a source of increased morbidity and prolonged length of hospital stay.
Diabetes and inflammation influence the development of atherosclerosis. We performed a study that showed the inflammatory markers high-sensitivity C-reactive protein and lipoprotein-associated phospholipase A2 were lowered with the use of fenofibrate, simvastatin, and combination therapy. The anti-inflammatory effects were most pronounced among patients with elevated baseline inflammatory markers. Combination therapy significantly altered lipid concentrations and exerted a greater positive effect on low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides than monotherapy with either drug.
Reducing inflammatory biomarkers: What does it mean?
September 10th 2008The principal finding of this study is that among patients with type II diabetes and mixed dyslipidemia, treatment with simvastatin, fenofibrate, or their combination was associated with reductions in inflammatory biomarkers high-sensitivity C-reactive protein (hsCRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2).
Preventing atrial fibrillation recurrence
September 10th 2008In patients with lone paroxysmal atrial fibrillation (AF) and normal cardiac function, in the absence of hypertension, myocardial infarction, and cardiac insufficiency, perindopril (Aceon) or losartan (Cozaar) and low-dose amiodarone (Cordarone) therapy are more effective in preventing recurrence of AF than low-dose amiodarone alone. Adding losartan or perindopril to amiodarone therapy can inhibit left atrial enlargement.