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Results of a large international study confirm that adherence to doctor's advice on diet, exercise, and smoking after an acute coronary syndrome can substantially lower the risk of recurrent cardiovascular adverse events within six months.
Hamilton, ON - Changes to a patient's eating, exercise, and smoking habits should be prioritized as high as adherence to a drug regimen following an acute coronary syndrome (ACS), according to the authors of a new international study on lifestyle changes following ACS [1].
The study shows that the benefits of improving diet, exercising more, and quitting smoking are additive and can reduce a patient's risk within six months if the patient sticks with it, "justifying a significant investment in establishing programs that systematically enhance early lifestyle modification and secondary prevention," study authors Dr Clara Chow (McMaster University, Hamilton, ON) and colleagues report in the February 1, 2010 issue of Circulation. Read full article »
Inside: Acute Coronary Syndromes
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Dr. Holmvang presents 2 cases of stent thrombosis to Dr. Kristensen outlining risk factors and potential strategies to prevent this catastrophic event.
Dr. Gabriel Steg introduces a discussion between Drs. Anthony Gershlick and Martial Hamon on achieving a balance between favorable outcomes and reducing bleeding in STEMI patients.
Our international panel of experts, Drs. Hamm, Verheugt, Dauerman, and Rao, give their insights into which antiplatelet and antithrombotic agents they prefer to use and when.
Join Drs. Alexander, Becker, and Weitz for a discussion on the coagulation cascade, its link to platelet function, and the risk/benefit and clinical utility of agents that target the coagulation cascade and platelet receptors.
Recently reported and new trials of antiplatelet therapy continue to redefine optimal management strategies for patients with atherothrombotic disease and patients with atrial fibrillation. Drs. Harrington, Angiolillo, Bhatt, Connolly, Mehta, and Simon discuss guidelines? recommendations for the use of antiplatelet therapies and the potential impact of emerging data regarding currently used and novel antiplatelet agents.
In the US, each year over 1.4 million people will be hospitalized for unstable angina (UA) and non-ST-segment-elevation myocardial infarction (NSTEMI). Multiple antiplatelet agents have been developed to interfere with or inhibit the specific pathways of platelet activation and aggregation that lead to the development of UA and NSTEMI. Join Drs Newby, Popma, and Wiviot as they discuss.
What Happened at ESC 2009? The Perspective From DUKE Heart Center and DUKE Clinical Research Institute Drs. Rao, Alexander, Newby, and O?Connor discuss RE-LY, PLATO, and MADIT-CRT.
UPDATED WITH COMMENTARY // A link between gout and AMI has been previously documented in men: now a new cohort study suggests gout may be even more important as a comorbidity in women.
A study comparing cardiovascular outcomes at the "best hospitals," according to two popular hospital ranking systems, shows that the systems do identify high-quality hospitals, but not all of them.
In the largest series of Brugada-syndrome patients studied to date, researchers have discovered that arrhythmic event rates appear to be low for asymptomatic patients. The decision as to whether or not to implant an ICD in such patients therefore requires some consideration, say the authors.
The number of deaths predicted would be half as high, if the US population met goals set out 10 years ago in the Healthy People 2010 report, researchers say. Obesity and diabetes have proved to be the major obstacles.
Low-risk hypertensive patients taking a combination of diuretics and calcium-channel blockers had a higher risk of MI than users of other common two-drug BP-lowering regimens in a new case-control study. The authors say a large clinical trial is needed to examine the best options for second-line therapy; others disagree.
More than 15 million people in the US alone take herbal remedies and/or vitamins at doses that may be interacting with their cardiovascular medications, potentially putting them at risk.
Most experts agree that reducing salt intake will cut blood pressure and in turn reduce the number of heart attacks and strokes. But messages to limit the amount of salt added to food have had little impact on sodium intake in the West, as more than 75% of salt in the diet there is contained in readily prepared foods. The UK has recently gotten tough with the food industry and cut salt intake by 10%; is it time the US and others took a similar stance? heartwire examines the issues.
The study is one of the first to compare rates of thin-cap, or vulnerable, plaques in AMI survivors and stable-angina patients, identifying important differences.
A new review notes that unlike well-established standards for statistical significance, no guidelines exist for deciding what magnitude of difference is clinically meaningful or practically important. Composite end points and subgroup analyses also pose problems for clinicians trying to understand trial results.
Those homozygous for the CYP2C19*17 polymorphism had significantly reduced platelet aggregation and significantly greater risks of bleeding than individuals without the variant, although there was no difference in rates of stent thrombosis, report investigators.
The FDA's Medwatch sent an alert yesterday announcing that the diet drug labeling will now include contraindications for people with a history of CVD. Meanwhile, Europe's EMEA announced it plans to withdraw the drug from the market altogether.
The role of lipids in women for primary prevention of cardiovascular disease is a challenging issue for all providers. Join Drs. Foody, Mora, and Welty as they discuss limitations to current risk stratification models, recent clinical trial data, and the changing paradigm in the management of lipids in women.
We know there are sex and biological differences in the manifestation of CVD. How do these pathophysiological differences affect the diagnosis and treatment of our female patients? Drs. Hayes, Johnson, Manson, and Piña provide their insight.
Despite increased awareness of CVD in women, contemporary studies demonstrate gender differences in outcomes. Differences in age and comorbidities account for some, but not all of these disparities. Join Dr. Foody as she discusses these issues with Drs. Mieres and Redberg.
Watch Drs Bob Harrington, Sanjay Kaul, and Gregg Stone as they debate the future of ticagrelor in a discussion moderated by heartwire's Lisa Nainggolan.
Join Dr Robert Califf for a thoughtful and timely interview with Dr Ray Gibbons on the core values he learned in his career in science and medicine and why they are imperative for physicians to keep in mind when contemplating the future of healthcare reform.
Drs. Hayes and Foody and a committee of experts address the gaps and correct the misconception that CVD is more common in men than women.