Cardiology (all articles)
Development and validation of QRISK3 risk prediction algorithms to estimate future risk of cardiovascular disease
25 May, 2017 | 14:55h | UTCRecommended: New QRISK-3 2017 Calculator (free)
QRISK-3 risk prediction model was developed with data from 7.89 million patients in the derivation cohort and 2.67 million patients in the validation cohort. QRISK-3 includes more factors than QRISK2 to help enable doctors to identify those at most risk of heart disease and stroke. New risk factors include: 1) Chronic kidney disease, which now includes stage 3 CKD; 2) Migraine; 3) Use of corticosteroids; 4) Systemic lupus erythematosus (SLE); 5) Use of atypical antipsychotics; 6) Severe mental illness; 7) Erectile dysfunction; 8) and Systolic blood pressure variability.
Complete versus culprit-only revascularisation in ST elevation myocardial infarction with multi-vessel disease
25 May, 2017 | 14:46h | UTCComplete versus culprit-only revascularisation in ST elevation myocardial infarction with multi-vessel disease – Cochrane Library (link to abstract – $ for full-text) (RT @Gas_Craic see Tweet)
“Compared with culprit-only intervention, the complete revascularisation strategy may be superior due to lower proportions of long-term cardiovascular mortality, long-term revascularisation, and long-term non-fatal myocardial infarction, but these findings are based on evidence of very low quality”
Perioperative management of patients on direct oral anticoagulants
24 May, 2017 | 14:42h | UTCReview: Perioperative management of patients on direct oral anticoagulants – Thrombosis Journal (free)
Cardiopulmonary Resuscitation in Adults and Children With Mechanical Circulatory Support
24 May, 2017 | 14:40h | UTCSee also: News release (free) AND Top Ten Things to Know (free PDF)
Trans-fat – The Worst Fat in the Food Supply
24 May, 2017 | 14:36h | UTCThe Worst Fat in the Food Supply – The New York Times (10 articles per month are free)
See also a recent study and commentaries on the effects of trans-fat bans in our April 23rd issue (see #1)
Trans-fat bans seem to be reducing cardiovascular deaths.
Effect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults
23 May, 2017 | 14:32h | UTCEffect of Statin Treatment vs Usual Care on Primary Cardiovascular Prevention Among Older Adults: The ALLHAT-LLT Randomized Clinical Trial – JAMA Internal Medicine (free) (RT @EricTopol see Tweet)
Editorial: Risks of Statin Therapy in Older Adults (free)
Commentaries: Older adults may not benefit from taking statins to prevent heart disease – Medical News Today (free) AND Pravastatin Doesn’t Improve Clinical Outcomes in Seniors – Physician’s First Watch (free)
Patients > 65 years with moderate hyperlipidemia and hypertension had no benefit from pravastatin for primary prevention. “A nonsignificant direction toward increased all-cause mortality with pravastatin was observed among adults 75 years and older” (HR 1.34; 95% CI, 0.98-1.84; P = .07).
Science Has Begun Taking Gluten Seriously
19 May, 2017 | 18:06h | UTCScience Has Begun Taking Gluten Seriously – The Atlantic (free)
Original article: Long term gluten consumption in adults without celiac disease and risk of coronary heart disease: prospective cohort study – The BMJ (free)
“New research from Harvard and Columbia says gluten does not cause heart disease. Why is that even a question?”
Reducing Recurrent Stroke With PFO Closure
19 May, 2017 | 18:00h | UTCFinally, Success Reducing Recurrent Stroke With PFO Closure – Medscape (free registration required)
Two randomized trials presented at the 3rd European Stroke Organization Conference (ESOC) 2017 showed that in carefully selected stroke patients in whom Patent Foramen Oval (PFO) was suspected to be a cause of their strokes, a reduction in recurrent stroke was observed with PFO closure.
Global, Regional, and National Burden of Cardiovascular Diseases
18 May, 2017 | 17:49h | UTCCommentaries: Cardiovascular disease causes one-third of deaths worldwide – Institute for Health Metrics and Evaluation (IHME) (free) AND CVD Causes One-Third of Deaths Worldwide: Study Examines Global Burden of CVD From 1990 to 2015 – American College of Cardiology, Latest in Cardiology (free)
“New Study: Cardiovascular disease causes one-third of deaths worldwide” (RT @IHME_UW see Tweet)
How to rein in the widening disease definitions that label more healthy people as sick
17 May, 2017 | 20:19h | UTCViewpoint: How to rein in the widening disease definitions that label more healthy people as sick – The Conversation (free)
BTS guideline for oxygen use in adults in healthcare and emergency settings
16 May, 2017 | 20:05h | UTCBTS guideline for oxygen use in adults in healthcare and emergency settings – British Thoracic Society (free PDF via Critical Care Reviews)
Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs
16 May, 2017 | 20:07h | UTCSource: Review: Sulfonylureas are associated with overall mortality and CV events vs other antihyperglycemics – ACP Diabetes Monthly (free)
Prevalence of Elevated Cardiovascular Risks in Young Adults
16 May, 2017 | 20:06h | UTCPrevalence of Elevated Cardiovascular Risks in Young Adults: A Cross-sectional Analysis of National Health and Nutrition Examination Surveys – Annals of Internal Medicine (link to abstract – $ for full-text)
Source: Study Assesses ASCVD Risk in Non-Diabetic Adults – American College of Cardiology, Latest in Cardiology (free)
In the absence of diabetes, smoking or hypertension, most adult men younger than 40 years and adult women younger than 50 years are at low risk of cardiovascular disease (defined as < 5% in 10 years, usually not eligible for statin therapy) and may not benefit from cholesterol screening.
Peripheral Artery Disease Guideline
15 May, 2017 | 19:40h | UTC2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines – Journal of the American College of Cardiology (free, and legal, PDF via Unpawall)
Reducing brain injury following cardiopulmonary resuscitation
11 May, 2017 | 18:43h | UTCPractice guideline summary: Reducing brain injury following cardiopulmonary resuscitation (link to abstract – free PDF available)
Sources: Guideline: Offer Cooling After Cardiac Arrest – MedPage Today (free) AND Body Cooling Recommended for Some Comatose Patients After Cardiac Arrest – Physician’s First Watch (free)
Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Unprotected Left Main Coronary Narrowing
11 May, 2017 | 18:37h | UTCMeta-Analysis of Drug-Eluting Stents Versus Coronary Artery Bypass Grafting in Unprotected Left Main Coronary Narrowing – Journal of The American College of Cardiology (link to abstract – $ for full-text) (source: EvidenceAlerts)
Related recent meta-analysis: Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Trials – Circulation: Cardiovascular Interventions (free) AND Percutaneous intervention versus coronary artery bypass graft surgery in left main coronary artery stenosis: a systematic review and meta-analysis – BMC Medicine (free)
PCI with drug-eluding stents seems to be a safe alternative to CABG in Unprotected Left Main Coronary Artery Stenosis, but it is associated with higher rates of repeat revascularization.
Risk of acute myocardial infarction with NSAIDs
11 May, 2017 | 18:38h | UTCCommentaries: Meta-Analysis: Just a Week of NSAID Use Tied to Increased Heart Attack Risk – Journal Watch (free) AND Common painkillers linked to increased risk of heart attack, study says – CNN (free) All NSAIDs Linked to Increased MI Risk – Medscape (free registration required)
Another study suggesting NSAIDs may be associated with increased cardiovascular risk.
Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality
10 May, 2017 | 18:27h | UTCMeta-analysis: Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality: dose–response meta-analysis of prospective cohort studies – European Journal of Epidemiology (free)
Source: Eating cheese does not raise risk of heart attack or stroke, study finds – The Guardian (free)
Dairy seems to be neutral regarding risks of cardiovascular diseases and all-cause mortality.
Mortality from different causes associated with meat, heme iron, nitrates, and nitrites
10 May, 2017 | 18:28h | UTCMeta-analysis: Mortality from different causes associated with meat, heme iron, nitrates, and nitrites in the NIH-AARP Diet and Health Study: population based cohort study – The BMJ (free)
High intakes of red and processed meat are associated with increased risks of all-cause mortality and death due to nine different causes.
Intravenous fluid therapy in adults in hospital – NICE Guideline
9 May, 2017 | 20:45h | UTC
Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes
9 May, 2017 | 18:17h | UTCReview: Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes – Circulation Research (free)
Cardiac Patients in Trials Don’t Reflect Real-World Populations – MedPage Today
6 May, 2017 | 20:39h | UTCResearch letter: Applicability of the IMPROVE-IT Trial to Current Patients With Acute Coronary Syndrome – JAMA Internal Medicine (link to abstract – $ for full text)
Source: Cardiac Patients in Trials Don’t Reflect Real-World Populations – MedPage Today (free registration required)
Related: Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at ClinicalTrials.gov: a systematic review of registration details – BMJ Open (free) AND Do cancer clinical trials exaggerate the real-world benefits of drugs? – STAT News (free)
Patients in clinical trials are often younger, healthier (with less comorbidities), better plugged in to the health care system, better educated and wealthier, indicating that the external validity or generalizability of much of the current evidence to real-world settings may be relatively weak.
Bystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest
4 May, 2017 | 20:17h | UTCBystander Efforts and 1-Year Outcomes in Out-of-Hospital Cardiac Arrest – New England Journal of Medicine (Link to abstract – $ for full-text)
Quick Take Video Summary: Bystander Efforts in Out-of-Hospital Cardiac Arrest (free)
Commentary: Bystander CPR and Defibrillation Are Associated with Better Long-Term Outcomes – Journal Watch (free)
In patients who have initially survived after out-of-hospital cardiac arrest, those who were submitted to bystander CPR and defibrillation had lower risk of brain damage, nursing home admission and death after one year when compared to patients who survived but were not submitted to bystander CPR.
Selection of patients for intra-arterial treatment for acute ischaemic stroke
4 May, 2017 | 20:18h | UTCNew decision tool: MR CLEAN-R Registry (free)
This new clinical decision tool will improve the selection of patients with acute ischemic stroke who will benefit the most from intra-arterial treatment.
PCSK9 inhibitors for prevention of cardiovascular disease – Cochrane Library
3 May, 2017 | 17:28h | UTCSystematic review: PCSK9 inhibitors for prevention of cardiovascular disease – Cochrane Library (free summary – $ for full-text))
The evidence so far suggests that PCSK9 inhibitor use probably leads to little or no difference in mortality and leads to a modest absolute risk reduction (often less than 1%) in cardiovascular events in high-risk patients.