A Norwegian survey carried out between 1974 and 2003 showed that there was a graded independent increase in the risk of AF with increasing levels of physical activity in a population-based study among men with ostensibly no other heart disease. In women the data were inconclusive.
Culture
The Homburg Cream and Sugar (HCS) study was designed to determine whether the measurement of postprandial triglyceride in addition to the assessment of glucose tolerance and traditional risk factors might improve the prediction of cardiovascular events.
There is great under-use of proven therapies for the secondary prevention of cardiovascular disease, according to results presented today from the PURE (Prospective Urban Rural Epidemiological) study.
"The study indicates a large gap in secondary prevention globally," said Dr Salim Yusuf, lead author and Executive Director of the Population Health Research Institute at McMaster University, Canada. "We found extremely low rates of use of proven therapies in all countries, but these were more marked in middle and low income countries."
A large-scale trial finds that apixaban, a new anticoagulant drug, is superior to the standard drug warfarin for preventing stroke and systemic embolism in patients with atrial fibrillation. Moreover, apixaban results in substantially less bleeding, and also results in lower mortality. The benefits of apixaban are consistent irrespective of how well warfarin is used at different centers, as measure by "time in therapeutic range."
Colchicine, when given in addition to conventional therapy, was more effective than placebo in reducing the incidence of recurrence and the persistence of symptoms of pericarditis in a randomised controlled trial. This is the first time that the efficacy of colchicine in preventing recurrent episodes of pericarditis has been demonstrated in a double-blind multicentre randomised trial.
Recently, interest in the fat around the heart -so called pericardial fat- is rapidly growing. Even a thin person can have pericardial fat. Several studies suggest that pericardial fat induces inflammation of the artery wall by secretion of pro-inflammatory proteins and plays a role in the pathogenesis of coronary artery disease. However, there is no information regarding the impact of pericardial fat on coronary arterial remodeling and plaque vulnerability- related with acute coronary syndrome.
Researchers from the Heart Research Centre in Melbourne, Australia, have demonstrated the benefits of the 8-week 'Beating Heart Problems' group programme in a randomised controlled trial. According to Principal Research Fellow at the Centre, Dr Barbara Murphy, depressed participants appear to have benefited from the contact with their non-depressed peers: "In groups for depressed patients, progress can be slow. With our programme, which involved depressed and non-depressed patients in a group together, we saw that the depressed patients improved dramatically.
Results from CREDO-Kyoto PCI/CABG Registry Cohort-2 show that percutaneous coronary intervention (PCI) was associated with significantly higher risk for serious adverse events in patients with triple vessel disease than coronary artery bypass grafting (CABG). The protective effect of CABG for myocardial infarction was described as "especially remarkable".
Results from the EVATEL (EVAluation of TELe follow-up) trial are the first in Europe to demonstrate potential safety and efficacy benefits from the remote follow-up of ICD patients. The trial was conducted in France, with the financial support of the French Ministry for Health and independent of any manufacturer grants.
The second generation drug-eluting stent, everolimus-eluting stent (EES), has consistently demonstrated superior clinical outcomes in randomised controlled trials over the first generation drug-eluting stent, paclitaxel-eluting stent. However, other earlier studies comparing EES with another first generation drug-eluting stent, sirolimus-eluting stent (SES), have only demonstrated the non-inferiority of EES; the superiority of EES relative to SES in terms of target-lesion revascularisation has not yet been investigated in adequately powered randomised controlled trials.
Lifestyle interventions, including stopping smoking, improving diet, exercising sufficiently and moderate alcohol consumption, should be the crucial first step for managing lipids in all patients. High risk patients should receive specialist advice to encourage adherence. If lipid targets are not met with lifestyle alone, statins are the treatment of choice for lowering LDL cholesterol.
A study conducted among cyclists in Copenhagen, Denmark1 showed that it is the relative intensity and not the duration of cycling which is of most importance in relation to all-cause mortality and even more pronounced for coronary heart disease mortality. The study presented today at the ESC Congress 2011, concluded that men with fast intensity cycling survived 5.3 years longer, and men with average intensity 2.9 years longer than men with slow cycling intensity. For women the figures were 3.9 and 2.2 years longer, respectively (see Figures below).
In this prospective cohort study, presented today at the ESC Congress 2011, discontinuation of smokeless tobacco after a myocardial infarction (MI) is associated with a lower risk of subsequent mortality. Investigators found that post MI snus quitters had a 44 % lower risk of total mortality.
The association seems to be independent of smoking habits, but partly explained by concomitant changes in other lifestyle variables.
In spite of an increased attention to gender differences in treatment of myocardial infarctions, focus on adherence to guidelines and a change in predominant therapy, the gender difference in treatment and mortality regarding the big infarctions – STEMI – has not diminished from 1998-2000 to 2004-2006. For some therapies, it has actually increased.
Montreal, August 29, 2011 – As guest speaker at the European Society of Cardiology's Congress currently under way in Paris, Dr. Jean-Claude Tardif, Director of the Montreal Heart Institute's Research Centre and professor of medicine at the Université de Montréal, today presented the results of an analysis demonstrating that ivabradine, a medication used to reduce heart rate, also reduces heart volume (left ventricle) among patients with cardiac insufficiency.