Amsterdam, The Netherlands – Sunday 1 September 2013 : Having a big belly increases the risk of death in heart attack survivors, according to research presented at ESC Congress 2013 by Professor Tabassome Simon and Professor Nicolas Danchin from France. The findings from the FAST-MI 2005 registry suggest that lifestyle interventions in heart attack patients should focus on losing abdominal fat. Professor Simon said: "The impact of obesity on long term mortality and cardiovascular complications in the general population has been the object of recent debate. Much emphasis ...

Professor Deljanin Ilic said: "In the setting of cardiovascular risk factors and cardiovascular disease the endothelium loses its normal function.1 Since endothelium derived nitric oxide is necessary to maintain an adequate vascular response, correction of endothelial dysfunction has become a goal of therapy." She added: "Exercise training has been shown to improve endothelial function and is the cornerstone of a multifaceted programme of cardiovascular rehabilitation. However, little is known about the role of music in cardiovascular rehabilitation or the effects of ...

Dr Laukkanen said: "Sudden cardiac death (SCD) accounts for approximately 50% of deaths from coronary heart disease. SCD typically occurs shortly after the onset of symptoms, leaving little time for effective medical interventions, and most cases occur outside hospital with few or no early warning signs. Finding ways to identify individuals at elevated risk of SCD would allow early interventions on risk factors to be implemented." The current study investigated the impact of high leisure-time physical activity (LTPA) combined with cardiorespiratory fitness (CRF) on risk ...

Professor Claeys said: "Air pollution and temperature changes are the most frequently reported environmental triggers for acute myocardial infarction (AMI). Epidemiologic studies have focused mainly on one environmental condition, but most environmental triggers are related to each other and may attenuate or reinforce the triggering effect of a single environmental factor." He added: "Better knowledge of the impact of environment on AMI will help medical care providers and policy makers to optimise prevention strategies for a target risk population." The present study ...

Dr Marques-Vidal said: "Deaths from cardiovascular disease are higher in winter and lower in summer. We decided to conduct a large scale study to see whether cardiovascular risk factors have a seasonal pattern which could explain the seasonality in deaths." The study used cross-sectional data from 10 population based studies in 7 countries. Information was obtained on cardiovascular risk factors in 107,090 subjects aged 35 to 80 years. The country breakdown was as follows: 21,128 subjects in Belgium, 15,664 in Denmark, 1,626 in France, 18,370 in Italy, 25,532 in Norway, ...

Amsterdam, The Netherlands – Sunday 1 September 2013: Survival for out-of-hospital cardiac arrest is just 7%, according to research presented at ESC Congress 2013 by Professor Xavier Jouven and Dr Wulfran Bougouin from France. Professor Jouven said: "Sudden cardiac death (SCD) is an important public health problem, accounting for more than 400,000 deaths every year. The main cause is ventricular tachyarrhythmias which are often triggered by acute ischaemic events that can occur in persons with or without known heart disease. The survival rate from cardiac arrest has remained ...

Dr Min said: "Smoking is an established risk factor for cardiovascular disease. Studies have identified that quitting smoking can reduce heart attacks and death but have not examined the relationship of this salutary effect on the presence and severity of coronary artery disease (CAD). Our study aimed to find out what impact stopping smoking had on the risk of cardiovascular events, death and the severity of CAD." The prospective CONFIRM (Coronary CT Evaluation for Clinical Outcomes: An International Multicenter Study) registry of 13,372 patients from 9 countries in Europe, ...

Aortic stenosis is the most common heart valve disease in the elderly. It is associated with congenital bicuspid aortic valve and previous rheumatic heart disease, but is also often caused by calcification of a normal valve. Calcification of a normal valve may be associated with atherosclerotic changes in the portion of the aorta closest to the valve. Dr Ranthe said: "Genetic factors may play a role in the development of aortic stenosis. A single nucleotide polymorphism in the lipoprotein(a) locus has been associated with aortic valve calcification and aortic stenosis.1 ...

AMSTERDAM, The Netherlands – In patients with non-ST-elevation acute coronary syndrome (NSTE- ACS), pre-treatment with the P2Y12 antagonist prasugrel prior to catheterization, significantly increases the risk of life-threatening bleeding without reducing the risk of major ischemic events, according to the results of the ACCOAST (A Comparison of Prasugrel at PCI or Time of Diagnosis of Non-ST Elevation Myocardial Infarction) trial. The findings point to a "paradigm shift" away from pre-treatment in such patients which will not only be "hard to believe and destabilizing ...

AMSTERDAM, The Netherlands – Heart attack patients with ST elevation who undergo a preventive procedure to unblock additional coronary arteries have significantly better outcomes than those whose treatment is confined to the culprit blockage only, according to the results of the Preventive Angioplasty in Myocardial Infarction (PRAMI) Trial. The findings, presented today at the ESC and published simultaneously in the New England Journal of Medicine, provide information that will help guide clinical practice and resolve uncertainty over how to approach percutaneous coronary ...

AMSTERDAM, The Netherlands – A shortened pre-surgical interruption of anti-thrombotic therapy, compared to the more traditional one-week interruption, has no influence on perioperative complications in cardiac patients, according to the results of the PRAGUE 14 trial. "Thus, there is no evidence to support changing the traditional approach of interrupting antithrombotic therapy one week before surgery," said lead investigator Petr Widimsky, MD., DrSc., from the Cardiocenter of Charles University, in Prague, Czech Republic. The results shed light on a persistent dilemma ...

"The study was designed to show a better 4-hour survival in the group treated with mechanical chest compressions, and this was not achieved," said lead investigator Sten Rubertsson, MD, PhD, professor and specialist consultant at Uppsala University and Uppsala University Hospital. "But we now have the scientific support to allow us to use mechanical chest compressions and defibrillate during ongoing compressions," he said, adding that this could potentially increase the efficiency and safety of emergency personnel as they deliver care during transportation of patients. ...

AMSTERDAM, The Netherlands – In patients with atrial fibrillation, delayed enhancement magnetic resonance imaging (DE-MRI) performed before ablative treatment can stage the degree of damaged heart tissue (atrial fibrosis) and help predict whether treatment will be successful or not, according to results of Delayed Enhancement - MRI determinant of successful Catheter Ablation of Atrial Fibrillation (DECAAF) trial. "The DECAAF results show that stage of atrial fibrosis prior to ablation is a new, powerful, independent predictor of outcome," said lead investigator Nasir ...

AMSTERDAM, The Netherlands – In the treatment of venous thromboembolism (VTE), the oral anticoagulant edoxaban resulted in equal efficacy and better safety compared to standard warfarin when either drug was used with initial low molecular weight heparin (LMWH), according to the results of the Hokusai-VTE trial. In the landscape of new trials with oral anticoagulants, the Hokusai-VTE findings offer fresh insight into a previously under-represented subgroup of patients with pulmonary embolism (PE), suggesting that treatment for this group might need to be different than ...

AMSTERDAM, The Netherlands -- Aspiration of the blood clot or "thrombus" that causes a heart attack before re-opening a patient's artery with a balloon catheter does not improve survival compared to performing balloon dilation and stenting alone according to the results of the Thrombus Aspiration in ST- Elevation myocardial infarction in Scandinavia (TASTE) trial. "We believe that TASTE questions the usefulness of thrombus aspiration as a routine adjunct and the recommendation for its general use in international guidelines should probably be down-graded," said lead author ...

Dr Lin said: "Statins are widely used in the older population to reduce the risk of cardiovascular disease. But recent reports of statin-associated cognitive impairment have led the US Food and Drug Administration (FDA) to list statin-induced cognitive changes, especially for the older population, in its safety communications." He added: "Previous studies had considered statin therapy to exert a beneficial effect on dementia. But few large-scale studies have focused on the impact of statins on new-onset, non-vascular dementia in the geriatric population." Accordingly, ...

Dr Gitt said: "There are wide variations between European countries in the achievement of LDL-cholesterol (LDL-C) targets. However the effect of different reimbursement systems on meeting the targets was unknown." Between June 2008 and February 2009 DYSIS assessed the prevalence and types of persistent lipid abnormalities in patients receiving statins. Eligible patients were at high risk of a cardiovascular event, aged >45 years, and had been on chronic statin treatment for at least three months. A total of 22,063 patients were enrolled from 2,954 sites across 11 European ...

Dr Nakano said: "Many randomised clinical trials, such as Treating to New Targets (TNT) and PROVE IT-TIMI, have shown that aggressive cholesterol lowering with statins improves clinical outcomes in patients with CAD and high LDL-C levels.1,2 But until now it was not known whether aggressive lipid lowering with statins would also benefit CAD patients with very low LDL-C levels." The current study used the Ibaraki Cardiovascular Assessment Study (ICAS), a registry of 2,238 patients from 12 hospitals in the Ibaraki region of Japan, who between 0 and 1 month underwent percutaneous ...

Dr Benn Christiansen said: "We know that atrial fibrillation increases the risk of ischemic stroke. And in patients with atrial fibrillation or previous ischemic stroke, the risk of stroke increases with the number of risk factors. But until now, little attention has been paid to the association between stroke risk and risk factors in patients without prior stroke or atrial fibrillation. We wanted to explore that association and to quantify if stroke risk was of comparable size in patients with numerous risk factors." The study included 4,198,119 people aged 18 to 90 ...

Stroke is the second cause of death worldwide. Atrial fibrillation is the most common clinically relevant cardiac arrhythmia in Europe, affecting approximately 1.5-2% of the general population.1 Prevalence is estimated to double in the next 50 years as the population ages. Patients with atrial fibrillation have a five-fold increased risk of ischaemic stroke even though around 30% have no symptoms. As blood is less adequately shifted from the heart during atrial fibrillation, blood clots can form and cause large ischaemic strokes. Strokes that occur in association with ...

In contrast, a CHA2DS2-VASc score of 0 identifies a subgroup of patients with very low stroke risk unlikely to benefit from anticoagulation treatment. Professor Nabauer said: "AF is the most frequent cardiac arrhythmia requiring hospitalisation and has a 1-2% prevalence in the general population. AF is associated with a significant risk of stroke with frequently disabling consequences. While oral anticoagulation is very effective in preventing ischaemic strokes in AF, it increases bleeding risk. Identification of patients with low risk of stroke not requiring oral anticoagulation ...

Cataracts are the leading cause of visual impairment worldwide affecting more than 20 million people. Statins are among the most commonly prescribed medications. In the USA they are prescribed to 1 in 3 people over 45 years of age at a cost of $35 billion annually. Professor Kostis said: "There is persistent concern among physicians and other health care providers about the possible cataractogenicity of statins.1 We therefore investigated the relationship of statins and cataracts in a meta-analysis of 14 studies selected after detailed review of the medical literature. ...

The findings were presented at the ESC Congress today by Ms Stina Jakobsson from Sweden. They reveal that reperfusion therapy and secondary prevention drugs produced the decline and brought stroke risk after AMI closer to that of non-diabetics. Ms Jakobsson said: "Ischemic stroke following an acute myocardial infarction is a fairly uncommon but devastating event with high mortality. It has long been recognized that patients with diabetes mellitus are at a particularly high risk of complications after an AMI but until now, the risk of ischemic stroke after an AMI in patients ...

Dr Dohi said: "Smokers are twice as likely to have a heart attack as people who have never smoked. Quitting smoking is the most important thing people can do to reduce their risk of cardiovascular disease. But until now, studies have not examined whether the increased risk caused by smoking is completely reversed after smoking cessation." The current study investigated how the vascular system is altered by smoking and whether the changes can be normalised by smoking cessation. The researchers focused on the effects of smoking and smoking cessation on arterial endothelial ...

Dr Emberson said: "Despite recent declines in the numbers of people smoking and tar yields of cigarettes, smoking remains the leading preventable cause of death in Europe." He added: "Previous studies had demonstrated that prolonged cigarette smoking from early adult life was associated with about 10 years loss of life expectancy, with about one quarter of smokers killed by their habit before the age of 70. Stopping at ages 60, 50, 40 or 30 years gained back about 3, 6, 9 or the full 10 years. However, the hazards of continuing to smoke and the benefits of stopping in ...