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Quitting smoking drops heart attack risk to levels of never smokers

2013-09-01
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, ...

Family history doubles aortic stenosis risk

2013-09-01
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 ...

Pre-treatment with prasugrel -- more risk, no benefit: ACCOAST

2013-09-01
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 ...

Preventive PCI results in better outcomes than culprit artery PCI alone in ST elevation MI

2013-09-01
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 ...

A shorter interruption of anti-thrombotics does not influence peri-operative complications

2013-09-01
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 ...

Study finds mechanical chest compressions are equally as effective as manual CPR

2013-09-01
"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. ...

Magnetic resonance imaging before ablation for atrial fibrosis helps predict success of treatment

2013-09-01
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 ...

Hokusai-VTE study suggests certain sub-groups of venous thromboembolism patients may need review

2013-09-01
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 ...

TASTE trial challenge current practice of blood clot aspiration after heart attack

2013-09-01
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 ...

High dose statins prevent dementia

2013-08-31
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, ...

Reimbursement systems influence achievement of cholesterol targets

2013-08-31
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 ...

Statins reduce CV events in CAD patients with very low LDL-C

2013-08-31
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 ...

Impact of AF on stroke risk eliminated with multiple risk factors

2013-08-31
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 ...

Mass screening identifies untreated AF in 5% of 75-76 year olds

2013-08-31
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 ...

CHADS2 risk score assigns over one-third of stroke patients to low or intermediate stroke risk

2013-08-31
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 ...

Statins prevent cataracts

2013-08-31
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. ...

Diabetic stroke risk after AMI drops in 10 year period

2013-08-31
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 ...

Short-term smoking cessation reverses endothelial damage

2013-08-31
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 ...

Smokers who survive to 70 still lose 4 years of life

2013-08-31
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 ...

STEMI incidence falls in southern Switzerland after smoking ban implemented

2013-08-31
Second-hand smoke increases the risk of coronary artery disease and acute myocardial infarction. For this reason, health policies aimed at reducing tobacco consumption and public smoke exposure are strongly recommended. Dr Porretta said: "Canton Ticino (CT), which is one of the 26 cantons of the Swiss Federation, was the first Swiss canton to introduce a smoking ban in April 2007. We had the opportunity to assess the long-term impact of the smoking ban on the incidence of ST-segment elevation myocardial infarction (STEMI) and to compare STEMI epidemiology with Canton ...

GPs undertreat women with AF

2013-08-31
Amsterdam, The Netherlands – Saturday 31 August 2013: General practitioners (GPs) undertreat women with atrial fibrillation (AF), according to research presented at ESC Congress 2013 today by Dr Pierre Sabouret from France. The analysis of more than 15,000 patients showed that women were undertreated with antithrombotic medications compared to men regardless of their stroke risk and comorbidities. Dr Sabouret said: "Gender-related differences among outpatients with stable coronary artery disease are well known.1-6 Heart diseases are one of the most important causes of ...

Brain imaging study reveals the wandering mind behind insomnia

2013-08-31
DARIEN, IL – A new brain imaging study may help explain why people with insomnia often complain that they struggle to concentrate during the day even when objective evidence of a cognitive problem is lacking. "We found that insomnia subjects did not properly turn on brain regions critical to a working memory task and did not turn off 'mind-wandering' brain regions irrelevant to the task," said lead author Sean P.A. Drummond, PhD, associate professor in the department of psychiatry at the University of California, San Diego, and the VA San Diego Healthcare System, and ...

Study reveals the face of sleep deprivation

2013-08-31
DARIEN, IL – A new study finds that sleep deprivation affects facial features such as the eyes, mouth and skin, and these features function as cues of sleep loss to other people. Results show that the faces of sleep-deprived individuals were perceived as having more hanging eyelids, redder eyes, more swollen eyes and darker circles under the eyes. Sleep deprivation also was associated with paler skin, more wrinkles or fine lines, and more droopy corners of the mouth. People also looked sadder when sleep-deprived than after normal sleep, and sadness was related to looking ...

Red spruce reviving in New England, but why?

2013-08-31
BURLINGTON, Vt., August 30, 2013 – In the 1970s, red spruce was the forest equivalent of a canary in the coal mine, signaling that acid rain was damaging forests and that some species, especially red spruce, were particularly sensitive to this human induced damage. In the course of studying the lingering effects of acid rain and whether trees stored less carbon as a result of winter injury, U.S. Forest Service and University of Vermont scientists came up with a surprising result – three decades later, the canary is feeling much better. Decline in red spruce has been attributed ...

Drug design success propels efforts to fight HIV with a combination of 2 FDA-approved drugs

2013-08-31
MINNEAPOLIS/ST. PAUL (08/30/2013) – A University of Minnesota research team featuring researchers from the Institute for Molecular Virology, School of Dentistry and Center for Drug Design has developed a new delivery system for a combination of two FDA approved drugs that may serve as an effective treatment for the human immunodeficiency virus (HIV). The discovery, which allows for a combination of decitabine and gemcitabine to be delivered in pill form, marks a major step forward in patient feasibility for the drugs, which previously had been available solely via injection ...
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