Atherosclerotic Cardiovascular Disease
VANISH Trial: 3 Year Follow Up Data Shows No Difference in Myocardial Blood Perfusion With Bioresorbable Stents Compared to Drug-Eluting Stents After Sympathetic Stimulation
A clinical trial led by Dr. Wijnand J. Stuijfzand published in JACC Cardiovascular Interventions showed that when compared to drug-eluting stents, bioresorbable everolimus-eluting stents (BVS) did not lead to improved myocardial blood flow after sympathetic stimulation.
Cohort Study with 27 Years of Follow Up Shows Oral Infections in Children Is Associated with Sub-clinical Atherosclerosis
A study led by Dr. Pirkko Pussinen demonstrated that clinical signs of oral infection during childhood were associated with subclinical atherosclerosis in adulthood. The paper published in JAMA Network Open suggests that childhood oral infection may be a modifiable risk factor for adult cardiovascular disease.
Depression Is Associated with More Severe Angina and Dyspnea in Patients with Chronic Total Occlusion
A study led by Dr. Robert Yeh that was published in JACC: Cardiovascular Interventions showed that in the setting of chronic total occlusion (CTO), patients with depression had more significant angina before percutaneous coronary intervention (PCI). However, these patients also had a greater improvement in health status after PCI.
Study Suggests ICU Care May Be Overutilized in Stable STEMI Patients
A study led by Dr. Jay S. Shavadia published in JACC: Cardiovascular Interventions showed that although more than 80% of stable patients with an ST-elevation myocardial infarction (STEMI) were treated in the intensive care unit (ICU), the risk of developing a complication requiring ICU care was around 16%. These findings suggest that implementing a risk-based triage strategy could be a better alternative to the current strategy where patients with STEMI are typically admitted to the ICU.
Study in China Indicates Current Practice of Lipid-Lowering Treatment Needs Improvement
In an article published in the American Heart Journal, Dr. Yueyan Xing emphasized the need to improve on current lipid-lowering treatment practices in patients with a history of myocardial infarction or revascularization. Patients with a previous history of acute coronary syndrome are at a high risk of a recurrent coronary event and death. Lowering low-density lipoprotein cholesterol (LDL-C) in these patients is essential in order to reduce the risk of a recurrent event. The authors used the Improving Care for Cardiovascular Disease in China (CCC) Project to assess current lipid-lowering treatment practices in China.
A Systematic Analysis Attributes Eleven Million Deaths in 2017 to Dietary Risk Factors
A systematic analysis by Dr. Ashkan Afshin and the Global Burden of Disease (GBD) 2017 Diet Collaborators published in the Lancet showed that in 2017, 11 million deaths and 255 million disability-adjusted life years (DALYs) were attributable to dietary risk factors. The leading dietary risk factors were a high intake of sodium, low intake of whole grains, and low intake of fruits. The study provides a clear image of the potential impact of a sub-optimal diet on death and disability.
AHA Releases a Scientific Statement Regarding Patients with Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease
The American Heart Association (AHA) released a scientific statement that aims to provide a formal and updated definition for Myocardial Infarction in the Absence of Obstructive Coronary Artery Disease (MINOCA). It also outlines a useful framework for the diagnostic approach and management of patients with potential MINOCA.
Total Event Analysis from REDUCE-IT Showcases a Substantial Reduction in the Burden of Ischemic Events, Experts Debate Possible Mechanisms of Action of Icosapent Ethyl Presented at ACC 2019, New Orleans, Los Angeles
The total event analysis from the REDUCE-IT trial, presented at ACC 2019 showed that among statin-treated patients with elevated triglycerides and cardiovascular disease or diabetes, icosapent ethyl substantially reduced the burden of first, subsequent, and total ischemic events. The results are exciting as this is one of the first non-LDL targeted trials to demonstrate a cardiovascular benefit, and is likely to be featured in future guidelines. Continue reading
Anti-Inflammatory Therapy May Not Prevent Atherosclerotic Events Low-Dose Methotrexate for the Prevention of Atherosclerotic Events
A randomized double-blinded trial called Cardiovascular Inflammation Reduction Trial (CIRT) recently published in the New England Journal of Medicine by Ridker, M.D. and his colleges at the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, Boston illustrated that that low-dose methotrexate did not reduce atherosclerotic events or any markers of inflammation such as interleukin-1β, interleukin-6, or C-reactive protein. Continue reading
Statin vs Healthy Adherer Effect On Mortality in ASCVD Association of Statin Adherence With Mortality in Patients With Atherosclerotic Cardiovascular Disease
In a vigorous retrospective cohort study published in JAMA, Fatima Rodriguez et al. found an inverse graded association between long-term statin adherence and all-cause mortality using a nationwide sample of the Veterans Affairs Health System, in patients with atherosclerotic cardiovascular disease(ASCVD). The study proposed that there was room for improvement in statin adherence and also stressed on its importance as a measure of secondary prevention of ASCVD. Continue reading
