Cerebrovascular Disease
Chronic Red Meat Consumption Associated With Increased TMAO Concentrations TMAO: Associated With Increased Risk of Atherosclerosis and CVD
A recent study published in the European Heart Journal showed that chronic red meat consumption is associated with increased serum and urine concentrations of trimethylamine N-oxide (TMAO), a metabolite associated with increased risk of atherosclerosis and cardiovascular disease (CVD), when compared to white meat and non-meat sources of protein. Continue reading
Endogenous Fibrinolysis Measurement as a Predictive Test for Recurrent Cardiovascular Events Impaired endogenous fibrinolysis in ST-segment elevation myocardial infarction patients undergoing primary percutaneous coronary intervention is a predictor of recurrent cardiovascular events: the RISK PPCI study.
A prospective cohort study that was conducted by Mohamed Farag et al. in European Heart Journal demonstrated that evaluating endogenous fibrinolysis in patients with acute coronary syndrome may help physicians identify high-risk patients developing recurrent cardiovascular events, especially among those treated with dual antiplatelet therapy (DAT) after primary percutaneous coronary intervention (PPCI). Continue reading
Persistently High Residual Inflammatory Risk Associated with Increased Mortality and MI Risk in Patients Undergoing PCI Residual inflammatory risk and the impact on clinical outcomes in patients after percutaneous coronary interventions
A recent study published in the European Heart Journal showed that a high percentage of patients undergoing percutaneous coronary intervention (PCI) had persistently high residual inflammatory risk (RIR). Moreover, high RIR was associated with increased all-cause mortality and myocardial infarction (MI) risk at 1 year of follow-up. Continue reading
Variability in Metabolic Parameters: A Prognostic Surrogate Marker for MI, Stroke and Death? Associations of Variability in Blood Pressure, Glucose and Cholesterol Concentrations, and Body Mass Index With Mortality and Cardiovascular Outcomes in the General Population
A study by Mee Kyoung Kim and her colleagues published in Circulation has shown that there is a graded association between the number of high variability parameters like fasting blood glucose and total cholesterol levels, systolic blood pressure, and body mass index and cardiovascular outcomes. They showed that the mentioned variables may be considered as independent predictors of mortality and cardiovascular events. Continue reading
Does the Wearable Cardioverter-Defibrillator Benefit MI Patients? Results From the VEST Trial
In patients with acute myocardial infarction (MI) and a left ventricular ejection fraction (LVEF) equal or less than 35%, the use of wearable cardioverter defibrillator early after the MI did not lead to significant lowering of death from arrhythmia or from any cause, according to a new study published in the New England Journal of Medicine. Continue reading
Antithrombotic therapy post TAVR: A double edged sword? ESC 2018: Insights from the French TAVI registry
A multicenter, prospective nation-wide French registry evaluated whether oral anticoagulation therapy was an independent correlate of long-term survival and early bioprosthetic valve dysfunction (BVD) in patients who underwent successful Transcatheter Valve Implantation (TAVI). The French registry was launched in 2007 and involved 11,469 patients with a mean duration follow-up was 495±3.5 days. This registry contained 11 years of data and analyzed patients from January 1, 2013, and December 31, 2015. Continue reading
Dual Therapy Reduces Bleeding Compared with Triple Therapy in A-Fib after PCI
Antithrombotic therapy with vitamin K antagonist (VKA) and aspirin plus a P2Y12 inhibitor has been the cornerstone of medication regimen among stented patients with atrial fibrillation (AF) for decades. However, this traditional “triple therapy” (TAT) has been associated with a three to four-fold increased risk of bleeding. The ISAR Triple and WOEST Trial demonstrated that VKA in addition to one antiplatelet therapy was associated with a reduced risk of bleeding compared to the triple therapy. More recently, safety of non-Vitamin K oral anti-coagulant (NOAC)-based strategies, using a NOAC plus a P2Y12 inhibitor, has been compared to vitamin K antagonist (VKA)-based triple therapy, in the PIONEER AF-PCI and REDUAL PCI randomized trials; both of which have demonstrated that NOAC-based strategies are safer and provide an attractive alternative to VKA-based triple therapy among AF patients who undergo percutaneous intervention (PCI). However, none of these randomized controlled trials was powered to assess the efficacy of dual anti-thrombotic (DAT) strategies. The higher safety associated with DAT has brought this fresh treatment modality into the limelight. Continue reading
EAGLES- A Randomized Clinical Trial Showing No Evidence of Smoking Cessation Treatments Association with MACE
EAGLES (Evaluating Adverse Events in a Global Smoking Cessation Study), a randomized clinical trial, published in the Journal of the American Medical Association, provides evidence that smoking cessation medications do not increase the risk of serious cardiovascular events in the general population of smokers. Continue reading
Thrombectomy Done Beyond 6 Hours has a Favorable Prognosis in Stroke Patients
In a recent study published in the New England Journal of Medicine, it was found that endovascular thrombectomy for ischemic stroke that is performed 6 to 16 hours after the onset of symptoms resulted in better functional outcomes than standard medical therapy alone among patients with a proximal middle cerebral artery or internal carotid artery occlusion. Continue reading
Does Marijuana Use Impact Cardiovascular Health?
With the increasing use and the legalization of marijuana in several states of USA, there is a need to evaluate its impact on the health. To explore this, a systematic review was recently published in Annals of Internal Medicine by Ravi et al. In the study, the investigators studied the association between marijuana use and cardiovascular outcomes. The authors concluded, “Evidence examining the effect of marijuana on cardiovascular risk factors and outcomes, including stroke and myocardial infarction, is insufficient”. Continue reading
Novel Echo Markers In Stroke Risk Stratification In AFib
The assessment of left atrial reservoir strain and P-wave to A’ duration on tissue Doppler imaging provides additional risk stratification for stroke after initial CHA2DS2-VASc scoring, according to a study published in the European Heart Journal, and may prove helpful in guiding decisions about anticoagulation for patients after the diagnosis of atrial fibrillation. Continue reading
Silent Cerebral Microbleeds During TAVR
Dr. Eric Van Belle and Dr. Serge Korjian Discuss
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