Cardiology

Are doctors implanting too many stents? Can a new diagnostic tool enable physicians to get a better picture of coronary arterial blood flow and determine whether medication may be a better option than stenting?

How many times have you had to ask a patient "Are you taking your medications?" And then get the response, "Yes, but I ran out a couple of days ago."

The American Roentgen Ray Society reported that two tools commonly used to assess patients for risk of CHD may not accurately predict patients’ risk of CHD.

Researchers have found that "testing patient's blood for two proteins or biomarkers that occur when inflammation is present could help doctors identify which patients are more likely to have a stroke."

Researchers have "identified a variation in a particular gene that increases a person's susceptibility to early coronary artery disease."

Coronary heart disease (CHD) and chronic heart failure (CHF) are common chronic conditions encountered in primary care. Studies have shown that despite a strong evidence base, these conditions are often poorly diagnosed and inadequately managed in primary care.

A 67-year-old man who had an inferior myocardial infarction (MI) 3 years earlier had a daily medication regimen that included aspirin, 75 mg; atenolol (Nova-Atenol, Tenormin), 50 mg; ramipril (Altace), 2.5 mg; and simvastatin (Zocor), 10 mg.

Chronic heart failure and coronary heart disease are chronic conditions that are frequently encountered in primary care and are often inadequately diagnosed and managed.

A 62-year-old man presented to our institution because of a history of chest pain that occurred once weekly, usually after eating, and improved with activity.

A study by Peterson and colleagues used a large electronic patient database to demonstrate how patients at risk for nonfatal coronary events may be identified using reduced exercise capacity on treadmill stress testing as a parameter.

Reduced exercise capacity is associated with an increased risk of myocardial infarction, unstable angina, and coronary revascularization in patients referred for exercise treadmill testing for clinical indications.

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, occurring in over 2% of the general population.

The first stent was invented in 1969 by Charles Theodore Dotter, experimenting on canine peripheral arteries.

The introduction of drug-eluting stents (DESs) in 2003 was a landmark development in the field of interventional cardiology.

According to an American Heart Association news release, "age-adjusted death rates for coronary heart disease and stroke have each reached about a 30 percent reduction since 1999." However, this welcome news is offset by troubling trends in several risk factors, including rising obesity rates among children and adolescents, as well as chronic lack of exercise among adults age 18 years and older.

Modulation of the renin-angiotensin-aldosterone (RAA) system using angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) has been shown to have beneficial effects on blood pressure, diabetic nephropathy, coronary heart disease, and heart failure.

In their post hoc analysis of the DIGAMI 2 (Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction 2) study, Mellbin and colleagues suggest that insulin therapy after myocardial infarction (MI) may be associated with increased clinical events (not mortality), whereas metformin therapy may be associated with reduced events and sulfonylurea therapy with neutral effects.

Researchers recently announced that they have discovered a "novel gene mutation among the Old Order Amish population that significantly reduces the level of triglycerides in the blood and appears to help prevent cardiovascular disease."

We studied platelet adenosine diphosphate P2Y12 receptor antagonism and inhibition of platelet aggregation in patients with stable coronary artery disease.

We conducted a post hoc analysis of the DIGAMI 2 (Diabetes Mellitus Insulin-Glucose Infusion in Acute Myocardial Infarction 2) trial to assess the impact of glucose-lowering treatment in 1181 diabetic patients who were discharged from the hospital after experiencing a myocardial infarction (MI).

New research into the capabilities of advanced computed tomography (CT) published recently in the New England Journal of Medicine (http://content.nejm.org/cgi/content/abstract/359/22/2324) revealed "solid evidence that the newer, more powerful 64-CT scans can easily and correctly identify people with major blood vessel disease and is nearly as accurate as invasive coronary angiography."

The following questions are exclusive to CRLive and can assist candidates in preparing for the Maintenance of Certification Exam in Cardiovascular Disease.

Researchers from the University of Michigan School of Public Health reported last month in the Archives of Internal Medicine that hormone therapy may produce adverse heart health effects even in women who begin treatment within the recommended timeframe post-menopause.

Study results published in the October 2008 issue of the American Journal of Physiology � Heart and Circulatory Physiology reveal that "young African American men have greater central [blood pressure] despite comparable brachial [blood pressure] when compared with young white men."

According to study results published recently in JAMA, elevated nonfasting triglyceride levels, previously associated with an increased risk for heart attack, also appear to be associated with an increased risk for ischemic stroke.

This editorial was stimulated one morning when I saw a patient with congestive heart failure and rapid atrial fibrillation (AF).