Cardiology

Low-density lipoprotein (LDL) cholesterol-lowering therapy decreases C-reactive protein (CRP) levels, but the importance of LDL cholesterol-independent effects is uncertain because of the variability in measuring LDL cholesterol and CRP levels in any individual patient. In this study, this variability was reduced by comparing average changes in LDL cholesterol and CRP levels after treatment with lipid-lowering therapy across different studies.

Extrapolating experimental findings to humans requires one to remember 2 basic dictums: (1) drugs do a lot of stuff; and (2) animal and in vitro findings are often wrong.

Only 2 cases of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) pericarditis have been reported in the English literature. Over the last 15 years, CA-MRSA has emerged as an increasingly common pathogen that is genetically and epidemiologically different from hospital-acquired MRSA (HA-MRSA).

Despite the fact that prehypertension has been shown to be associated with atherosclerosis and target-organ damage, no studies evaluating coronary flow reserve (CFR) among prehypertensive patients have been done. We assessed CFR in normotensive subjects, in subjects with prehypertension, and in newly diagnosed and never-treated subjects with established hypertension. We found that CFR was decreased in prehypertensive subjects, although not as significantly as in subjects with hypertension.

Hypertension has traditionally been defined by the arbitrary criteria of systolic pressure > 140 mm Hg or diastolic pressure > 90 mm Hg.

We analyzed a subgroup of 2445 subjects with diabetes, macrovascular disease, and previous myocardial infarction (MI) from the Prospective Pioglitazone Clinical Trial in Macrovascular Events to determine the effects of pioglitazone on mortality and macrovascular morbidity. Pioglitazone was shown to decrease the occurrence of adverse cardiac outcomes, including recurrent MI, in these high-risk subjects. This additional benefit of pioglitazone in patients with diabetes and a previous MI suggests that it may be appropriate to include this medication in the management strategy of patients with MI.

Patients with type 2 diabetes have a 2- to 4-fold increased incidence of coronary artery disease than those without diabetes.

We evaluated the accuracy of the 64-slice computed tomography (CT) angiography scanner in subjects who were scheduled to undergo invasive angiography for possible stenosis in coronary artery bypass grafts. Results showed that the improved resolution of CT scanners with 64-slice technology allowed for a precise delineation of bypass graft occlusion or stenosis. It permitted an accurate noninvasive assessment of bypass grafts, even in subgroups of subjects with suboptimal scan conditions, such as those with arrhythmias or higher heart rates.

In their study, Meyer and colleagues investigated the accuracy of multislice computed tomography (MSCT) in the assessment of bypass grafts following coronary artery bypass graft (CABG) surgery.

One size doesn't fit all, yet we often approach medicine as if it does.

The importance of blood lipids in the risk of ischemic heart disease in older people is unclear; as a result, cholesterol-lowering drug therapy is not widely prescribed for older individuals without diagnosed cardiovascular disease. We conducted a study to determine the relationship between death from ischemic heart disease and the level of cholesterol, cholesterol fractions, and apolipoproteins

In the United States, 42% of acute myocardial infarctions (MIs) and more than 60% of deaths attributable to acute MIs occur in the 6.1% of the population 75 years of age or older.

Prior studies have shown an association between heart failure and the presence of hypertension and left ventricular hypertrophy (LVH). We investigated the relationship between regression of electrocardiographic (ECG) LVH by Cornell product with antihypertensive regimens and new-onset heart failure in subjects with hypertension and baseline LVH.

As clinical cardiologists, we face an ever-changing landscape with regard to the management and care of hypertensive patients.

We evaluated the differences in higher systolic blood pressure (SBP) between boys and girls in a longitudinal adolescent cohort. Results showed that although boys have a 19% relative increase in the risk of higher SBP annually between the ages of 13 and 17 years, girls do not experience the same risk increase. Among both boys and girls, being overweight increases the likelihood of high SBP almost 3-fold, and every 5 additional hours of "screen time" (television viewing, video game playing, Internet use) is associated with a 4% relative increase in the likelihood of higher SBP levels. For every 5 additional sports-related or other active behaviors over a 7-day recall, there was an 8% relative reduction in high SBP risk. Annual blood pressure assessment in teens that continues into adulthood may facilitate early detection of adult hypertension. Weight control, increased physical activity, and reduced screen time may reduce the likelihood of higher SBP levels developing in adolescents.

Dasgupta has demonstrated that adolescent Canadian boys experience an increased risk of hypertension during longitudinal follow-up compared with girls.