February 2015

In states that expanded the number of low-income people eligible for Medicaid under the Affordable Care Act, the number of people with newly diagnosed type 2 diabetes increased by 23 percent.

Obesity Week 2014 was the second annual combined meeting of The Obesity Society (TOS) and the American Society for Metabolic & Bariatric Surgery (ASMBS).

In this edition of Clinical Forum, we asked three Cardiology Review editorial board members to comment on multivessel versus culprit-vessel-only PCI in patients with acute myocardial infarction, considering perspectives from the PRAMI and CvLPRIT trials.

With the fifth anniversary of the signing of the Affordable Care Act (ACA) into law upon us, ample time has passed to allow us to take stock of the law's effects on the practice and business of cardiology, and to make some informed predictions regarding future developments.

Cardiology Review editor-in-chief Debabrata Mukherjee, MD, reviews the contents of this month's issue.

Click here to review the CME questions for this month's issue.

The American Heart Association was one of the first organizations to advocate dietary changes to decrease the risk of coronary heart disease (CHD). The organization's first recommendation appeared in 1957 advising a decrease in the amount of fat intake to decrease atherosclerosis risk. Today, a different approach is recommended, which considers the diet as a whole, with recommendations of what to both include and avoid. Among other nutritional and lifestyle recommendations, the AHA advises the consumption of 2 servings of fish weekly for both men and women.

Click here to read the statement of need, learning objectives, instructions on how to obtain CME credit, faculty list and disclosures, and other information for this activity.

Obstructive peripheral artery disease (PAD) manifests itself with intermittent claudication (affecting 20 to 40 million individuals worldwide), which is described as exertional lower extremity pains, and in more advanced stages with critical limb ischemia and acute or chronic limb ischemia. Irrespective of presentation, patients with PAD are at increased risk for adverse cardiovascular (CV) events. Therefore, risk factor modification is the cornerstone of the management of PAD.

Studies have identified lower-than-normal BMIs to be associated with higher mortality in comparison with normal body weight and overweight individuals in patients with coronary artery disease. This has given rise to the term "obesity paradox" in which being overweight/obese confers a survival advantage in individuals that have been diagnosed with a medical condition. Against this backdrop, this study attempted to evaluate whether there is an association between BMI and death risk among patients with type 2 diabetes mellitus.

It is well established that among patients with the clinical syndrome of heart failure, approximately half have preserved systolic function, known commonly as heart failure with preserved ejection fraction (HFpEF). Although originally considered to be a syndrome that pathophysiologically involves diastolic dysfunction, ongoing investigation suggests that although diastolic abnormalities may be present in many patients, other aspects of pathophysiology likely also contribute to symptoms. This study examined the association of beta-blockers with mortality in patients with HFpEF.

It is widely accepted that sexual activity is an important component of quality of life for men and women with cardiovascular disease (CVD), as well as for their partners, and is a safe activity, in general. Yet, older studies show that most CVD patients do not believe they have been educated by health care providers on when to resume sexual activity or any necessary restrictions following acute myocardial infarction.