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Saturday, December 21, 2002

NEJM: C-Reactive Protein and Low-Density Lipoprotein Cholesterol Levels Both Help in the Prediction of First Cardiovascular Events $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_12_01_heartarchive.php#90079577"; ?>
NEJM -- Abstracts: Ridker et al. 347 (20): 1557 ] posted at 10:45 AM by Tom Heston, MD

AMNews: Dec. 23/30, 2002. Coordinated care improves outcomes for MI patients ... American Medical News $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_12_01_heartarchive.php#90079574"; ?>
AMNews: Dec. 23/30, 2002. Coordinated care improves outcomes for MI patients ... American Medical News ] posted at 10:44 AM by Tom Heston, MD

Wednesday, December 11, 2002

Conversion of Atrial Fibrillation to Sinus Does Not Improve Survival Compared to Rate Control Only $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_12_01_heartarchive.php#90042341"; ?>
This study of 4060 patients with atrial fibrillation who had a high risk of stroke or death. One group was assigned to rhythm-control therapy, the other to rate-control therapy. The researchers conclude that the rhythm-control therapy has no survival advantage over the rate-control strategy. In fact, side-effects from medications used in the rhythm-control group may make a rate-control strategy better in terms of health benefits. Comment: a rate-control strategy also may be significantly less expensive, as well as associated with fewer side-effects and an equal mortality rate. [ NEJM 2002, Volume 347:1825-1833 ] posted at 6:12 PM by Tom Heston, MD

Tuesday, December 10, 2002

Drug Eluting Stents $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_12_01_heartarchive.php#90035495"; ?>
This editorial covers the status of drug eluting stents, the cost savings, and future. The author notes that the current rate of reintervention after angioplasty is 6% in the UK. [ bmj.com Jenkins et al. 325 (7376): 1315 ] posted at 9:14 AM by Tom Heston, MD

Tuesday, December 03, 2002

Coffee Consumption Shown to Increase Homocysteine Levels $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_12_01_heartarchive.php#90009446"; ?>
This randomized study of 48 volunteers found that coffee (0.45 L, ~ 1.5 cups) raised homocysteine levels by 0.9 umol/L (an 11% increase) at 4 hours after consumption. The researchers looked specifically at whether or not caffeine was the responsible ingredient, and found that caffeine was only partly responsible for the elevation in homocysteine levels, raising the plasma concentration by 0.4 umol/L (a 5% increase) whereas coffee raised homocysteine by 0.9 umol/L. Comment: this is an interesting finding, and it is worthwhile looking into the effects of caffeinated soft drinks on homocysteine levels as well. [ AJCN -- Abstracts: Verhoef et al. 76 (6): 1244 ] posted at 1:28 PM by Tom Heston, MD

Tuesday, October 29, 2002

Warfarin, Aspirin, or Both? $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_10_01_heartarchive.php#85617052"; ?>
This review article looked at the secondary prevention of myocardial infarction using aspirin, warfarin, or both. The author concludes that the issue remains unresolved. There is no difference in mortality, but in high risk groups it may be helpful to add warfarin to standard aspirin therapy of 75 mg/day. [ CMAJ • October 29, 2002; 167 (9) ] posted at 3:55 PM by Tom Heston, MD

Saturday, September 21, 2002

Restricting Dietary Salt of Unknown Benefit in Hypertension $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_09_01_heartarchive.php#85477162"; ?>
This meta-analysis found little objective benefit of dietary salt restriction upon long-term blood pressure control. The authors also note that existing research is inconclusive in terms of overall mortality because clinical trails usually have not reported cardiovascular events or deaths. Comment: this review is not the only one to cast doubt upon previous claims that dietary salt reduction is an important part of blood pressure control. At this point it does not seem that restricting dietary salt is important in patients with hypertension. [ BMJ 2002;325:628 ( 21 September ) ] posted at 3:54 PM by Tom Heston, MD

Monday, September 09, 2002

Public Access Defibrillators Not Cost-Effective $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_09_01_heartarchive.php#85430456"; ?>
This study looked at all out of hospital cardiac arrests in Scotland in 1991 to 1998. The authors conclude that public access defibrillators most likely will not save as many lives as increasing funding for the expansion of first responder defibrillation, or via bystander cardiopulmonary resuscitation. Comment: we shouldn't jump on the bandwagon too quickly in terms of buying more automatic external defibrillators. The authors point -- that our money is best spent by increasing emergency response services -- needs to be carefully considered. This is potentially a wiser investment. [ BMJ 2002;325:515 ( 7 September ) ] posted at 11:26 AM by Tom Heston, MD

Friday, September 06, 2002

Prolonged Sitting Increases Cardiac Risk in Women $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_09_01_heartarchive.php#85423098"; ?>
This study of 73 743 postmenopausal women found that both walking and vigorous exercise decreased the risk of cardiovascular events. Prolonged sitting was found to increase risk. Comment: not surprising, but a valuable study due to the large number of participants. [ NEJM Volume 347:716-725 September 5, 2002 Number 10 ] posted at 4:22 PM by Tom Heston, MD

Friday, August 30, 2002

Broad Use of AEDs Improves Cardiac Survival $BlogItemSubject"; $newslink[$countera]="http://www.medjournal.com/blog/archives/2002_08_01_heartarchive.php#85399854"; ?>
This study found that lay volunteers trained in the use of the AED, but without traditional education in CPR, were able to help improve the community's survival rate from cardiac arrest. [ (Circulation. 2002;106:1065.) ] posted at 9:51 PM by Tom Heston, MD

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