Category: Cardiology

Hot Topics: Atrial Fibrillation May Be Commonly Undiganosed

Jackie Werner Cardiology, Hot Topics in Research

Incidence of Previously Undiagnosed Atrial Fibrillation Using Insertable Cardiac Monitors in a High-Risk Population: The REVEAL AF Study Reiffel JA, Verma A, Kowey PR, al e. Incidence of previously undiagnosed atrial fibrillation using insertable cardiac monitors in a high-risk population: The reveal af study. JAMA Cardiology. 2017. http://dx.doi.org/10.1001/jamacardio.2017.3180. Importance  In approximately 20% of atrial fibrillation (AF)–related ischemic strokes, stroke is the first clinical manifestation of AF. Strategies are needed to identify and therapeutically address previously undetected AF. Objective  To quantify the incidence of AF in patients at high risk for but without previously known AF using an insertable cardiac monitor. Design, Setting, and Participants  This…

Hot Topics: Cardiovascular Event Risk Lowered by Reducing Inflammation Alone

Jackie Werner Cardiology, Hot Topics in Research

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med. 2017. http://dx.doi.org/10.1056/NEJMoa1707914. BACKGROUND Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. METHODS We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150…

Hot Topics: Anti-Statin Internet Trend Could Threaten Lives

Jackie Werner Cardiology, Hot Topics in Research

Statin Denial: An Internet-Driven Cult With Deadly Consequences Nissen SE. Statin Denial: An Internet-Driven Cult With Deadly Consequences. Ann Intern Med. doi: 10.7326/M17-1566 The reduction in cardiovascular morbidity and mortality during the past 3 decades represents one of the great triumphs of contemporary medicine. In 1987, the age-adjusted mortality rate in the U.S. population for cardiovascular disease was 357 in 100 000, decreasing to 167 in 100 000 by 2014 (1). Although precisely gauging the relative contributions of various public health measures to the decline in cardiovascular morbidity and mortality is impossible, most critical observers consider the introduction of statins in 1987…

Hot Topics: Cardiologists Weigh In On Nutrition Facts and Fads

Jackie Werner Cardiology, Hot Topics in Research, Nutrition

Trending Cardiovascular Nutrition Controversies Freeman AM, Morris PB, Barnard N, et al. Trending cardiovascular nutrition controversies. J Am Coll Cardiol. 2017;69(9):1172-1187. http://dx.doi.org/10.1016/j.jacc.2016.10.086. The potential cardiovascular benefits of several trending foods and dietary patterns are still incompletely understood, and nutritional science continues to evolve. However, in the meantime, a number of controversial dietary patterns, foods, and nutrients have received significant media exposure and are mired by hype. This review addresses some of the more popular foods and dietary patterns that are promoted for cardiovascular health to provide clinicians with accurate information for patient discussions in the clinical setting.

Hot Topics: Women in Poverty More at Risk for Heart Attacks Than Men

Jackie Werner Cardiology, Hot Topics in Research

Sex differences in the relationship between socioeconomic status and cardiovascular disease: A systematic review and meta-analysis Backholer K, Peters SAE, Bots SH, Peeters A, Huxley RR, Woodward M. Sex differences in the relationship between socioeconomic status and cardiovascular disease: A systematic review and meta-analysis. Journal of Epidemiology and Community Health. 2016. http://dx.doi.org/10.1136/jech-2016-207890. Background Low socioeconomic status (SES) is a known risk factor for cardiovascular disease (CVD) but whether its effects are comparable in women and men is unknown. Methods PubMed MEDLINE was systematically searched. Studies that reported sex-specific estimates, and associated variability, of the relative risk (RR) for coronary heart disease…

Hot Topics: Lifestyle Makes a Difference in Heart Disease

Jackie Werner Cardiology, Hot Topics in Research, Internal Medicine, January

Genetic Risk, Adherence to a Healthy Lifestyle, and Coronary Disease Khera AV, Emdin CA, Drake I, et al. Genetic risk, adherence to a healthy lifestyle, and coronary disease. N Engl J Med. 2016;375(24):2349-2358. http://dx.doi.org/10.1056/NEJMoa1605086. BACKGROUND Both genetic and lifestyle factors contribute to individual-level risk of coronary artery disease. The extent to which increased genetic risk can be offset by a healthy lifestyle is unknown. METHODS Using a polygenic score of DNA sequence polymorphisms, we quantified genetic risk for coronary artery disease in three prospective cohorts — 7814 participants in the Atherosclerosis Risk in Communities (ARIC) study, 21,222 in the Women’s…

Phenotype-Specific Treatment of Heart Failure With Preserved Ejection Fraction

PJ Grier Cardiology, coronary artery disease, December, Hot Topics in Research

Phenotype-Specific Treatment of Heart Failure With Preserved Ejection Fraction Heart failure (HF) with preserved ejection fraction (EF; HFpEF) accounts for 50% of HF cases, and its prevalence relative to HF with reduced EF continues to rise. In contrast to HF with reduced EF, large trials testing neurohumoral inhibition in HFpEF failed to reach a positive outcome. This failure was recently attributed to distinct systemic and myocardial signaling in HFpEF and to diversity of HFpEF phenotypes. In this review, an HFpEF treatment strategy is proposed that addresses HFpEF-specific signaling and phenotypic diversity. In HFpEF, extracardiac comorbidities such as metabolic risk, arterial…

Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial

PJ Grier August, Blood, Hot Topics in Research, Oncology

Long-term benefits and risks of frontline nilotinib vs imatinib for chronic myeloid leukemia in chronic phase: 5-year update of the randomized ENESTnd trial In the phase 3 Evaluating Nilotinib Efficacy and Safety in Clinical Trials–Newly Diagnosed Patients (ENESTnd) study, nilotinib resulted in earlier and higher response rates and a lower risk of progression to accelerated phase/blast crisis (AP/BC) than imatinib in patients with newly diagnosed chronic myeloid leukemia in chronic phase (CML-CP). Here, patients’ long-term outcomes in ENESTnd are evaluated after a minimum follow-up of 5 years. By 5 years, more than half of all patients in each nilotinib arm…

Detyrosinated microtubules buckle and bear load in contracting cardiomyocytes

PJ Grier Cardiology, Hot Topics in Research, June

Detyrosinated microtubules buckle and bear load in contracting cardiomyocytes The microtubule (MT) cytoskeleton can transmit mechanical signals and resist compression in contracting cardiomyocytes. How MTs perform these roles remains unclear because of difficulties in observing MTs during the rapid contractile cycle. Here, we used high spatial and temporal resolution imaging to characterize MT behavior in beating mouse myocytes. MTs deformed under contractile load into sinusoidal buckles, a behavior dependent on posttranslational “detyrosination” of α-tubulin. Detyrosinated MTs associated with desmin at force-generating sarcomeres. When detyrosination was reduced, MTs uncoupled from sarcomeres and buckled less during contraction, which allowed sarcomeres to shorten…

Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease

PJ Grier Cardiology, coronary artery disease, Hot Topics in Research, May

Dietary patterns and the risk of major adverse cardiovascular events in a global study of high-risk patients with stable coronary heart disease Objectives To determine whether dietary pattern assessed by a simple self-administered food frequency questionnaire is associated with major adverse cardiovascular events (MACE) in high-risk patients with stable coronary artery disease. Background A Mediterranean dietary pattern has been associated with lower cardiovascular (CV) mortality. It is less certain whether foods common in western diets are associated with CV risk. Methods At baseline, 15 482 (97.8%) patients (mean age 67 ± 9 years) with stable coronary heart disease from 39…