Oral anticoagulants have been demonstrated to reduce the incidence of, and mortality secondary to, embolic strokes associated with atrial fibrillation. Despite this, oral anticoagulants are underprescribed with some estimates suggesting as few as 40% of eligible patients receive therapy. The risk of falls is the most commonly cited reason for not providing oral anticoagulation, although […]
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Glucose-Insulin-Potassium shows some benefit in acute coronary syndrome
Intravenous glucose-insulin-potassium (GIK) is postulated to be beneficial in acute ischaemic syndromes via two mechanisms: by providing metabolic support to ischaemic myocardium, and by preventing arrhythmias and cardiac arrest due to ischaemia-related metabolic derangements. Importantly, these benefits are most likely to be seen if GIK is started as soon as possible after the onset of […]
Acute effects of air pollution – Beijing Olympics study
Although it is now well established that air pollution is a risk factor for cardiovascular disease (CVD), the mechanisms by which air pollution leads to CVD are not well understood. Postulated mechanisms include systemic inflammation and thrombosis or endothelial dysfunction. However, pollution-associated increases in these biomarkers have been inconsistent, partly due to inherent limitations of […]
Lipid-related markers improve cardiovascular disease prediction
While the measurement and management of cholesterol forms an integral part of cardiovascular risk management, it has been suggested that risk assessment could be improved by the assessment of various additional lipid-related markers either to supplement or replace traditional cholesterol measurements. The aim of this paper was to determine whether cardiovascular risk prediction could be […]
Aspirin use and major bleeding
The American Diabetes Association recommends low-dose aspirin (75-162mg per day) for adults with diabetes and no previous history of vascular disease, but with a 10-year risk of cardiovascular events greater than 10% and who do not have an increased risk for bleeding. However, as the benefits of low-dose aspirin in the primary prevention setting are […]
Quality improvement measures ameliorate ACS outcomes
While multiple randomised controlled trials have outlined the optimal care for patients with acute coronary syndromes (ACS), evidence-based therapies are not always applied, particularly in low- and middle-income countries. In this Brazilian study, the authors hypothesised that a multifaceted quality improvement (QI) intervention could improve the use of evidence-based therapies and improve ACS outcomes. […]
PCI in centres without surgical backup
As percutaneous coronary intervention (PCI) has advanced, improved technology and increased collective experience have led to a marked reduction in the need for emergency coronary artery bypass surgery (CABG), with only 0.15% of patients requiring emergency surgical intervention in 2002. In fact, PCI is now commonly practiced in hospitals without on-site cardiothoracic back-up, something that […]
Azithromycin and cardiac death
Macrolide antibiotics are associated with prolongation of the QT interval in susceptible individuals and increase the risk of serious ventricular arrhythmias and sudden cardiac death. Azithromycin has become one of the most widely used macrolides worldwide due to its broad spectrum, excellent tissue penetrance, and long half-life, and has been reported to be minimally cardiotoxic. […]
MicroRNA-214 attenuates ischaemia-reperfusion injury
Ischaemia reperfusion injury (IR) is characterised by abnormal increases in intracellular calcium during myocardial reperfusion that lead to cardiomyocyte death. In addition, IR is accompanied by an increase in the expression of microRNAs (miRNAs) such as miR-214, which has previously been identified as a sensitive marker of cardiac stress. […]
Atrial Fibrillation: Women at higher stroke risk
Patients with atrial fibrillation (AF) have a risk of stroke that is five times greater than that of the general population. Moreover, it has previously been described that women with atrial fibrillation have a higher annual rate of stroke than men (3% vs. 1.6%). The reasons for this remain unclear, although previous studies have […]