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Ischemic Heart Disease Mortality Decreased Worldwide in High Income Countries

Angina.com Interview with:
Andrew E. Moran MD
Columbia University,
Division of General Medicine
Presbyterian Hospital
New York, NY

Angina.com: What are the main findings of the study?

Dr. Moran: We published two reports from the Global Burden of Disease, Injuries and Risk Factors (GBD) 2010 Study in Circulation.  The strength of this study is that disease outcome definitions were standardized across data types, countries, and time.  For many countries, there is little information available about ischemic heart disease.   The GBD study used modeling methods to improve the accuracy of estimates for those countries.

The main finding of the study was that age-adjusted ischemic heart disease mortality rates have declined substantially in the high income countries of the world since 1990, but there are some regions like South Asia and Eastern Europe where mortality increased.  Because the world’s population is aging, the absolute numbers of people dying from or living with ischemic heart disease  have increased.

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CVD Risk: Measuring Cardiorespiratory Fitness Without An Exercise Test

Dr. Enrique García Artero PhD Fac. CC de la Educación, Enfermería y Fisioterapia Edif. Departamental Humanidades y CC. Educación I (A) Universidad de Almería, España and Department of Exercise Science, Arnold School of Public Health University of South Carolina.Angina.com Interview with:
Dr. Enrique García Artero PhD
Fac. CC de la Educación, Enfermería y Fisioterapia
Edif. Departamental Humanidades y CC. Educación I (A)
Universidad de Almería, España and
Department of Exercise Science,
Arnold School of Public Health
University of South Carolina.

Angina.com What are the main findings of the study?

Dr. Artero: An individual’s cardiorespiratory fitness (CRF) level has long been established as one of the strongest predictors of morbidity and mortality risk. However, CRF is not routinely measured in the clinical and health care settings. In this study we provide algorithms to estimate CRF level without performing an exercise test, and we explore how that estimation can predict risk of all-cause and CVD mortality, as well as CVD incidence. This tool has shown a predictive capacity close to that from other well-known risk calculator models such as the Framingham score.

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ICD Risk Profiling Using Biomarker SCN5A

Samuel C. Dudley, MD, PhD Chief of Cardiology, The Miriam and Rhode Island Hospitals Director, Lifespan Cardiovascular Institute Ruth and Paul Levinger Professor in Cardiology The Warren Alpert Medical School of Brown University Providence, RI   02903Angina.com Interview with:
Samuel C. Dudley, MD, PhD
Chief of Cardiology, The Miriam and Rhode Island Hospitals
Director, Lifespan Cardiovascular Institute
Ruth and Paul Levinger Professor in Cardiology
The Warren Alpert Medical School of Brown University
Providence, RI   02903

Angina.com: What are the main findings of the study?

Dr. Dudley: Circulating expression levels of cardiac sodium channel (SCN5A) variants were strongly associated with myocardial tissue levels. Furthermore, circulating variant levels were correlative with arrhythmic risk as measured by ICD events in a heart failure population within one year.

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Chest Pain: Risk of MI Low if hsTroponin T Undetectable and EKG Negative

dr_nadia_bandsteinAngina.com Interview with:
Nadia Bandstein, MD
Department of Emergency Medicine
Karolinska University Hospital
Huddinge, Sweden

Angina.com: What are the main findings of the study?

Dr. Bandstein: Chest pain is a potentially life-threatening symptom. In addition it is a very common symptom to seek medical attention for. Previous studies have indicated that 10% of all visits to the ED are because of chest pain. Since there are no established rapid ways to rule out MIs in the ED (the ones that have been suggested all require serial testing of troponins or other investigations) many patients are admitted to the hospital without having MI. In previous studies only 10-15% of patients admitted for chest pain will ultimately have a MI. The major finding of our study is that patients seeking medical attention for chest pain in the ED with an undetectable hs-cTnT (< 5 ηg/L) at the first blood sample taken and an ECG without signs of ischemia, independent of duration of symptoms, and risk factors for MI may be sent home since their risk of MI within 30 days is minimal. We found that the negative predictive value of a first hs-cTnT < 5 ηg/L for MI within 30 days was almost 100% (99,8%). In order to find 1 myocardial infarction we needed to admit 594 patients, with hs-cTnT < 5 ηg/L, and no signs of ischemia on the electrocardiogram (ECG).

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Comparing Imaging Assessments of Coronary Artery Stenosis

Angina.com Interview with:
By Dr Dennis TL Wong MBBS (Hons), PhD, FRACP, and
Dr Brian Ko MBBS(Hons), PhD, FRACP
Monash Cardiovascular Research Centre,
Department of Medicine (Monash Medical Centre)Monash University and Monash Heart, Monash Health
VIC, Australia

Angina.com: What are the main findings of the study?

Answer: Our study is the first to compare the diagnostic accuracy of combined TAG320 + CTA and combined CTP + CTA assessments. In addition we also assessed the diagnostic accuracy of combining all three techniques (TAG320, CTP and CTA) to predict functional significance of coronary artery stenosis. We demonstrated that combined TAG320 + CTA and combined CTP + CTA assessments provide comparable diagnostic accuracy in vessels without significant calcification or artefact. The addition of CTP increased the number of vessels that could be evaluated. We also showed that combined TAG320 + CTP + CTA (MDCT-IP) may provide improved diagnostic accuracy for functional assessment of coronary artery stenosis.

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Does Metformin Improve LV Function Post MI in Non-Diabetics?

Angina.com Interview with:
Iwan C.C. van der Horst, MD PhD, Principal investigator
on behalf of the GIPS-III investigators
University of Groningen, University Medical Center Groningen
Department of Critical Care, Groningen, the Netherlands

Angina.com: What are the main findings of the study?

Answer:

  • Randomization of 380 patients with a first ST elevation myocardial infarction and without diabetes to either 4 months metformin 500 mg twice daily or matching placebo twice daily resulted in
    • a left ventricular ejection fraction measured by MRI between patients assigned metformin or placebo (53.1% vs. 54.8%; P= .0961).
    • a N-terminal pro-brain natriuretic peptide level of 167 ng/L in both groups (P=.66).
    • a rate of major adverse cardiac events occurred in 3.1% of the metformin group compared with 1.1% of the placebo group (P=.16).
    • survival of all patients.
    • Moreover, treatment of patients within a ST elevation myocardial network and according to secondary prevention guidelines thereafter is associated with a very favourable outcome in all patients.
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Latest update: 16-4-2014 .