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News from the 59th Annual Scientific Session of the American College of Cardiology

May 2010 Br J Cardiol 2010;17:111-5

News from the 59th Annual Scientific Session of the American College of Cardiology

BJ Cardio Staff

Abstract

ACCORD/INVEST: do not aim for normal blood pressure in diabetes patients with CAD The results of two trials comparing intensive versus more conventional blood pressure lowering in patients with diabetes at high cardiovascular risk have suggested that intensive treatment is not necessary and may be harmful in this population. In the ACCORD BP (Action to Control Cardiovascular Risk in Diabetes – Blood Pressure) trial, while intensive blood pressure treatment did reduce the risk of stroke, it failed to reduce the overall risk of cardiovascular events in patients and was associated with an increase in adverse events due to antihypertensive ther

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In brief

May 2010 Br J Cardiol 2010;17:117

In brief

BJ Cardio Staff

Abstract

New pocket-sized visualisation tool This new pocket-sized visualisation tool provides ultrasound technology at the point-of-care. Similar in size to a mobile phone and weighing less than one pound, it can give high quality colour images enabling physicians to take a quick look inside the body and detect disease earlier. Vscan™ is marketed by GE Healthcare and has received the CE Mark by the European Union. Heart failure report published A comprehensive review of the quality of heart failure care in England Bridging the quality gap: heart failure, has been published by The Health Foundation. It highlights that prevention is key to imp

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What is the best blood sugar level in diabetics? –New UK data

March 2010 Br J Cardiol 2010;17:59-61

What is the best blood sugar level in diabetics? –New UK data

BJ Cardio Staff

Abstract

These findings are in line with those of the US ACCORD trial which was stopped early because of an increased risk of death in type 2 diabetes patients who underwent intensive blood glucose lowering compared with conventional therapy. In the new UK study, published recently in The Lancet (Lancet 2010;375:481–9), the lowest death and event rates were seen at an HbA1c level of 7.5%. The new data come from studying around 48,000 type 2 diabetes patients aged 50 or over who are included in the UK General Practice Research Database. These patients had either had their treatment intensified from oral monotherapy to combination therapy with oral bl

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March 2010 Br J Cardiol 2010;17:59-61

Statins appear to increase risk of diabetes

BJ Cardio Staff

Abstract

They note that trials of statin therapy have had conflicting findings on the risk of development of diabetes. They therefore performed a meta-analysis of published and unpublished data to look at this issue further. They included 13 statin trials with 91,140 participants in total, of whom 4,278 had diabetes during a mean of four years. Treatment of 255 patients with statins for four years resulted in one extra case of diabetes. They conclude that the risk of developing diabetes with statin therapy is low both in absolute terms and when compared with the reduction in coronary events, and that “Clinical practice in patients with moderate or h

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March 2010 Br J Cardiol 2009;17(Suppl 1):S8-S9

Aspirin – scope and limitations

Paul A Gurbel

Abstract

Identifying targets in the thrombosis pathway Figure 1. Central role of platelets and interaction with coagulation in the genesis of thrombosis (1) Figure 1 summarises the central role of platelets in the genesis of thrombosis.1 The platelet is initially activated in response to shear stress, events such as percutaneous coronary intervention (PCI) or plaque rupture, and the release of local agonists and exposure of the subendothelial components to flowing blood. Tissue factor ‘lights the fire’ by producing minute quantities of thrombin which then amplify the process. Binding of platelets to collagen and von Willebrand

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July 2009 Br J Cardiol 2009;16:163-6

New NICE guidelines on new treatments for type 2 diabetes

BJCardio editorial staff

Abstract

Summary of therapies and key recommendations are: Insulin therapy (including the long-acting insulin analogues, insulin detemir, insulin glargine) Insulin detemir and insulin glargine, like NPH insulin, provide slowly-released insulin to meet basal requirements.  When the decision to start insulin is made, human NPH insulin should be started; healthcare professionals should consider switching to a long-acting insulin analogue if the patient experiences significant hypoglycaemia, is unable to use the device needed to inject NPH insulin, or needs help to inject the insulin from a carer or healthcare professional, and for whom switching to a lo

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March 2009 Br J Cardiol 2009;16:63-64

Diabetes rising dramatically in UK

BJCardio editorial staff

Abstract

There was a 63% increase in the incidence of diabetes in the UK in the ten years between 1996 and 2005, a new study shows. The study, published online in the Journal of Epidemiology and Community Health, used data on 49,999 prevalent cases and 42,642 incident cases (1,256 type I diabetes and 41,386 type 2 diabetes) in UK patients aged 10 to 79 contained in The Health Improvement Network (THIN) database. During the 10-years examined, the prevalence increased from 2.8% to 4.3% while the incidence rose from 2.71 per 1,000 person-years to 4.42 per 1,000 person-years. Type 2 diabetes accounted for most of the increase, and the proportion of patie

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July 2008 Br J Cardiol 2008;15:185-88

News

BJCardio editorial team

Abstract

New data on intensive glucose lowering in type 2 diabetes The results of three large trials investigating the clinical effects of intensive glucose lowering in patients with type II diabetes were presented at the recent American Diabetes Association meeting in San Francisco, USA, and have shown somewhat conflicting results. The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial was stopped earlier this year because of an increased mortality in the intensive glucose lowering group. The two other trials – ADVANCE (Action in Diabetes and Vascular Disease – Preterax and Diamicron MR Controlled Evaluation) and VADT (Veteran’s A

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March 2008 Br J Cardiol 2008;15:65-6

Rosiglitazone and pioglitazone – where do we go from here?

Sarah Jarvis

Abstract

The struggle to meet targets GPs are struggling to meet these targets, with only 56–59% of patients achieving HbA1c <7.5% in at least 50% of patients in 2004/5, and 59–62% of patients in 2005/6.6 While metformin has an excellent safety and efficacy record, and continues to be standard first-line therapy for all patients who can tolerate it, UKPDS has shown us that for most patients, multiple hypoglycaemic agents are necessary. Sulphonylureas are also well tried and tested, and relatively cheap, but carry the risk of weight gain and hypoglycaemia, especially with longer-acting versions such as chlorpropamide and glibenclamide. In additi

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March 2008 Br J Cardiol 2008;15:68-9

Questions raised on very intensive glucose lowering in type 2 diabetes

BJCardio editorial team

Abstract

The ACCORD (Action to Control Cardiovascular Risk in Diabetes) trial, conducted by the US National Heart, Lung, and Blood Institute (NHLBI), was stopped in February because the group being treated with intensive glucose lowering was showing a higher mortality rate than the group receiving standard treatment. But just days later, the group organising another similar trial, ADVANCE (Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation), announced that preliminary results of their study did not confirm the adverse mortality trend with intensive treatment reported from the ACCORD study.

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