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Tag Archives: myocardial infarction

Updates from the American Diabetes Association 2019

September 2019 Br J Cardiol 2019;26:88–9

Updates from the American Diabetes Association 2019

Amar Puttanna

Abstract

The American Diabetes Association Scientific Sessions 2019 were held in San Francisco REWIND One of the highlights of the conference and, for many, the main event was the presentation of results from REWIND (Researching CV Events with a Weekly Incretin in Diabetes), a cardiovascular outcome trial (CVOT) for the GLP-1 receptor agonist (GLP-1RA) dulaglutide.1 Prior to this trial, the majority of CVOTs (and all prior CVOTs with GLP-1 RAs) were conducted in a predominantly secondary prevention population. Thus any positive cardiovascular (CV) outcomes were only shown in those with established atherosclerotic cardiovascular disease (ASCVD). The ba

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May 2019 Br J Cardiol 2019;26:59–62 doi:10.5837/bjc.2019.018

Rapid rule-out of NSTEMI: clinical characteristics and outcome of patients with undetectable troponin

Sally Youssef, Mariam Ali, Kim Heathcote, Alistair Mackay, Chris Isles

Abstract

Introduction Most patients presenting as an emergency with chest pain do not have myocardial infarction (MI),1 which must, nevertheless, be ruled out in order to reassure and discharge from hospital. High-sensitivity cardiac troponin T (hs-TnT) and troponin I (hs-TnI) have streamlined the assessment and management of chest pain, as a rapid rule out of MI is now possible, particularly if hs-TnT or hs-TnI are undetectable at presentation.2-8 Undetectable troponin cannot, however, be used to exclude unstable angina, which by definition is not associated with a troponin rise.9 It is for this reason that physicians and cardiologists may be reluct

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Drugs for diabetes: the cardiovascular evidence base

September 2018 Br J Cardiol 2018;25(suppl 2):S14–S18 doi:10.5837/bjc.2018.s09

Drugs for diabetes: the cardiovascular evidence base

Sam M Pearson, Ramzi A Ajjan

Abstract

Introduction Individuals with diabetes are at increased risk of vascular outcomes, and their prognosis following an event remains worse compared with those having normal glucose metabolism.1 The relationship between glycaemia and vascular disease is complex as it is affected by multiple glucose parameters, including chronic hyperglycaemia, hypoglycaemia and, potentially, glycaemic variability.2 To add to the complexity, the type of hypoglycaemic agent used may also alter predisposition to vascular events. Over a decade ago, one hypoglycaemic agent, rosiglitazone, was implicated in increasing the risk of vascular disease, which prompted the U

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What next for troponin? When diagnostic precision muddies the water for the physician

January 2018 doi:10.5837/bjc.2018.003 Online First

What next for troponin? When diagnostic precision muddies the water for the physician

Thomas E Kaier

Abstract

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October 2017

ESC 2017: REVEAL – modest beneficial effects with anacetrapib

BJC Staff

Abstract

Presented in a hotline session by Dr Martin Landray (University of Oxford), the trial’s co-principal investigator, and simultaneously published in the New England Journal of Medicine (https://doi.org/10.1056/NEJMoa1706444), this large-scale, placebo-controlled study was carried out on 30,449 patients with cardiovascular disease, who were all receiving lipid-lowering treatment with atorvastatin. Those patients also receiving anacetrapib (100 mg once daily) showed a significant reduction in the primary outcome, the risk of major coronary events (coronary death, myocardial infarction or coronary re-vascularisation) by 9% relative to those pati

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October 2017

ESC 2017: DETO2X – oxygen therapy does not improve survival in myocardial infarction

BJC staff

Abstract

The DETO2X-AMI study questioned the current practice of routine oxygen therapy for all patients with suspected myocardial infarction (MI), said Dr Robin Hofmann (Karolinska Institutet at Södersjukhuset, Stockholm, Sweden) who presented the study at the meeting. This prospective, randomised, open label trial enrolled 6,229 patients with suspected heart attack from 35 hospitals across Sweden. Half of the patients were assigned to oxygen given through an open face mask and the other half to room air without a mask. The study – using a registry-based randomised clinical trial protocol – was representative of real world practice and used nati

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Improving communication with GPs post-STEMI

November 2016 Br J Cardiol 2016;23:138–40 doi:10.5837/bjc.2016.037

Improving communication with GPs post-STEMI

JJ Coughlan, Conor Hickie, Barbara Gorna, Ross Murphy, Peter Crean

Abstract

Introduction Coronary artery disease remains one of the leading causes of death in Ireland,1 the UK,2 and worldwide. Despite advances in management, it is a major source of morbidity and mortality in our healthcare system. Numerous trials (PROVE-IT,3 ISIS-1,4 ISIS-2,5 ISIS-3,6 ISIS-4,7 AIRE,8 CAPRICORN9) have established the prognostic benefits associated with adequate secondary prevention post ST-elevation myocardial infarction (STEMI). National Institute for Health and Care Excellence (NICE) guidelines10 recommend all patients discharged post-STEMI should be offered treatment with an angiotensin-converting enzyme inhibitor (ACEi), beta bloc

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Book review: Upon a trailing edge

June 2016 Br J Cardiol 2016;23:81

Book review: Upon a trailing edge

William D Toff

Abstract

Publisher: Matador, 2015 ISBN: 9781784624729 Price: £17.99 The author describes this as a story about aviation, its risks and the heart of the pilot. It is a story told extremely well from a unique personal perspective and should have wide appeal. It is principally an autobiography charting the author’s life in aviation and cardiology, and the interface between them that deals with the impact of cardiovascular disease on a pilot’s fitness to fly. It also includes a brief history of powered flight, insights into human factors and the quantification and containment of risk, as well as some entertaining travel writing, as the author recount

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June 2015 Br J Cardiol 2015;22:79 doi:10.5837/bjc.2015.022

Implementation of point-of-care troponin T testing in clinical practice

Faheem A Ahmad, Stephen Dobbin, Allister D Hargreaves

Abstract

Introduction Current evidence suggests there has been a marked proliferation of troponin testing within medical units as the troponin assay has become the cornerstone biomarker in the diagnosis of an acute myocardial infarction (AMI).1,2 Both troponin T (TnT) and troponin I (TnI) are cardio-specific structural subunits and highly sensitive and specific markers of myocardial injury.3,4 Newer generation high-sensitivity troponin (hs-Tn) assays can detect increasingly lower troponin concentrations within an earlier time window of up to three hours.5 Early implementation of first-generation assays were accompanied with poor patient selection; ava

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Synthetic and natural cannabinoids: the cardiovascular risk

March 2015 Br J Cardiol 2015;22:7–9 doi:10.5837/bjc.2015.006

Synthetic and natural cannabinoids: the cardiovascular risk

Ethan B Russo

Abstract

Ethan B Russo Morbidity and cannabinoids Cardiovascular morbidity secondary to cannabis has been reported: THC metabolites in unexplained cardiac deaths in young people,14 and a claim of a 4.8 times increased risk of myocardial infarction (MI) in the first hour after cannabis smoking,15 but given the meteoric increase in cannabis usage over the past five decades, one might expect a commensurate public health signal, which has been quite unapparent in epidemiological studies.16,17 Cannabis smoking did decrease exercise tolerance in angina.18 While increased all-causation death rates after first MI in cannabis smokers were initially claimed,19

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