Tag Archives: risk

New AF guidelines The first collaborative European Society of Cardiology (ESC) and European Association for Cardio-Thoracic Surgery (EACTS) Guidelines on Atrial Fibrillation (AF) were published at the start of the congress.1 These multidisciplinary guidelines focus on early detection of asymptomatic AF, recommending both opportunistic and targeted screening for all patients aged ≥65 years, or with stroke or transient ischaemic attack (TIA). In addition, the guidelines deal with long-term challenges in the management of AF patients, with recommendations on what to do when patients develop complications on anticoagulation, re-initiation of an

The National Institute for Health and Care Excellence (NICE) has said that thousands of people with atrial fibrillation (AF) could be prevented from having strokes, disability or death if its new guidance is followed. It says many patients with AF are not being appropriately anticoagulated and highlights how there has not been widespread uptake of novel oral anticoagulant drugs (NOACs) which were approved by NICE in 2012. Clinical guideline 180 published in June 2014 updates and replaces the 2006 NICE clinical guideline 36. The full guidance can be found at http://www.nice.org.uk/guidance/CG180 NICE Chair, Professor David Haslam writes on the

Introduction There is no universal definition for stable angina, as there is for acute coronary syndrome.1 The diagnosis may be based on clinical history alone or on clinical history supplemented by functional testing, or angiography, or both. Angina pectoris is most often due to obstruction to flow in the epicardial coronary arteries, and the ‘gold-standard’ investigation, to date, to detect this, has been invasive coronary angiography.2 A small proportion of patients may have angina with unobstructed coronary arteries secondary to either microvascular coronary disease or coronary spasm.3 Functional ischaemia is not routinely tested for

Controversial salt paper published A new European study has caused controversy by suggesting that lowering salt intake may not be beneficial. The study, published recently in JAMA (May 4th 2011 issue), was conducted by a team from the University of Leuven, Belgium. They followed 3,681 participants who were free of cardiovascular disease at baseline for a median of 7.9 years, and found an inverse relationship between cardiovascular deaths and 24-hour sodium excretion (which correlates to salt intake), although systolic blood pressure was higher with higher salt intake. But an editorial in the Lancet (May 12th 2011 issue) criticises the study,

Traditional methods of risk assessment for cardiovascular events use conventional risk factors to calculate risk often expressed as the 10-year Framingham Risk Score (10y FRS). However, these methods are far from perfect. Although they identify high-risk groups, if followed up these high-risk groups contain at best only a fraction of the events that will occur in the subsequent 10 years. In the Prospective Cardiovascular Munster (PROCAM) study 6.5% of the population were classified as high risk (10-year risk >20%), 14% as intermediate risk (10-year risk 10–20%) and 79.5% as low risk (10-year risk <10%). At 10 years, 33% of all the myo

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