Tag Archives: secondary prevention

Introduction Claire Jones Research suggests that globally, attainment of lipid targets is poor, with significant scope for improved optimisation of lipid lowering therapy (LLT) and cardiovascular (CV) risk factor management. Evidence suggests that the key initiating event in atherogenesis is retention of low-density lipoprotein cholesterol (LDL-C). To align with this, the European Society of Cardiology and European Atherosclerosis Society (ESC/EAS) proposed new LDL-C goals in 2019,1 and revised CV risk stratification guidance (particularly relevant to high-risk and very high-risk patients). National Institute for Health and Care Excellence (N

Physio-Control, a global leader in lifesaving emergency response technology, is launching a new automated external defibrillator (AED) in European countries (LIFEPAK® CR2). The LIFEPAK® AED Response System: Features a new design intended for ease of use by bystanders and rescuers Launches new technology that supports high quality cardiopulmonary resuscitation Has been demonstrated to offer faster time-to-first-shock Deploys a new remote monitoring and connectivity capability through the online LIFELINKcentral™ AED Program Manager. The CR2 can be remotely monitored and can even, in some areas, transmit a heart rhythm to emergency medical

Introduction ACRAN healthcare team Cardiac rehabilitation (CR) services are comprehensive, long-term programmes involving medical evaluation, prescribed exercise, cardiac risk factor modification, education and counselling. CR has been extensively reviewed in the literature,1 and, in patients after myocardial infarction, has been shown to reduce all-cause and cardiovascular mortality rates in a Cochrane review.2 However, it has also been shown by others to have little effect on outcomes.3 Doubts over the efficacy of CR have led commissioners to question the value of such services. While the debate continues, the Anglia region CR services (reb

Introduction Over 90 people die from myocardial infarction (MI) every day in the UK.1 Cardiac rehabilitation, which incorporates cardioprotective drug therapies as one of its core components,2 has been shown to be associated with a reduction in recurrent MI.3 The National Service Framework (NSF) for Coronary Heart Disease (CHD) set out a strategy in 2000 to change CHD services over the next 10 years.4 Improvements have been delivered in most standards of cardiac services but uptake and adherence to cardiac rehabilitation programmes following MI, coronary angioplasty or coronary artery bypass (CABG) surgery are still below the 85% target set f

Introduction Stable angina is the most common manifestation of coronary heart disease. While considered relatively benign in terms of prognosis, the condition confers a higher risk of cardiovascular events than in the general population, with average annual mortality rates of 1–2%. Guidelines for the management of stable angina are relatively conservative in their approach, given their process of development. Moreover, stable angina management has not been as rigorously evaluated in large randomised trials as other coronary conditions. The role of newer treatment options in management algorithms also merits wider consideration. This expert

ARISTOTLE: apixaban superior to warfarin in AF patients Another oral anticoagulant has shown good results in comparison to warfarin for use in the prevention of stroke in patients with atrial fibrillation (AF). The new oral factor Xa inhibitor, apixaban, was superior to warfarin in preventing stroke or systemic embolism and was also associated with less bleeding and lower mortality than warfarin in the ARISTOTLE trial. Apixaban is the third of the new generation of oral anticoagulants to be tested in this indication, and seems to have performed the best. The other two agents – dabigatran and rivaroxaban – have also been shown to be viable

Introduction Myocardial infarction (MI) is a common condition, estimated to affect almost 150,000 people per year in the UK.1 Without effective treatment, the immediate mortality of MI approaches 40% with a further 10% of patients dying in the subsequent year.2 In those who survive the initial post-MI period, an increased risk of death from cardiovascular causes (5% per year) persists indefinitely.2 However, effective secondary prevention measures can significantly reduce this risk.3 An estimated 1.4 million people in the UK have had an MI.4 Reducing morbidity and mortality among this group requires effective secondary prevention measures. In

Introduction Patients with peripheral arterial disease (PAD) have a high prevalence of modifiable risk factors for coronary artery disease (CAD).1 Consequently, they represent a suitable target for secondary prevention and there is strong evidence that this is beneficial.2–4 We aimed to establish whether people with PAD who are admitted to hospital receive equal pharmacological secondary prevention to those with CAD. Methods We prospectively recruited patients from 1st March 2003 until 1st June 2003 admitted to a vascular surgery ward (PAD) or cardiology ward (CAD) until discharge. All patients had symptomatic established disease and underw

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