November 11, 2008, 9:43 PM CT

Damage inflicted during cardiac attacks more widespread

Cholesterol crystals released in the bloodstream during a cardiac attack or stroke can damage artery linings much further away from the site of the attack, leaving survivors at greater risk than previously thought.

George Abela, a doctor in Michigan State University's College of Human Medicine and chief of the Department of Medicine's cardiology section, is leading innovative research into the role that the crystallization and expansion of cholesterol play in heart attacks, strokes and other cardiovascular events in humans.

He presented his latest research this week at the American Heart Association's Scientific Sessions meeting in New Orleans.

In recent medical trials, Abela and his team of scientists tested carotid arteries in a laboratory by injecting cholesterol crystals into them.

"Cholesterol has been shown to expand when crystallizing and then be released into the circulation following a cardiac event," Abela said. "We observed that the flow of sharp-ended crystals in arteries damage the lining of arteries and decrease the ability of arteries to dilate properly at intervals far away from the site of the attack".

Abela compared the process to a tree, with the trunk as the site of the cardiac event and the branches representing arteries where damage is afflicted far away from the trunk......... Posted by: April      Read more         Source

November 9, 2008, 10:23 PM CT

Vitamins E and C supplements andcardiovascular disease

Neither vitamin E nor vitamin C supplements reduced the risk of major cardiovascular events in a large, long-term study of male physicians, as per a research studyin the November 12 issue of JAMA The article is being released early online November 9 to coincide with the scientific presentation of the study findings at the American Heart Association meeting.

Most adults in the United States have taken vitamin supplements in the past year, as per background information provided by the authors. "Basic research studies suggest that vitamin E, vitamin C, and other antioxidants reduce cardiovascular disease by trapping organic free radicals, by deactivating excited oxygen molecules, or both, to prevent tissue damage." Some prior findings based on observation have supported a role for vitamin E in cardiovascular disease prevention. Some prior findings based on observation have also shown a role for vitamin C in reducing coronary heart disease risk.

In this study, known as the Physicians' Health Study II, Howard D. Sesso, Sc.D, M.P.H., and his colleagues from Brigham and Women's Hospital, Harvard Medical School and School of Public Health and VA Boston Healthcare System, Boston, assessed the effects of vitamin E and vitamin C supplements on the risk of major cardiovascular disease events among 14,641 male physicians. These physicians were 50 years or older and at low risk of cardiovascular disease at the beginning of the study in 1997, and 754 (5.1 percent) had prevalent cardiovascular disease. The study participants were randomized to receive 400 IU of vitamin E every other day or a placebo and 500 mg of vitamin C daily or a placebo......... Posted by: April      Read more         Source

November 9, 2008, 10:00 PM CT

New risk factor for cardiovascular disease

This release is available in French.

Montreal, November 9th 2008 - A team of international scientists including researchers from the McGill University Health Centre (MUHC) and McGill University have discovered that having high levels of particular protein puts patients at increased risk of developing cardiovascular disease. The results of the study were so conclusive that the clinical trial had to be stopped before its scheduled completion date.

Scientists linked to the international JUPITER Project have demonstrated that high levels of high-sensitivity C-reactive protein (hs-CRP) leads to increased risk of cardiovascular disease. This risk decreases by up to 44% if the patients are treated with statin medications.

Dr. Jacques Genest, of the Research Institute of the MUHC and McGill's Faculty of Medicine led the Canadian component of the JUPITER clinical study, which was initiated by Dr. Paul Ridker of the Harvard University Faculty of Medicine.

"The risk of cardiovascular disease due to increased hs-CRP levels has been greatly underestimated until now," as per Dr Genest. "Our results show that this is an extremely important indicator that doctors will have to consider in the future".

"We hope that this study will prompt a review of current clinical practices, particularly in terms of screening and prevention in adults," he added. "However, we still need to do more research to establish specific standards"......... Posted by: April      Read more         Source

November 6, 2008, 6:23 PM CT

Factors that influence carotid-surgery success

Advanced age and race are among the factors that can affect whether a patient dies or suffers a stroke after carotid-artery surgery, a UT Southwestern doctor involved in a multicenter study has observed.

"This study identified 11 readily available, clinical risk factors that can help referring physicians, neurologists, surgeons and anesthesiologists better weigh the risks and benefits of carotid surgery for an individual patient," said Dr. Ethan Halm, new chief of the William T. and Gay F. Solomon Division of General Internal Medicine at UT Southwestern and the study's lead author. "You don't want to cause a stroke to prevent a stroke".

The new findings are reported in the current online version of the journal Stroke.

Dr. Halm and his colleagues used data from the New York Carotid Artery Surgery (NYCAS) study, which reviewed the outcomes of 9,308 carotid surgeries performed on elderly patients by 482 surgeons in 167 hospitals in New York state. It is the largest study of its kind to use clinically detailed data on a population-based study of carotid-surgery outcomes and risk factors in community practice. Dr. Halm recently left Mt. Sinai School of Medicine in New York to lead UT Southwestern's general internal medicine division.

Carotid-artery surgery, one of the most common types of vascular surgeries performed in the U.S., involves opening the carotid artery in the neck and removing harmful plaque to restore blood flow to the brain. Eventhough prior controlled trials have shown carotid surgery reduces the long-term risk of death or stroke in some patients, there is a chance the procedure could cause death or stroke......... Posted by: April      Read more         Source

October 27, 2008, 10:34 PM CT

Cardiovascular effects of diabetes medications

The diabetes medicine metformin may be linked to a lower risk of death from cardiovascular disease, as per a meta-analysis of previously published studies in the October 27 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. No associations were found between other diabetes medications and beneficial or harmful cardiovascular effects, in part because of insufficient data, the authors note.

"A wide variety of oral diabetes medications are currently available for the therapy of type 2 diabetes mellitus," they write as background information in the article. "With the addition of newer oral therapies to the market in the late 1990s (e.g., thiazolidinediones and meglitinides), it is critical to evaluate how these agents compare with older medications. This is especially important in light of the expense of a number of of the newer therapies." The specific effects of these medications on cardiovascular health remains unclear, and recent controversy has surrounded possible cardiac risks linked to one newer drug, rosiglitazone.

Elizabeth Selvin, Ph.D., M.P.H., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and his colleagues performed a meta-analysis of data from 40 clinical trials published on or before Jan. 19, 2006. All the trials assessed the benefits or harms of oral diabetes medications approved for use in the United States, including combinations of therapies usually prescribed by physicians, and included information about heart attack, stroke or other cardiovascular events. The average age of participants ranged from 52 to 69 and 27 of the studies (68 percent) were less than one year in duration......... Posted by: April      Read more         Source

September 10, 2008, 10:15 PM CT

Bleeding gums linked to heart disease

Bleeding gums and poor dental hygiene can end up causing heart disease, scientists heard today (Thursday 11 September2008) at the Society for General Microbiology's Autumn meeting being held this week at Trinity College, Dublin.

People with poor dental hygiene and those who don't brush their teeth regularly end up with bleeding gums, which provide an entry to the bloodstream for up to 700 different types of bacteria found in our mouths. This increases the risk of having a heart attack, according to microbiologists from the University of Bristol and the Royal College of Surgeons in Ireland.

"The mouth is probably the dirtiest place in the human body," said Dr Steve Kerrigan from the Royal College of Surgeons in Dublin, Ireland. "If you have an open blood vessel from bleeding gums, bacteria will gain entry to your bloodstream. When bacteria get into the bloodstream they encounter tiny fragments called platelets that clot blood when you get a cut. By sticking to the platelets bacteria cause them to clot inside the blood vessel, partially blocking it. This prevents the blood flow back to the heart and we run the risk of suffering a heart attack".

The only treatment for this type of disease is aggressive antibiotic therapy, but with the increasing problem of multiple drug resistant bacteria, this option is becoming short lived......... Posted by: April      Read more         Source

July 19, 2008, 9:56 AM CT

Elderly with coronary artery disease

A new study from Duke University Medical Center finds that patients treated solely with medications after suffering from chest pain, heart attack or coronary artery disease are more likely to die during the first year following their initial hospitalization.

"Patients managed medically without stenting or bypass surgery tend to be elderly and frail, and in some sense we feel they have been overlooked," says Matthew Roe, a heart specialist at Duke and the senior author of the study appearing in the recent issue of the Journal of the American College of Cardiology: Cardiovascular Intervention "We wanted to find out what clinical factors were funneling them into a medicine-only group and what happened to them, when in comparison to patients who received stents and bypass procedures".

Roe led a team of scientists in examining a subset of 8,225 patients from a prior study (the SYNERGY trial) which compared the effects of two different anti-clotting drugs in heart patients. For the current study, scientists included only patients who had undergone cardiac catheterization and who had been found to have at least one significant blockage in a coronary artery. A majority of these patients (52 percent) underwent coronary stent implantation to open their arteries, while 32 percent were medically managed, and 16 percent underwent coronary bypass surgery......... Posted by: April      Read more         Source

July 14, 2008, 9:52 PM CT

Young adults with prehypertension and atherosclerosis

Prehigh blood pressure during young adulthood is common and is linked to subsequent coronary atherosclerosis, as per a research studypublished in today's issue of Annals of Internal Medicine

Scientists from the University of California, San Francisco, analyzed blood pressure measurements of 3,560 adults aged 18 to 30 from seven examinations over the course of 20 years. Nearly 20 percent (635) of the study participants developed prehigh blood pressure (systolic blood pressure 120 to 139 mmHg or diastolic blood pressure 80 to 89 mmHg) before the age of 35.

Eventhough these blood pressure levels are below the cutoff for hypertension, the young adults with prehigh blood pressure were more likely than those with lower blood pressure to have calcium in their coronary arteries during the later part of life. Coronary calcium is a marker of atherosclerosis and a predictor of future heart attacks and strokes.

"Our findings suggest the possibility that prehigh blood pressure itself is harmful, and not just because it is linked to subsequent hypertension," said Mark J. Pletcher, MD, MPH, the study's lead author. "People with a lot of calcium in their coronary arteries are more likely to have heart attacks and strokes, and these outcomes might be avoidable by keeping blood pressure low when you're young"......... Posted by: April      Read more         Source

July 10, 2008, 9:37 PM CT

Alaskan Eskimos' high rates of artery plaque

Alaskan Eskimos' significantly higher rates of fatty artery plaque than the general U.S. population may be due to unhealthy lifestyle habits, scientists report in Stroke: Journal of the American Heart Association.

Scientists observed that more than half of Alaskan Eskimo adults smoke, their level of physical activity has decreased from traditional levels, and their intake of saturated and trans fats, rather than heart-healthy omega 3 fatty acids (found in fish), has increased.

"Traditionally, American Eskimos have not had much cardiovascular disease, but more recent population surveys have shown that cardiovascular disease is increasing in this population," said Mary J. Roman, M.D., lead author of the study. "We sought to confirm this increase and determine whether it was correlation to the things that cause coronary heart disease in other populations or something else."

In the Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) study, scientists examined extensive medical histories, dietary surveys, blood analyses and ultrasound images of carotid arteries of more than 1,200 Eskimo adults (average age 42) in Alaskan villages to determine if signs of atherosclerosis - fatty plaque buildup - were present before symptoms occurred.

"Carotid arteries are the major arteries taking blood up to the brain," said Roman, a professor of medicine in the cardiology division at Weill Cornell Medical College in New York, N.Y. "We looked for thickening of the lining of the arteries, called intimal-medial thickness, and whether there was evidence of plaque or fatty buildup, known as atherosclerosis......... Posted by: April      Read more         Source

July 3, 2008, 9:06 PM CT

Screening for heart disorders in competitive athletes

Athletes who take part in competitive sport should be screened for potentially fatal heart problems before they compete, as per a research studypublished on BMJ.com today.

The findings show that a pre-participation screening programme, which involves checking the activity of the heart during exercise, would detect more athletes at risk of sudden cardiac death and save lives, say the authors.

One young competitive athlete dies every three days from an unrecognised cardiovascular disorder in the United States alone.

In the majority of cases the athletes appear healthy and there is no prior clinical sign of heart problems. The clinical usefulness of pre-screening programmes to identify people at high risk has been hotly debated. Whether or not to include an electrocardiogram (ECG) as part of pre-screening has been especially controversial because of concerns over cost-effectiveness and the number of false-positive test results.

In America and Europe authorities have recommended a pre-participation evaluation which includes taking a detailed patient and family history as well as a physical examination.

However, in Italy for the past 25 years, athletes wishing to enter competitive sport have also had to have two ECGs (a test to measure the electrical activity of the heart), one at rest and one while exercising. Scientists from the University of Florence set out to evaluate the clinical usefulness of this programme......... Posted by: April      Read more         Source