March 25, 2007, 7:08 PM CT

Statins slow progression of arterial thickening

Among low-risk middle-aged people with subclinical atherosclerosis, the cholesterol-lowering drug rosuvastatin reduces the rate of progression of arterial thickening and stops but does not reverse atherosclerotic disease, as per a research studyin the March 28 issue of JAMA. The study is being released early to coincide with its presentation at the American College of Cardiology's annual conference.

Lipid-lowering treatment has been shown to reduce cardiovascular events in a large number of studies. Statin drugs as well as other agents and changes in lifestyle have also been shown to slow the progression of and even regress atherosclerosis, as per background information in the article. Atherosclerosis is the progressive thickening and hardening of the walls of medium-sized and large arteries as a result of fat deposits on their inner lining. Atherosclerosis is often advanced before symptoms appear, and it is not clear whether therapy is beneficial in middle-aged individuals with a low Framingham risk score (a measure used to predict the risk of cardiovascular disease) and mild to moderate subclinical atherosclerosis.

John R. Crouse III, M.D., of the Wake Forest University School of Medicine, Winston-Salem, N.C., and his colleagues conducted a randomized study of 984 individuals. The Measuring Effects on Intima-Media Thickness: an Evaluation of Rosuvastatin (METEOR) study was designed to investigate the effect of a 40-mg. dose of rosuvastatin on carotid intima-media thickness (CIMT, a measure of the thickness of the middle layers of the carotid arteries) over two years in middle-aged individuals with low Framingham risk scores, but with evidence of subclinical atherosclerosis......... Posted by: April      Read more         Source

March 15, 2007, 8:51 PM CT

Apple consumers reap heart-health

Apples may prove to be a winner when it comes to reducing the risk of heart disease, says a new study of more than 34,000 women. In this study, flavonoid-rich apples were found to be one of three foods (along with red wine and pears) that decrease the risk of mortality for both coronary heart disease (CHD) and cardiovascular disease (CVD) among post-menopausal women, The findings were reported in the March 2007 American Journal of Clinical Nutrition.

Women of all ages are encouraged to consume more fruit and vegetables, including apples and apple products, for heart health. However, this study focused on postmenopausal woman, a group becoming more aware of the risk for heart disease. Using a government database that assesses the flavonoid-compound content of foods, the scientists hypothesized that flavonoid intake (in general and from specific foods), might be inversely linked to mortality from CVD and CHD among the women in the study groupSubjects selected for this research analysis were postmenopausal and part of the ongoing Iowa Women's Health Study, each of which has been monitored for dietary intake and various health outcomes for nearly 20 years.

As a result of the extensive analysis that considered what the women ate, the types of cardiovascular-related diseases they experienced, and the overall flavonoid content of an extensive list of foods, the scientists concluded that consumption of apples, pears and red wine were linked with the lowest risk for mortality correlation to both CHD and CVD (not just one or the other)......... Posted by: April      Read more         Source

March 12, 2007, 8:51 PM CT

Adult Stem Cells For Heart Damage Repair

The University of Wisconsin School of Medicine and Public Health is among the first medical centers in the country taking part in a novel clinical trial investigating if a subject's own stem cells can treat a form of severe coronary artery disease.

The trial, just underway at UW Hospital and Clinics, is enrolling subjects in the Autologous Cellular Therapy CD34-Chronic Myocardial Ischemia (ACT34-CMI) Trial. The first patient underwent the procedure March 7. Because the study is randomized and "double-blinded," however, neither the patient nor the research doctor knows if he received his own stem cells or a placebo substance.

This trial is the first human Phase II adult stem cell treatment study in the U.S. Its goal is to investigate the efficacy, tolerability, and safety of blood-derived selected stem cells to improve symptoms and clinical outcomes in patients with chronic myocardial ischemia (CMI), a severe form of coronary artery disease.

Myocardial ischemia, which affects hundreds of thousands of people, is a serious heart condition that involves narrowing of coronary arteries and results in limited blood flow to the heart. A person who suffers from chronic myocardial ischemia continues to experience insufficient flow of oxygen-rich blood to the heart despite optimum medical intervention......... Posted by: April      Read more         Source

February 26, 2007, 6:40 PM CT

Usefulness of cardiovascular disease test?

Researchers with Dartmouth Medical School and the Veterans Affairs Outcomes Group at the White River Junction (Vt.) VA Medical Center are questioning the usefulness of the C-Reactive Protein (CRP) test for guiding decisions about the use of cholesterol-lowering medication.

The researchers show that adding CRP testing to routine assessments would increase the number of Americans eligible for cholesterol-lowering treatment by about 2 million if used judiciously, and by over 25 million if used broadly-with most of these people being at low risk for heart attacks or heart disease. The authors argue that the medical community should focus energies on treating high-risk patients before expanding the pool to include so many low-risk patients. Their study was published in the recent issue of the Journal of General Internal Medicine.

"There is a push to use this test, and that probably doesn't make much sense," says Steven Woloshin, one of the authors on the paper and an associate professor of community and family medicine at Dartmouth Medical School (DMS).

According to co-author Lisa Schwartz, associate professor of medicine at DMS, "A general population use of the test would identify millions of low-risk people, and we don't know if exposing them to cholesterol medications will do more good than harm. Plus, focusing on low-risk people seems misplaced since over half of high-risk people, who we know are helped by treatment, remain untreated"......... Posted by: April      Read more         Source

February 13, 2007, 9:30 PM CT

Poor people worse off following heart attack

People from lower socioeconomic backgrounds who suffer a heart attack come to the emergency department more often, are less likely to be treated aggressively and have higher mortality rates a year after the attack, says new University of Alberta research that has important implications for access to cardiac care.

Dr. Padma Kaul and a group of U of A scientists investigated 5622 patients in Alberta who went to a hospital emergency department with a first heart attack. Following the common practice of using the neighbourhood median household income as a proxy for socioeconomic status, the scientists classified patients into separate income groups. Patients in the lowest income quartile were more likely to be older, female and to have other illnesses such as diabetes and peripheral vascular diseases. Scientists first looked at who was more likely to have an angioplasty or coronary bypass surgery and then did a one-year follow-up after the emergency department visit to see whether the patient was still alive. The study is reported in the January 2007 issue of the prestigious American Journal of Medicine.

"We found a clear discrepancy when it comes to socioeconomic status," said Kaul. "We may have equal access health-care coverage in Canada but the bottom line is that people may not be getting equal therapy"......... Posted by: April      Read more         Source

February 7, 2007, 8:51 PM CT

Patients with ICDs have less driving restrictions

People who receive implantable cardioverter defibrillators (ICD) as a preventative measure don't need the same driving restrictions as people who get an ICD after surviving a life-threatening heart rhythm disturbance, as per an updated scientific statement.

The statement, issued by the American Heart Association and the Heart Rhythm Society, is an addendum to "Personal and Public Safety Issues Correlation to Arrhythmias that May Affect Consciousness." It will be published online today in Circulation: Journal of the American Heart Association and on the Heart Rhythm Society's Web site.

The original advisory was published in Circulation in 1996. The addendum addresses driving restrictions in patients who receive an ICD for primary prevention, meaning they have never had a life-threatening heart rhythm disturbance. The original advisory referred to prophylactic ICDs, which at the time were more usually used for secondary prevention, meaning the recipient has survived at least one life-threatening arrhythmia.

"Because the majority of defibrillators being implanted now are for primary rather than secondary prevention, it seemed prudent to review the recommendations for driving," said Andrew E. Epstein, M.D., head of the statement writing committee and Professor of Medicine in the Division of Cardiovascular Disease at the University of Alabama at Birmingham.........

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February 5, 2007, 7:38 PM CT

Women In Polluted Areas

Women living in areas with higher levels of air pollution have a greater risk of developing cardiovascular disease and subsequently dying from cardiovascular causes, as per a University of Washington study appearing in the Feb. 1 issue of The New England Journal (NEJM). The study is one of the largest of its kind, involving more than 65,000 Women's Health Initiative Observational Study participants, age 50 to 79, living in 36 cities across the United States.

UW scientists studied women who did not initially have cardiovascular disease, following them for up to nine years to see who went on to have a heart attack, stroke, or coronary bypass surgery, or died from cardiovascular causes. They linked this health information with the average outdoor air pollution levels near each woman's home, and observed that higher pollution levels posed a significant hazard -- much higher than previously thought -- for development of cardiovascular disease.

The scientists studied levels of fine particulate matter, which are tiny airborne particles of soot or dust, and can come from a variety of sources, like vehicle exhaust, coal-fired power plants, industrial sources, and wood-burning fireplaces. These particles are less than 2.5 microns in diameter -- about 30 to 40 of them would equal the diameter of a human hair. Particulate matter levels are monitored and regulated by the U.S. Environmental Protection Agency (EPA). They're typically invisible to the human eye once they're in the atmosphere, though they may be visible in dense clouds as they come out of a tailpipe, smokestack or chimney, and are responsible for urban haze.........

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February 4, 2007, 9:16 PM CT

Teamwork For Chronic Heart Failure

Active patient involvement during therapy of chronic heart failure, coupled with partnership with healthcare team members to provide care consistent with evidence-based guidelines, dramatically improves quality of care for chronic heart failure patients.

The study by scientists from the Indiana University School of Medicine, the Regenstrief Institute, Inc. and the Richard Roudebush VA Medical Center in Indianapolis, reported in the January 2007 issue of the journal Medical Care, reported on chronic heart failure patients in 143 Department of Veterans Affairs Medical Centers nationwide.

Chronic heart failure is a serious condition caused by structural or functional cardiac problems impairing the ability of the heart to pump blood. Risk factors for chronic heart failure include prior heart attack, hypertension or diabetes.

"We found hospitals providing complex care like the care needed for chronic heart failure perform significantly better when members of the patient's health-care team collectively work together to follow processes and procedures incorporated in national guidelines. Facilities with providers receptive to the guidelines, which have guideline-specific task forces to support implementation and a well-planned implementation process were those who gave the highest quality of care for patients with chronic heart failure," said the study's senior author, Bradley Doebbeling, M.D., M.S., professor of health services research and medicine at the IU School of Medicine and program director for health services research at the Regenstrief Institute.........

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January 11, 2007, 9:03 PM CT

Prehypertension In Young Linked With Heart Enlargement

High blood pressure and prehigh blood pressure in adolescents and young adults was linked to a higher risk of having an abnormally enlarged heart, scientists report in Circulation: Journal of the American Heart Association.

In a study of American Indians, average age 26.5, those with high blood pressure or prehigh blood pressure were more likely to have changes in the heart structure linked to increased cardiovascular risk: higher left ventricular wall thickness, higher left ventricular mass and higher prevalence of left ventricular hypertrophy. The prevalence of left ventricular hypertrophy was three times higher among those with high blood pressure and two times higher among those with prehypertension, in comparison to those with normal blood pressure.

Left ventricular hypertrophy is an abnormal thickening of the muscles of the heart's left ventricle (main pumping chamber). It is linked to heart and blood vessel complications, such as heart failure.

"The findings are a wake-up call for increased preventive measures to head off heart disease with lifestyle modifications, such as reducing caloric intake and increasing physical activity in this population," said Richard B. Devereux, M.D., senior study author and professor of medicine at Weill Medical College of Cornell University in New York City.........

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January 10, 2007, 8:58 PM CT

New Therapy For Severely Elevated Cholesterol Levels

Scientists at the University of Pennsylvania School of Medicine have demonstrated the potential of a new type of treatment for patients who suffer from high cholesterol levels. The findings are in the January 11 issue of the New England Journal (NEJM) (NEJM). In this study, patients with homozygous familial hypercholesterolemia (FH), a high-risk condition refractory to conventional treatment, had a remarkable 51% reduction in low-density lipoprotein (LDL) or "bad cholesterol" levels.

"Our study shows that targeted inhibition of the microsomal triglyceride transfer protein (MTP) is highly effective in reducing cholesterol levels in these very high risk patients," stated Daniel J. Rader, MD, Director of Preventive Cardiology and the Clinical and Translational Research Center at Penn, and principal investigator of this study. "Furthermore, there are a number of other patients who have cholesterol levels that are difficult to treat or who are not tolerant to therapy with statins. New therapies are mandatory for these patients as well, and it is possible that after further research MTP inhibition could eventually be used for such patients".

Genetic defects in MTP lead to profoundly low levels of LDL. Using this information, Bristol-Myers Squibb began to search for inhibitors of this protein and discovered the study drug, originally known as BMS-201038. Bristol-Myers Squibb then donated it to Penn for use in clinical trials in patients with severe cholesterol problems. Rader and his team at Penn designed and carried out the current study in homozygous FH patients with support from the Doris Duke Charitable Foundation. Due to the success in this study, Penn has licensed the drug to Aegerion Pharmaceuticals Inc for further development as AEGR-733.........

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