12 weeks prior the ORBITA randomization, medical therapy optimization of all antianginal medication was achieved. Most importantly, optimization was well tolerated by all patients, with scarce adverse effects leading to therapy termination. In clinical practice, there is skepticism towards achieving maximal dosage with a cost-effective therapy, good tolerance, adherence, and no drug-drug interaction. The ORBITA…
Regression of High-Risk Plaque with Lifestyle Changes
Diet and lifestyle intervention in addition to optimal medical therapy can slow down plaque building and even reduce plaque volume compared against optimal medical treatment (OTM) alone. Diet and lifestyle intervention are amongst the most important strategies to manage coronary artery disease. However, its direct impact on atherosclerosis remains unclear. Atherosclerosis plaque building is associated…
Might Alcohol Consumption Reduce Stroke?
A J shaped curve illustrating the link between alcohol consumption and ischemic stroke has been reported, suggesting that a certain amount of alcohol would be beneficial compared against absolute abstinence and excessive consumption. In order to shed some light on this matter, this study looked at alcohol consumption patterns and their effect on stroke in…
Reducing Chronic Inflammation in Atherosclerosis with an Old Drug
Inflammation plays a crucial role in atherosclerosis progression. Recently, the COLCOT study has shown the benefits of colchicine in cardiovascular events. This good old drug has an inflammatory effect which attenuates the NLRP3 cascade. This explains its effect on uric acid crystals in gout, which might be the same on atherosclerosis cholesterol crystals. This study…
Latest News on AHA/ACC Primary Prevention Guidelines
Most cardiovascular diseases and mortality come down to 4 years of unhealthy habits (smoking, poor diet, obesity and sedentarism) and 3 major risk factors (cholesterol, hypertension, and diabetes). Ideal cardiovascular health, defined as absence or control of these 7 factors, is far less frequent than we might believe. It is estimated that 87% of the…
Pleiotropic Effect of Metoprolol: Different From other B-blockers
The clinical practice guidelines recommend the early use of endovenous B-blockers in patients undergoing acute myocardial MI, taking for granted that all B-blockers have a similar class effect. This experimental study might show metoprolol has other benefits that could make it superior to the rest of the B-blocker family. Using an animal model with 45-minute…
Saturated Fats: Dietary Angels or Demons?
In order to reduce cardiovascular events, dietary guidelines recommend restricting saturated fatty acids—without taking into account differences among them—to <10% of the daily caloric intake. It should be noted that there are many different saturated fatty acids, each with its own biological effect. Moreover, said biological effect could be modified by the food matrix and…
AHA 2020 | Effect of Evolocumab in Complex Coronary Revascularization
Evolocumab, a PCSK9 inhibitor, has shown significant reduction of complex coronary disease requiring revascularization (be it PCI or CABG). Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors induce plaque regression and could eventually reduce the risk of coronary revascularization, especially complex revascularization. The FOURIER study randomized 27564 patients with stable CAD already on statins to evolocumab…
AHA 2020 | Omega-3 Fatty Acids Provide No Cardiovascular Benefits and Cause More Atrial Fibrillation
Results confirm the interim analysis, whereby the study was suspended for futility. Omega-3 fatty acids do not reduce cardiovascular events in patients with high triglycerides and low HDL. Previous studies, such as REDUCE-IT, had shown positive results, but given this new research (presented at the American Heart Association [AHA] 2020 Congress and simultaneously published in…
AHA 2020 | EMPATROPISM: Empagliflozin in Non-Diabetics with Cardiac Failure
Empagliflozin improves cardiac function, exercise capacity and quality of life in non-diabetic patients with cardiac failure and deteriorated ejection fraction. These findings were presented during the scientific sessions at AHA 2020 and published simultaneously in JACC. EMPATROPISM outcomes are on the same line as other studies using sodium glucose 2 cotransporter inhibitors (SGLT2) which showed…
AHA 2020 | POLYPILL: One Pill Plus Aspirin to Treat Everything
Using only one compressed tablet or pill with a fixed combination of statins, angiotensin-converting enzyme inhibitors, beta-blockers, and diuretics significantly lowered cardiovascular risk in a large population without previous events (primary prevention). However, it presented an intermediate risk of cardiovascular disease onset. The TIPS-3 (The International Polycap Study 3) study had a 2-by-2-by-2 factorial design,…