Several studies have associated skipping breakfast (having little to no breakfast) with increased cardiometabolic risk factors such as obesity, hypertension, dyslipidemia, diabetes and metabolic syndrome. This study examined all the available evidence on the association of skipping breakfast and cardiovascular and all-cause mortality. It included 4 studies with close to 200,000 adults (mean age ≥40,…
Artificially Sweetened Beverages and Alzheimer Risk
Artificially sweetened beverages (with different kinds of sweeteners) could be responsible for increased cerebrovascular risk and close to a 3-fold increase in dementia risk due to Alzheimer’s disease. Both sweet and artificially sweetened drinks have been associated with cardiometabolic, cerebrovascular and dementia risk. This study prospectively evaluated sweet and sweetened beverage consumption in relation to…
Egg Consumption and Mortality Due to Cardiovascular Events
According to this study recently published in prestigious journal JAMA, eating too much cholesterol or eggs (which have a high concentration of it in the yolk) is significantly associated with a higher risk of cardiovascular events and all-cause mortality, with a typical dose/effect curve. According to the authors, this information should be considered for an…
Ticagrelor Monotherapy One Month After DES Implantation
The GLOBAL LEADERS study includes a pre-specified sub-study, GLASSY, that showed that ticagrelor monotherapy after one month of dual antiplatelet therapy is non-inferior (but not superior) to conventional treatment in terms of ischemic events. As regards safety, ticagrelor monotherapy did not decrease major bleeding compared with conventional therapy. The GLOBAL LEADERS randomized 15,991 patients who required…
The Elderly and Polypharmacy: What to Discontinue
We often receive elderly poly-medicated patients (with more than 10 different drugs) who ask us to reassess these prescriptions and, if possible, discontinue some drugs. The reasons are many: they forget to take it, mix up intakes or drugs, and of course, most often find it expensive. Statins are one of the most expensive drugs…
Sugar-Sweetened Beverages and Artificially Sweetened Beverages Associated with Cardiovascular Events and Mortality
While the consumption of carbonated soft drinks has decreased in most Western countries over the last 20 years, these are still the main source of simple sugars in our diet. The World Health Organization recommends 25-50 g of simple sugars per day, a dose covered with a single can of a carbonated soft drink. For other associations,…
What is Optimal Blood Pressure?
In the last 30 years, the clinical practice guidelines on both sides of the Atlantic have been lowering blood pressure thresholds. From the starting 160 mmHg systolic blood pressure to 130 mmHg or even 120 mmHg. In 2017, the American and the ACC/AHA guidelines were the first to lower said threshold, followed by the European…
Secondary Prevention: A Responsibility We Should Not Delegate
After coronary angioplasty, the use of drugs whose efficacy for the reduction of major events has been proven declines over time, which is associated with worse patient prognosis. Sometimes, without meaning to, we convey to patients the idea that, once the stent has been implanted, the artery is “cured” or that the only potential future…
Benefit of Anticoagulation in the Elderly with Atrial Fibrillation
Guidelines recommend oral anticoagulation for all ≥ 75-year-old patients with atrial fibrillation. However, there is little evidence as to its net clinical benefit in the elderly population. This study looked at the life net clinical benefit in atrial fibrillation patients over 75 years of age treated with warfarin or apixaban vs. no treatment. Researchers observed…
Net Benefit of Left Atrial Appendage Closure vs. Anticoagulation in Atrial Fibrillation
This analysis shows that the long-term clinical benefit of left atrial appendage closure with Watchman is superior to warfarin in patients with atrial fibrillation (AF). The initial peri-procedural risks of device implantation are counterbalanced over time, with reduced risk of bleeding and death. The PROTECT-AF (Watchman Left Atrial Appendage Closure Technology for Embolic Protection in…
AHA 2019 | Treat Stroke to Target: Post-Stroke Aggressive Therapy with Statins
Indicating statins to reach more aggressive LDL goals in patients that have suffered transient ischemic attack or ischemic stroke driven by atherosclerosis significantly reduces major cardiovascular events according to this study presented in the AHA 2019 scientific sessions simultaneously published in NEJM. The study was prematurely ended because of lack of funding, but its outcomes…