The latest studies seem to support higher baseline LDL-C levels would justify further intensifying and already aggressive drug strategy. A more aggressive hypolipidemic therapy would involve adding far more expensive new drugs that many specialists are reluctant to accept, in terms of their cost benefit ratio. The intensive therapy to lower LDL-C levels reduces cardiovascular…
ACC 2018 | Flu Vaccination Reduces Mortality in Heart Failure Hospitalizations
Heart failure patients vaccinated against influenza are at a significantly lower risk of dying, both during flu season and outside of it. Patients with heart failure vaccinated had a 48% lower risk of death during influenza season and a 21% lower risk during the rest of the year. Dr. Fukuta, lead investigator in this study,…
ACC 2018 | SECURE-PCI: High Dose of Statins pior PCI Could Help
Patients undergoing acute coronary syndrome (ACS) loaded with a high dose of statins prior diagnostic catheterization do not seem to benefit from this strategy. However, when looking at those undergoing PCI alone (excluding all patients who had received surgery or medical treatment), the benefit appears as a reduction of combined major events. The benefit of atorvastatin loading…
CANTOS: Less Cardiovascular Events with Canakinumab
A new analysis from the CANTOS trial shows that individuals who initially respond to canakinumab benefit the most from this new drug as regards cardiovascular events. This sub-analysis presented at the American Heart Association 2017 Scientific Sessions and simultaneously published in the Lancet showed that the magnitude of the reduction in C-reactive protein following a…
New High Blood Pressure Guidelines
The wait is finally over: the high blood pressure guidelines that have been in the works for the past 3 years saw the light of day at the American Heart Association (AHA) 2017 Scientific Sessions. As expected, after the findings of the SPRINT trial and other recently published studies, the treatment goal was lowered and is…
FOURIER: Evolocumab Found Beneficial for Patients with Peripheral Vascular Disease of Prior MI
Patients with peripheral vascular disease or prior acute myocardial infarction (especially within the first two years after the event) could find a particular benefit the PCSK9 receptor inhibitor evolocumab. Given its high cost, the drug is not yet cost/effective and when prescribed, most patients were no table to complete the treatment. Read also: “Missed Opportunities with…
FOURIER: Efficacy of Evolocumab for Ultra-Low LDL Levels
It seems that a LDL level of 70 mg/dL is no longer low enough for high-risk secondary patients; in consequence, this study attempted to set a new target, one that appears almost impossible to reach: 40 mg/dL or lower. This study, simultaneously presented at the European Society of Cardiology Congress 2017 and published in The Lancet, showed…
CANTOS: Anti-inflammatory Drug Canakinumab Seems to Reduce CV Events
This human monoclonal antibody that specifically targets inflammatory cells seems to reduce cardiovascular events when associated with optimal medical therapy, according to a new study presented at the European Society of Cardiology Congress and published simultaneously in the New England Journal of Medicine. The CANTOS trial enrolled 10,061 patients with a previous infarction and high C-reactive…
Are 7 Fr Dedicated Transradial Introducers Safe?
Courtesy of Dr. Carlos Fava. The transradial approach has been proven beneficial for quite some time now, but certain scenarios require the use of a 7 Fr or 8 Fr introducer, which is a great limitation. This study included 60 patients who underwent complex angioplasty with the help of 7 Fr dedicated transradial (TR) introducer Glidesheath Slender (Terumo, Tokyo,…
When to Indicate Statin Therapy
The use of non-invasive imaging can identify or rule out subclinical atheromatosis and help reduce the number of elderly patients unnecessarily treated with statins without increasing the risk of cardiovascular events. Using calcium score and carotid ECG to find elderly patients without atheromatosis helps to safely avoid the use of statins with no clinical…
Beta-Blockers for Revascularized Patients: To Prescribe or Not?
This study examines predictors and outcomes associated with the prescription of beta-blockers at discharge after a successful coronary angioplasty in patients with stable chronic angina WITHOUT prior history of acute myocardial infarction or heart failure. The benefit of beta-blockers in patients with acute myocardial infarction or systolic heart failure is well documented. However, their…