Top Cardiology News of 2011

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1. ARISTOTLE trial: new oral factor Xa inhibitor apixaban is better than warfarin in atrial fibrillation (AF) patients.
2. British scientists have reported that it may be possible for the heart to repair itself after injury, and they have discovered a protein molecule that seems to stimulate this process [Dr Peter Weissberg, medical director of the British Heart Foundation]. The cells that are capable of this healing are already there in the epicardium.
3. Cholesteryl ester transfer protein (CETP) inhibitor dalcetrapib) raised HDL-cholesterol levels without increasing blood pressure and without impairing endothelial function. [dal-VESSEL trial]
4. The FDA is recommending that physicians restrict prescribing high-dose simvastatin (Zocor, Merck) to patients, given an increased risk of muscle damage . The new FDA drug safety communication, states that physicians should limit using the 80-mg dose unless the patient has already been taking the drug for 12 months and there is no evidence of myopathy. Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug. The new label has warnings not to use the drug with various medications, including itraconazole , ketoconazole, posaconazole , erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, nefazodone, gemfibrozil, cyclosporine, and danazol. In addition, the 10-mg dose should not be exceeded in patients taking amiodarone, verapamil, and diltiazem, and the 20-mg dose should not be exceeded with amlodipine and ranolazine.
5. A trial of high-dose extended-release niacin given in addition to statin therapy in patients with a history of cardiovascular disease, high triglycerides (TG), and low levels of HDL cholesterol has been halted prematurely, 18 months ahead of schedule, because niacin offered no additional benefits in this patient population [AIM-HIGH].
6. New reports of two elderly women faring badly when taking the novel anticoagulant dabigatran for stroke prevention in atrial fibrillation (AF) have prompted more discussion about the caution needed with this drug when treating the very old or those with renal impairment.
7. Sanofi-Aventis has sent US healthcare professionals a letter warning them about cases of rare but severe hepatic injury associated with use of the anti arrhythmic drug dronedarone. The FDA has also issued a “safety communication”.
8. A new Cochrane review has provoked controversy by concluding that there is not enough evidence to recommend the widespread use of statins in the primary prevention of heart disease [Dr Fiona Taylor at London School of Hygiene and Tropical Medicine, UK]
9. New data help shed light on the malpractice risk physicians face in clinical practice. Cardiologists have a higher-than-average risk of being sued, but these lawsuits are less likely to result in a financial payment to plaintiffs. The surgical specialties face the largest threat of litigation, with approximately 20% of neurosurgeons and cardiothoracic surgeons facing a malpractice claim each year. Pediatricians and psychiatrists had the lowest risk of being sued [Dr Amitabh Chandra (Harvard University, Boston].
10. Arrhythmia-free survival rates after a single catheter-ablation procedure are relatively low at five years, just 29%, but the long-term success increases to 63% when outcomes are measured after the last ablation procedure [Dr Rukshen Weerasooriya Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France].

Top Health Stories Of The Year (CNN)

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1. A congresswoman’s recovery: In January shots rang out in a grocery store in Tucson, Arizona. U.S. Rep. Gabrielle Giffords, 40, had been shot in the head by a gunman. The bullet passed through the left side of Gifford’s brain, but she survived.
2. Nuclear fears in Japan: An 9.0-magnitude earthquake, the most powerful one to hit Japan in recorded history, led to a tsunami that engulfed parts of Honshu. It also started a meltdown at the Fukushima Daiichi’s nuclear facility in northeast Japan. Subsequent tests have detected radiation in a sample of people who live around the power plant.
3. WHO warns of possible cancer risk from cell phones: While there are no definitive studies, the warning gave people pause about cell phone use.
4. Tainted fruit: A listeria outbreak in cantaloupe killed 29 people and sickened nearly 150 in the United States, making this year’s outbreak the deadliest for listeria.
5. Prostate cancer screening controversy: The question of whether prostate-specific antigen tests for prostate cancer do more harm than good stirred controversy this year. The U.S. Preventive Services Task Force gave the PSA test a “D” rating, meaning it offers “no net benefit or that the harms outweigh the benefits.”
6. Cancer’s toll: Cancer claimed the lives of several luminaries this year: tech innovator Steve Jobs (pancreatic cancer), author Christopher Hitchens (esophageal cancer) and former heavyweight champion Joe Frazier (liver cancer).
7. 30 years of HIV/AIDS:The first report of the disease appeared on June 5, 1981, in the Center for Disease Control’s Morbidity and Mortality Weekly Report.
8. Head injuries: The toll of repeated head blows and injuries loomed over football again. One former football player killed himself after leaving a message telling his family to get his brain to the NFL brain bank. An examination of his brain showed that he had signs of a brain disease found in athletes who have been exposed to repeated brain trauma.

Top 10 cardiology myths as defines by AHA

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  1. I’m too young to worry about heart disease. Even young and middle-aged people can develop heart problems – especially now that obesity, type 2 diabetes and other risk factors are becoming more common at a younger age.
  2. I’d know if I had high blood pressure because there would be warning signs. High blood pressure is called the “silent killer” because you don’t usually know you have it. Early treatment of high blood pressure is critical because, if left untreated, it can cause heart attack, stroke, kidney damage and other serious health problems.
  3. I’ll know when I’m having a heart attack because I’ll have chest pain. A heart attack may cause subtle symptoms. These include shortness of breath, nausea, feeling lightheaded, and pain or discomfort in one or both arms, the jaw, neck or back.
  4. Diabetes won’t threaten my heart as long as I take my medication. Even when blood sugar levels are under control, you’re still at increased risk for heart disease and stroke.  The risk factors that contribute to diabetes onset also make you more likely to develop cardiovascular disease. These overlapping risk factors include high blood pressure, overweight and obesity, physical inactivity and smoking.
  5. Heart disease runs in my family, so there’s nothing I can do to prevent it. You can take steps to dramatically reduce your risk. Create an action plan to keep your heart healthy by tackling these to-dos: get active; control cholesterol; eat better; manage blood pressure; maintain a healthy weight; control blood sugar; and stop smoking.
  6. I don’t need to have my cholesterol checked until I’m middle-aged. The American Heart Association recommends you start getting your cholesterol checked at age 20. It’s a good idea to start having a cholesterol test even earlier if your family has a history of heart disease.
  7. Heart failure means the heart stops beating. The heart suddenly stops beating during cardiac arrest, not heart failure.
  8. This pain in my legs must be a sign of aging. I’m sure it has nothing to do with my heart. Leg pain felt in the muscles could be a sign of a condition called peripheral artery disease.
  9. My heart is beating really fast. I must be having a heart attack. Most of the time, a change in your heartbeat is nothing to worry about. But sometimes, it can be a sign of arrhythmia, an abnormal or irregular heartbeat.
  10. I should avoid exercise after having a heart attack. No! As soon as possible, get moving with a plan approved for you.

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