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Fitness and Atrial Fibrillation

What is the relationship between cardiorespiratory fitness (CRF) and the risk of atrial fibrillation (AF)? The FIT project study group consisted of 64,561 adults (mean age, 55 years; 46% female; 64% whites) who underwent clinically indicated exercise treadmill testing (ETT). There were 4,616 new cases of AF over a median follow-up period of 5.4 years. […]

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Chemotherapy-induced cardiotoxicity: Who Will Get Chemotherapy-Induced Cardiotoxicity?

  Many of the chemotherapeutic agents in use today can have associated cardiovascular side effects, the most common of which are cardiomyopathy and heart failure (HF). Amongst the various medications, the anthracycline class of drugs (e.g., doxorubicin and epirubicin) and the human epidermal growth factor receptor type 2 (HER 2) monoclonal antibody, trastuzumab, have been […]

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Myocardial Strain Imaging by Echocardiography for the Early Detection of Chemotherapy-induced Cardiotoxicity

The mortality rate among patients with cancer has decreased over the past 20 to 30 years. However, cardiac toxicity (cardiotoxicity) from cancer therapy has become a leading cause of morbidity and mortality in survivors. In patients who develop heart failure (HF) from cancer therapy, the mortality rate is as high as 60% by 2 years. […]

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In non–ST elevation acute coronary syndrome with and without percutaneous coronary intervention, pretreatment with thienopyridines did not reduce mortality and was associated with increased risk for major bleeding

To investigate the effect of pretreatment with P2Y12 receptor inhibitors compared with no pretreatment on efficacy and safety of treatment of non-ST elevation acute coronary syndrome (ACS). The authors of this paper report the results of a pooled analysis of randomized and observational studies of pretreatment with thienopyridines (clopidogrel or prasugrel) vs no pretreatment in […]

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Antibiotic associated with increased risk for sudden death in patients taking ACE inhibitors or ARBs

  Trimethoprim/sulfamethoxazole (or co-trimoxazole) was associated with an increased risk of sudden death in older patients receiving angiotensin-converting enzyme (ACE) inhibitors or angiotensin-receptor blockers (ARBs), a study found (published online Oct. 30, 2014 by BMJ). Researchers conducted a population-based, nested, case-control study in Ontario, Canada, from April 1994 to January 2012 among patients age 66 […]

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2014 AHA/ACC Guideline for the Management of Patients with Non-ST-Elevation Acute Coronary Syndromes (NSTE-ACS): 10 Points to Remember

The new guideline emphasizes the pathophysiologic continuum of unstable angina and NSTEMI and their frequently indistinguishable clinical presentations. In terms of treatment, another notable element of the new guideline, is the recognition that while an early invasive strategy for patients with NSTE-ACS with significant coronary artery disease is generally accepted, low-risk patients can substantially benefit […]

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What Is a Normal ECG in Athletes?

Up to 60% of athletes show ECG changes, and some of these changes are often striking to look at.  The Seattle ECG criteria is often used to separate the normal from the abnormal ECG in an athlete. This is important, as many normal athletes undergo cardiac angiography and even pacemaker surgery because of misinterpretation of […]

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Colchicine for Recurrent Pericarditis

In a new trial (Lancet March 30, 2014), colchicine, was found to be safe and beneficial adjunct to nonsteroidal anti-inflammatory drugs, even in patients with multiple recurrences.  Previous trials have demonstrated the efficacy and safety of colchicine as an adjunct to conventional treatment in patients with acute pericarditis or first recurrences. To assess whether colchicine’s […]

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β blockers for Heart Failure: Which One Should You Use?

β blockers are a cornerstone of the medical management of heart failure. The long term use of certain β blockers in patients with heart failure reduces hospital admissions and improves symptoms, quality of life, and survival. However, it is still unclear whether this is a class effect or whether one β blocker is superior to […]

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Effect of ACE Inhibitors and ARBs on Cardiovascular Outcomes in Diabetes

A recent meta-analysis, published in JAMA Intern Med on March 31, 2014, analyzed the effect of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) on all-cause mortality, cardiovascular (CV) deaths, and major CV events in patients with diabetes mellitus (DM). The authors of this study included randomized clinical trials reporting the effects of ACEI […]

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