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Cardiovascular disease management

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https://www.readbyqxmd.com/read/28431138/cardiovascular-outcome-trials-in-patients-with-chronic-kidney-disease-challenges-associated-with-selection-of-patients-and-endpoints
#1
Patrick Rossignol, Rajiv Agarwal, Bernard Canaud, Alan Charney, Gilles Chatellier, Jonathan C Craig, William C Cushman, Ronald T Gansevoort, Bengt Fellström, Dahlia Garza, Nicolas Guzman, Frank A Holtkamp, Gerard M London, Ziad A Massy, Alexandre Mebazaa, Peter G M Mol, Marc A Pfeffer, Yves Rosenberg, Luis M Ruilope, Jonathan Seltzer, Amil M Shah, Salim Shah, Bhupinder Singh, Bergur V Stefánsson, Norman Stockbridge, Wendy Gattis Stough, Kristian Thygesen, Michael Walsh, Christoph Wanner, David G Warnock, Christopher S Wilcox, Janet Wittes, Bertram Pitt, Aliza Thompson, Faiez Zannad
Although cardiovascular disease is a major health burden for patients with chronic kidney disease, most cardiovascular outcome trials have excluded patients with advanced chronic kidney disease. Moreover, the major cardiovascular outcome trials that have been conducted in patients with end-stage renal disease have not demonstrated a treatment benefit. Thus, clinicians have limited evidence to guide the management of cardiovascular disease in patients with chronic kidney disease, particularly those on dialysis...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28429651/time-to-improve-statin-prescription-guidelines-in-low-risk-patients
#2
Jan W Balder, Jeroen K de Vries, Douwe J Mulder, Pieter W Kamphuisen
Background The challenge of the primary prevention of cardiovascular disease (CVD) is to identify patients who would benefit from treatment with statins. Statins are currently prescribed to many patients, even those at a low 10-year risk of CVD. These latter patients may not be eligible for statins according to current guidelines. Design This study investigated the prescription of guideline-consistent (according to guidelines) and guideline-inconsistent (not according to guidelines) lipid-lowering treatment in primary prevention in a large contemporary Dutch cohort study (Lifelines)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28429577/investigating-general-medication-prescription-by-general-practitioners-during-a-12-month-randomized-controlled-weight-loss-trial
#3
N R Fuller, N S Lau, T P Markovic, I D Caterson
Much healthcare expenditure is on pharmaceutical drugs. Expenditure on medications has increased both in absolute terms, and as a proportion of total health expenditure. No previous studies have investigated the prescribing costs by general practitioners when managing patients during a weight loss intervention. This study evaluated the medication costs by individual class during a 1-year study in which 268 participants were randomized to one of two weight loss programmes, either standard care (SC) as defined by national guidelines, or a commercial provider (Weight Watchers) (CP)...
April 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/28429545/do-the-benefits-of-using-calcitriol-and-other-vitamin-d-receptor-activators-in-patients-with-chronic-kidney-disease-outweigh-the-harms
#4
Nigel D Toussaint, Matthew J Damasiewicz
The primary indication for administration of calcitriol or other vitamin D receptor activators (VDRA) in chronic kidney disease (CKD) is secondary hyperparathyroidism (SHPT). Prevention and treatment of SHPT appears important, as imbalances in mineral metabolism are associated with renal osteodystrophy, and higher parathyroid hormone (PTH) levels are associated with increased rates of mortality and morbidity in CKD patients. There is, however, a lack of controlled trial data that show lowering PTH with calcitriol/VDRA equates to improved clinical outcomes...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429032/obstructive-sleep-apnoea-and-type-2-diabetes-mellitus-are-they-connected
#5
Yingjuan Mok, Chee Wei Tan, Hang Siang Wong, Choon How How, Kah Leong Alvin Tan, Pon Poh Hsu
Obstructive sleep apnoea (OSA), a sleep-related breathing condition, is diagnosed based on a patient's apnoea-hypopnea index from a sleep study, and the presence or absence of symptoms. Diabetes mellitus (DM) and OSA share a significant common risk factor, obesity, with all three conditions contributing to the risk of developing cardiovascular diseases. The pathophysiological links between OSA and DM are still unclear, but intermittent hypoxia may be an important mechanism. More awareness of the possible link between OSA and DM is needed, given their increasing prevalence locally and worldwide...
April 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28427339/cardiovascular-disease-risk-among-chinese-antiretroviral-na%C3%A3-ve-adults-with-advanced-hiv-disease
#6
Fuping Guo, Evelyn Hsieh, Wei Lv, Yang Han, Jing Xie, Yanling Li, Xiaojing Song, Taisheng Li
BACKGROUND: Cardiovascular disease (CVD) is an important cause of mortality among HIV-infected patients, however little is known about the burden of CVD among this population in Asia. We sought to quantify prevalence of CVD risk factors, 10-year CVD risk, and patterns of CVD risk factor treatment in a group of individuals with HIV in China. METHODS: We retrospectively analyzed baseline data from treatment-naïve HIV-infected adults enrolled in two multicenter clinical trials in China...
April 20, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28427291/antioxidant-therapy-for-management-of-oxidative-stress-induced-hypertension
#7
Khalil Ali Ahmad, Dai Yuan Yuan, Waqas Nawaz, Hong Ze, Chen Xue Zhuo, Bashar Talal, Abdoh Taleb, Enos Mais, Ding Qilong
Hypertension is considered as the most common risk factor for cardiovascular diseases, also is regarded as a leading cause of the mortality and morbidity worldwide. The mechanisms underlying the pathological process of hypertension are not completely explained. However, there is growing evidence that increased oxidative stress plays an important role in the pathophysiology of hypertension. Several preclinical studies and clinical trials have indicated that antioxidant therapy is important for management of hypertension, using antioxidants compounds such as alpha tocopherol (Vit E) and ascorbic acid (Vit C), polyphenols with others and some antihypertensive drugs that are now in clinical use (e...
April 20, 2017: Free Radical Research
https://www.readbyqxmd.com/read/28426619/committee-opinion-no-698-hormone-therapy-in-primary-ovarian-insufficiency
#8
(no author information available yet)
Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426614/committee-opinion-no-698-summary-hormone-therapy-in-primary-ovarian-insufficiency
#9
(no author information available yet)
Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426470/identification-and-management-of-pleural-effusions-of-multiple-aetiologies
#10
Steven Walker, Nick Maskell
PURPOSE OF REVIEW: Historically, pleural effusions have been attributed to a single cause. There is growing recognition that a substantial proportion of pleural effusions may have more than one underlying cause. The purpose of this review is to summarise recent findings regarding the diagnosis and treatment of effusions secondary to more than one aetiology. RECENT FINDINGS: A recent prospective study identified that 30% of pleural effusions had more than one underlying aetiology...
April 19, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28425056/ischemic-heart-disease-special-considerations-in-cardio-oncology
#11
REVIEW
Dana Elena Giza, Fernando Boccalandro, Juan Lopez-Mattei, Gloria Iliescu, Kaveh Karimzad, Peter Kim, Cezar Iliescu
The interplay and balance between the competing morbidity and mortality of cardiovascular diseases and cancer have a significant impact on both short- and long-term health outcomes of patients who survived cancer or are being treated for cancer. Ischemic heart disease in patients with cancer or caused by cancer therapy is a clinical problem of emerging importance. Prompt recognition and optimum management of ischemic heart disease mean that patients with cancer can successfully receive therapies to treat their malignancy and reduce morbidity and mortality due to cardiovascular disease...
May 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28424040/challenges-of-takayasu-arteritis-in-pregnancy-a-case-report
#12
Sarah Soo-Hoo, Jenny Seong, Brandon R Porten, Nedaa Skeik
Takayasu arteritis is a rare, chronic vasculitis of unknown etiology characterized by inflammation of the aorta and its main branches. Although Takayasu arteritis mostly affects women of childbearing age, there is a paucity in the literature on pregnancy associated with Takayasu arteritis. Pregnant patients are at increased risk of cardiovascular complications, including hypertension and congestive heart failure, which may jeopardize both maternal and fetal outcomes. Furthermore, optimal management has not yet been established for pregnant patients with Takayasu arteritis, posing a clinical challenge...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28423226/rvx-208-a-novel-bet-protein-inhibitor-role-as-an-inducer-of-apo-a-i-hdl-and-beyond
#13
Gopal C Ghosh, Rajarshi Bhadra, Raktim K Ghosh, Kinjal Banerjee, Anjan Gupta
Low density cholesterol (LDL) has been the prime target of currently available lipid-lowering therapies although current research is expanding the focus beyond LDL lowering and has included high density cholesterol (HDL) also as the target. Bromo and extra-terminal (BET) proteins are implicated in the regulation of transcription of several regulatory genes and regulation of pro-inflammatory pathways. As atherosclerosis is an inflammatory pathway and studies showed that BET inhibition has a role in inhibiting inflammation, the concept of BET inhibition came in the field of atherosclerosis...
April 19, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28422968/the-impact-of-a-point-of-care-testing-device-on-cvd-risk-assessment-completion-in-new-zealand-primary-care-practice-a-cluster-randomised-controlled-trial-and-qualitative-investigation
#14
Sue Wells, Natasha Rafter, Timothy Kenealy, Geoff Herd, Kyle Eggleton, Rose Lightfoot, Kim Arcus, Angela Wadham, Yannan Jiang, Chris Bullen
OBJECTIVES: To assess the effect of a point of care (POC) device for testing lipids and HbA1c in addition to testing by community laboratory facilities (usual practice) on the completion of cardiovascular disease (CVD) risk assessments in general practice. METHODS: We conducted a pragmatic, cluster randomised controlled trial in 20 New Zealand general practices stratified by size and rurality and randomised to POC device plus usual practice or usual practice alone (controls)...
2017: PloS One
https://www.readbyqxmd.com/read/28421812/the-frequency-of-incidental-findings-and-subsequent-evaluation-in-low-dose-ct-scans-for-lung-cancer-screening
#15
Lillie Morgan, Humberto Choi, Michal Reid, Ali Khawaja, Peter J Mazzone
RATIONALE: The USPSTF recommends lung cancer screening with low-dose chest CT scans (LDCT) for a well-defined high-risk population. Data on the frequency and impact of incidental findings on LDCT scans performed within a centralized lung cancer screening program has not been reported. OBJECTIVES: Previous studies have reported IFs in the setting of clinical trials. We present our findings in a real clinical setting where the decision to manage these findings may depend on factors that are not captured in a research trial such as disclosing IFs, patient preferences, severity of comorbidities, and physician expertise...
April 19, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28420139/interplay-between-oxidative-stress-and-nutrient-sensing-signaling-in-the-developmental-origins-of-cardiovascular-disease
#16
REVIEW
You-Lin Tain, Chien-Ning Hsu
Cardiovascular disease (CVD) presents a global health burden, despite recent advances in management. CVD can originate from early life by so-called "developmental origins of health and disease" (DOHaD). Epidemiological and experimental evidence supports that early-life insults can induce programming of later CVD. Underlying the DOHaD concept, early intervention may offset programming process to prevent the development of CVD, namely reprogramming. Oxidative stress and nutrient sensing signals have been considered to be major mechanisms of cardiovascular programming, while the interplay between these two mechanisms have not been examined in detail...
April 15, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28419972/neprilysin-inhibitors-a-new-hope-to-halt-the-diabetic-cardiovascular-and-renal-complications
#17
REVIEW
Vajir Malek, Anil Bhanudas Gaikwad
Diabetes is an enormous and ever-growing calamity and a global public health threat of the 21st century. Besides insulin and oral hypoglycaemic drugs, blockage of the renin-angiotensin system (RAS) denotes a key pharmacotherapy for the management of cardiovascular (CVD) and chronic kidney diseases (CKD), which are the leading causes of disability and death among diabetic patients. Neprilysin (NEP) inhibition, auxiliary to RAS blockage increases the bioavailability of natriuretic peptides and benefits the cardio-renal system...
April 15, 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28419565/evolution-of-silent-myocardial-ischaemia-prevalence-and-cardiovascular-disease-risk-factor-management-in-type-2-diabetes-over-a-10-year-period-an-observational-study
#18
A Sultan, F Perriard, V Macioce, D Mariano-Goulart, C Boegner, J-P Daures, A Avignon
AIMS: To assess the evolution of silent myocardial ischaemia prevalence and of cardiovascular disease risk factor management over 10 years in people with Type 2 diabetes. METHODS: This repeated cross-sectional study prospectively included 770 people with Type 2 diabetes who presented at our centre in the period 1999-2009. All had at least one additional cardiovascular disease risk factor, no history of coronary disease and were screened for silent myocardial ischaemia using myocardial perfusion imaging...
April 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28418691/editor-s-choice-the-organization-of-chest-pain-units-position-statement-of-the-acute-cardiovascular-care-association
#19
Marc J Claeys, Ingo Ahrens, Peter Sinnaeve, Roberto Diletti, Roberta Rossini, Patrick Goldstein, Kasia Czerwińska, Héctor Bueno, Maddalena Lettino, Thomas Münzel, Uwe Zeymer
Chest pain units are defined as organizational short stay units with specific management protocols designed to facilitate and optimize the diagnosis of patients presenting with chest pain in the emergency department. The present document is intended to standardize and facilitate the installation of chest pain units nearby to the emergency department or as an integral part of the emergency department. Recommendations on organizational structure, physical and technical requirements and on disease management are presented...
April 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28416830/-analysis-on-the-causes-of-unscheduled-suspensions-of-knee-and-hip-arthroplasty
#20
Y Li, Z J Li, K Zhang, H Tian, Y Q Liu, H Cai, F Li, M W Zhao
OBJECTIVE: To analyze and summarize the causes of unscheduled suspension of knee and hip arthroplasty and to provide the method for optimizing the patient's preoperative management and improving the efficiency of medical resources as well as the patient's satisfaction. METHODS: The data for this report was retrospectively collected from September 2013 to August 2014 in our hospital, from cases of knee and hip arthroplasty that were suspended before the scheduled operation time...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
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