Cardiology

Every physician knows that a “magic pill” that would safely and effectively prevent dementia has eluded the multiple and expensive efforts of the world’s greatest pharmaceutical companies. A new study offers a ray of hope on this front.

Smoking can increase cholesterol, triglycerides, and LDL while decreasing HDL.

Artificial sweeteners are associated with both weight gain and weight loss and a counterintuitive effect on human physiology.

PCI is not recommended for asymptomatic adults who are highly functional and report no exercise-induced symptoms.

Bleeding risk is increased in patients receiving oral anticoagulation and concomitant aspirin.

Feeling cheerful, relaxed, energetic, and satisfied with life can reduce the chances of a myocardial infarction in patients who have early-onset coronary artery disease.

Incidence of CHD was more than double in twins diagnosed with PTSD than those without the disorder.

All-cause mortality was 80% lower among subjects who maintained normal weight, ate moderately, exercised, and did not smoke compared with those who followed none of these habits.

Oral apixaban for acute VTE was superior to enoxaparin followed by warfarin.

Novel anticoagulants have a half life much shorter than warfarin and so adherence and medication error are significant issues.

Oral anticoagulation with rivaroxaban must continue while initiating a switch to warfarin. Duration of overlap will be variable.

The “infectious” hypothesis of atherosclerosis (including bacterial and viral etiologies) may have new support.

Simvastatin 40 mg once daily can attenuate increases in cardiorespiratory fitness in response to exercise training.

New oral anticoagulants require careful initiation and follow-up. A new guide is offered by the European Heart Rhythm Association.

HAS-BLED, HEMORRHAGES, OBRI: Risk calculators to assess potential for bleeding in AF patients before anticoagulation.

Periprocedural dabigatran increases the risk of bleeding and thromboembolic complications compared with warfarin during radiofrequency ablation of AF.

Among the NSAIDs used for relieving the pain of inflammatory arthritis, naproxen may have the best benefit to risk ratio on cardiovascular disease.

Among many considerations when ordering or interpreting a stress test are the limitations and adequacy of the stress modality (exercise, vasodilator, ionotrope) as well as the imaging modality used. Here, top-line reminders for primary care practice.

Aldosterone antagonists, eg, eplerenone, decrease adverse cardiovascular outcomes in patients with HF and AF.

Colesevelam helps reduce serum glucose levels and also lowers LDL-C in patients with type 2 diabetes. Bromocriptine reduces the relative risk of cardiovascular events in patients with type 2 diabetes.

Metformin and the class of sulfonylureas are the "work horses" of therapy for type 2 diabetes. Metformin even confers some protection from vascular complications. But, how do they stack up against newer agents? Here, a closer look.

Every-other-day dosing, especially of statins with longer half-lives is shown to preserve lipid-lowering benefits.

CD4+ count and viral load were complementary and were independently associated with increased incidence of AF.

Recommendations consider the whole patient, the spectrum of risks and complications for the patient, and evidence-based approaches to treatment.

Lp(a) is an LDL-like particle that exists in plasma in the VLDL range; its density lies between that of LDL and HDL. Lp(a) increases CV risk.