Existing practice surrounding many cardiovascular medications, including anti-hypertensive and lipid-lowering agents, is based on the evaluation of response to therapy. In cases where ideal therapeutic targets (which have been identified through several previous studies) are not met in the single individual, there is evidence to support the need to intensify standard treatment so as to achieve better control of the cardiovascular risk factor under treatment (e.g. blood pressure or cholesterol levels) as this translates into a better outcome.
Body
REGENT is a multicenter, randomized trial for comparison of intracoronary infusion of bone marrow-derived unselected mononuclear cells (MNC) and selected CD34+CXCR4+ cells in 200 patients with acute myocardial infarction and reduced LVEF ≤ 40%.
Primary end-point was change of LV ejection fraction (LVEF) and volumes measured by MRI before and 6 months after the procedure.
A twelve month study of treatment with darapladib concluded that, Lp-PLA2 inhibition with darapladib prevented necrotic core expansion, a key determinant of plaque vulnerability. These findings suggest that Lp-PLA2 inhibition may represent a novel therapeutic approach. In contrast, despite adherence to a high level of standard of care treatment, necrotic core continued to expand among patients receiving a placebo.
Professor Dan Atar, the Coordinating Investigator of the F.I.R.E. (FX06 In ischemia and REperfusion) trial, a Phase II clinical study of FX06, will present the results of the trial at 12-noon on September 2nd in the Hot Line III Session at the European Society of Cardiology Congress in Munich, Germany.
Munich, Germany, Tuesday 2 September 2008 :
While the results of the study did not show a statistically significant difference in ischemic events among any of the four doses of apixaban evaluated, trends emerged that support further study, according to researchers at the Duke Clinical Research Institute.
Munich, Germany, Tuesday 2 September 2008:
The guidelines are developed through a rigorous process involving a task force of 15 experts in the field and a review committee of 21 international authorities.
The 2008 ESC guidelines cover for the first time both acute and chronic heart failure. Indeed, the guidelines have built upon the realisation that patients with acute heart failure often develop chronic problems and likewise, those with chronic heart failure, often suffer from acute illness.
Munich, Germany, Tuesday 2 September 2008:
Compared to the 2003 guidelines, important new recommendations have been formulated regarding:
Parents expect to pass on their eye or hair color, their knobby knees or their big feet to their children through their genes. But they don't expect to pass on viruses through those same genes.
Affecting eight percent of America's population, diabetes can lead to blindness, kidney failure, strokes and heart disease. Thanks to Tel Aviv University researchers, a new cure –– based on advances in cell therapy –– may be within reach.
Prof. Shimon Efrat from TAU's Sackler Faculty of Medicine, whose research group is among world leaders in beta cell expansion, has developed a way to cultivate cells derived from insulin-producing beta cells from human tissue in the laboratory. It may be possible to implant these new healthy cells into patients with type 1 diabetes.
The need for long term studies to establish the best means of treating Diabetes, was underlined by Prof John Cleland from the University of Hull at the ESC Congress in Munich. Prof Cleland listed the latest treatment available for patients and voiced his concern about the side-effects and efficacy of available anti-diabetic drugs.
Treating Patients with Diabetes Mellitus
Current experiences with one of the two CE Marked devices, the CoreValve ReValving® System for Percutaneous Aortic Valve Replacement (PAVR) have proved to be an overall success. This device consists of a porcine pericardial valve prosthesis mounted on a self-expanding Nitonol frame, which is delivered by means of an 18 French size (6mm) catheter.
Transapical access is based on decades of clinical experience with de-airing the heart, through the tip (apex) of the left ventricle, during routine cardiac surgical interventions. Insertion of a catheter and later-on closure through the apex is possible in a relatively uncomplicated manner. An anterolateral minithoracotomy is a simple and standardized access to the apex. It is applicable in almost all patients and they can be extubated soon afterwards. This procedure can even be performed without intubation under regional anaesthesia in some patients.
In recent years, much attention has been given to depression following heart attack and its effects on prognosis. Several large scale studies have been undertaken (ENRICHD, SADHART, MIND-IT, CREATE) in which depression was targeted. Although we hoped that treating depression would result in an improved prognosis, these studies have not provided much evidence to support this position: effects on depression itself have been minor and did not translate into cardiovascular benefits.
Conversely, lifestyle, diabetes, dyslipidemia, cigarette smoking and hypertension contribute to most of the population-attributable risk in the large, international INTERHEART study of acute myocardial infarction (heart attacks). The identification of single gene disorders may pave the way to a better understanding of complex metabolic pathways. Understanding the genes that regulate high density lipoprotein (HDL) metabolism may lead to novel therapeutic approaches. This has been emphasized by two therapeutic approaches for the treatment of CAD:
According to recent evidence school-based intervention programmes provide the best results for reducing prevalence of childhood overweight and obesity if they are performed with involvement of stakeholders and political support. In this context physical activity education in schools, reducing television viewing and nutritional education are examples of interventions that have been successful. Reducing the consumption of sugar-added drinks has significant beneficial effects on weight development.