Conclusions Carotid endarterectomy was found to be superior to carotid artery stenting for short term outcomes but the difference was not significant for intermediate term outcomes; this difference was mainly driven by non-disabling stroke. Significantly fewer cranial nerve injuries and myocardial infarctions occurred with carotid artery stenting.
After a Stroke, High Risk for a Recurrence – BusinessWeek
For the study, published in the Feb. 16 issue of Neurology, Feng’s team collected data on almost 10,400 people in South Carolina who’d had a stroke.
They found that 25 percent of those who had a stroke died within a year, and eight percent had another stroke within a year of their first stroke.
After one year, the risk for another stroke or death continued to rise, the researchers found, with about 18 percent having had another stroke within four years. In that time, about six percent had a heart attack and 41 percent had died from any cause, including 27 percent whose deaths were attributed to a stroke or heart attack.
“Celebratory” of course refers to the practice of some insurance company underwriting departments to allow non-tobacco rates for applicants with occasional use of cigars and pipes.
Cigars, Pipes No ‘Healthy’ Alternative to Cigarettes – BusinessWeek
The study results show clearly that cigar and pipe smokers are exposed to toxins and run the risk of developing chronic obstructive pulmonary disease (COPD), a progressive destruction of airways than can be crippling. Emphysema and chronic obstructive bronchitis are the two major forms of COPD, which is a leading cause of death among U.S. adults.
Persistent Favorable Trends in Cancer Mortality Rates in Europe
Overall cancer mortality rates in the European Union decreased by 9% in men and 8% in women from 1990 to 1994 and from 2000 to 2004.
Overlapping use of tamoxifen and the antidepressant paroxetine (Paxil) significantly increases the risk of breast cancer mortality, data from a large cohort of breast cancer patients showed.
The excess breast-cancer mortality risk ranged as high as 91%, depending on the duration of simultaneous use, researchers reported online in BMJ.
Oops.
Contrary to guidelines, the absence of coronary artery calcium doesn’t rule out coronary artery disease in symptomatic patients, researchers found in a new study.
In a multicenter clinical trial, 19% of patients with a coronary calcium score of 0 had stenosis of at least 50% in one or more coronary artery segments, according to Carlos E. Rochitte, MD, of the University of São Paulo, Brazil, and colleagues.
Likewise, 20% of vessels seen to be totally occluded on revascularization had no calcium on scans, they reported in the Feb. 16 issue of the Journal of the American College of Cardiology.
“The absence of coronary calcification should not be used as a gatekeeper and should not prevent a symptomatic patient from undergoing angiography,” the researchers wrote.
Oops.
RESULTS There were 160 deaths (24.6%) during follow-up, with 70 (43.8%) due to CVD. In Kaplan-Meier survival analysis, there was no difference in either CVD or all-cause mortality in aspirin users versus nonusers (P = 0.52 and 0.94, respectively, by log-rank test). After adjustment for significant variables in the most parsimonious Cox models, regular aspirin use at baseline independently predicted reduced CVD and all-cause mortality (hazard ratio [HR] 0.30 [95% CI 0.09–0.95] and 0.53 [0.28–0.98[, respectively; P ≤ 0.044). In subgroup analyses, aspirin use was independently associated with reduced all-cause mortality in those aged ≥65 years and men.
CONCLUSIONS Regular low-dose aspirin may reduce all-cause and CVD mortality in a primary prevention setting in type 2 diabetes. All-cause mortality reductions are greatest in men and in those aged ≥65 years. The present observational data support recommendations that aspirin should be used in primary CVD prevention in all but the lowest risk patients.
CONCLUSIONS Increased CIMT was significantly related to the presence and extent of abnormal myocardial perfusion. Assessment of CIMT may be useful to identify asymptomatic patients with type 2 diabetes at higher risk for CAD.
RESULTS Increased CIMT was an independent predictor of the extent of abnormal perfusion (P < 0.001). In patients with increased CIMT as compared with patients with normal CIMT, abnormal perfusion (75 vs. 9%) and severely abnormal perfusion (28 vs. 3%) were observed more frequently.
Androgen deprivation therapy (ADT) for prostate cancer can exacerbate cardiac risk factors and may increase the risk of heart attack and cardiac death, according to an advisory supported by four medical organizations.
The three-year risk of death, heart attack, and kidney failure was markedly increased in patients with baseline proteinuria, regardless of their estimated glomerular filtration rate (eGFR), researchers said.
In a population-based study of nearly 1 million people, mortality was approximately doubled with heavy proteinuria among individuals stratified according to their eGFR, reported Brenda R. Hemmelgarn, MD, PhD, of the University of Calgary in Canada, and colleagues.
Rates of myocardial infarction were increased by about 50% with heavy proteinuria, and end-stage renal disease and doubled levels of serum creatinine were as much as 30 times more common, the researchers reported in the Feb. 3 issue of the Journal of the American Medical Association.
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