After reading this article I remain in a state of disbelief.
F.D.A. Says Millions Got Unapproved Nitroglycerin – NYTimes.com
The problem of the unapproved tablets stems from a longstanding ambiguity about the rules for drugs whose use predates the establishment of the F.D.A. in 1938. Only one brand of nitroglycerin pills is federally approved: Nitrostat, made by Pfizer, on the market since 2000.
A proximal location significantly increases the risk of poor outcomes in peripheral arterial disease (PAD), independent of risk factors and comorbidities, a review of records on 400 patients showed.
Proximal (aortoiliac) involvement tripled the risk of cardiovascular events compared with distal disease. The findings contrast with evidence of poorer limb prognosis in patients with distal PAD, according to an article published online in the Journal of the American College of Cardiology.
Newer Blood Test Predicts Diabetes, Heart Disease – BusinessWeek
For the current study, Selvin and her colleagues measured A1C from more than 11,000 stored blood samples from the Atherosclerosis Risk in Communities Study, which began in 1990. None of the study volunteers had diabetes or cardiovascular disease at the time the blood samples were taken.
The researchers then compared the A1C levels to fasting blood sugar levels and to the 15 years of overall health follow-up information gathered for the previous study.
During that time, 2,251 people were diagnosed with diabetes, nearly 1,200 were diagnosed with heart disease and 358 people had an ischemic (non-bleeding) stroke, according to the study.
As expected, the researchers found that elevated A1C levels were associated with an increased risk of being diagnosed with diabetes. Those with an A1C of less than 5 percent had a 48 percent reduced risk of diabetes, while people whose A1Cs were between 5 and 5.5 percent had a normal risk of diabetes. From there, however, the risk quickly went up. Those with an A1C of 5.5 to 6 percent had an 86 percent increased risk of diabetes. For those between 6 and 6.5 percent, the risk more than quadrupled. For people with levels above 6.5 percent, the odds of being diagnosed were more than 16 times higher than for someone with levels under 5.5 percent. These results were similar to those for fasting glucose levels, the study authors noted.
Where fasting glucose and A1C differed greatly, however, was in the prediction of future heart disease and stroke risk. While fasting glucose failed to predict future risk, the study found that A1C levels accurately did so.
People with A1Cs under 5.5 percent had an average risk of heart disease and stroke, but for people with an A1C between 5.5 and 6 percent, the risk went up 23 percent. For those with an A1C between 6 and 6.5 percent, the risk of cardiovascular disease jumped to 78 percent. When A1C went over 6.5 percent, the risk of cardiovascular disease went up nearly twofold.
Results of the study are published in the March 4 issue of the New England Journal of Medicine.
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.
I’ve added a new link to a journal I uncovered while working on one of my projects.
http://www.thrombosisjournal.com/
A journal devoted to thrombosis. Is this cool or what?
CRP concentration has continuous associations with the risk of coronary heart disease, ischaemic stroke, vascular mortality, and death from several cancers and lung disease that are each of broadly similar size. The relevance of CRP to such a range of disorders is unclear. Associations with ischaemic vascular disease depend considerably on conventional risk factors and other markers of inflammation.
Conclusion: Strong evidence indicates that CRP is associated with CHD events. Moderate, consistent evidence suggests that adding CRP to risk prediction models among initially intermediate-risk persons improves risk stratification. However, sufficient evidence that reducing CRP levels prevents CHD events is lacking.
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