Primary PCI for Myocardial Infarction

Primary PCI for Myocardial Infarction

Bacterial persistence a risk factor for atherosclerosis

New research is showing that bacterial infections contribute to cardiovascular disease. Chronic infection may cause the process of atherosclerosis to get worse. Research study shows that the Bacillus Enterobacter hormaechei is responsible for the disease progression and bacterial persistence in the carotid artery.

Reference:

Journal of Atherosclerosis and Thrombosis.

How do omega-3 fatty acids work?

Omega-3 fatty acids (like docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA)) activate a G-protein receptor called GPR120 resulting in broad anti-inflammatory effects and improved systemic insulin sensitivity

References:

Da Young Oh, Saswata Talukdar, Eun Ju Bae, Takeshi Imamura, Hidetaka Morinaga, WuQiang Fan, Pingping Li, Wendell J. Lu, Steven M. Watkins, Jerrold M. Olefsky. GPR120 Is an Omega-3 Fatty Acid Receptor Mediating Potent Anti-inflammatory and Insulin-Sensitizing Effects. Cell,

New Atrial fibrillation Treatment Guide

Controlling the heart rate of patients provides no advantage over lenient control.

• Not a candidate for coumadin? Then clopidogrel and aspirin is recommended to prevent stroke or clots.
• Dronedarone –reduces hospitalizations for cardiovascular events but cannot be used in Stage IV ventricular dysfunction and  depressed ventricular function.
• Catheter Ablation (to maintain sinus rhythm)- a tube is inserted into a blood vessel and guided to the heart. Ablation is ideal if patients have not had success with drug treatment, don’t have severe lung disease.

References:

L. Samuel Wann, Anne B. Curtis, Craig T. January, Kenneth A. Ellenbogen, James E. Lowe, N.A. Mark Estes III, Richard L. Page, Michael D. Ezekowitz, David J. Slotwiner, Warren M. Jackman, William G. Stevenson, and Cynthia M. Tracy. 2011 ACCF/AHA/HRS Focused Update on the Management of Patients With Atrial Fibrillation (Updating the 2006 Guideline): A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation,

C/EPB-beta expression gene and cardiomyopathies

Changes in the genetics causing reduced C/EPB-beta expression raised the activity of CITED4. As a result, heart cells called cardiomyocytes increasingly divide and grow in size to similar levels of an athlete. Lowering C/EPB-beta expression protected mice from developing heart failure.

References:

Pontus Boström, Nina Mann, Jun Wu, Pablo A. Quintero, Eva R. Plovie, Daniela Panáková, Rana K. Gupta, Chunyang Xiao, Calum A. MacRae, Anthony Rosenzweig, Bruce M. Spiegelman. C/EBPβ Controls Exercise-Induced Cardiac Growth and Protects against Pathological Cardiac Remodeling. Cell

Reducing the risk of developing cardiovascular disease for people with diabetes

The ACCORD Study Group results summary:

1. Effective blood pressure control does not reduce CVD risk in people with type 2 diabetes at high risk for CVD.

2. A combination of a statin and a fibrate was no better at reducing risk than a statin alone in patients with type 2 diabetes at high risk for CVD.

3. For patients with low HDL and low triglycerides, the combination lipid therapy may be successful in reducing CVD risk in those with type 2 diabetes patients.

The ACCORD Study Group – New England Journal of Medicine, March 14,2010; N Engl J Med 2010;362:1575-85. N Engl J Med 2010; 362:1563-74. www.nejm.org;