Cardiovascular News – November, 2020
DMS Cardiovascular news is a curated collection of articles, posts & studies related to general & interventional cardiology, cardiovascular & heart health that I found interesting and may be of help or interest to others. All articles are published on reliable and respected sources cited with links to read the original full article.
Report on latest menopause science looks at heart risks
The most recent data on the years just before menopause – a time when cardiovascular risks accelerate – includes a look at the timing of hormone replacement therapy, the age when menopause begins and the lifestyle factors that affect a woman's risk during that time.
Also discussed are:
- Importance of health monitoring
- Life phases from reproductive to non-reproductive phases and related changes
- Cardiovascular benefits of combination hormone replacement therapies
- AHA Scientific Statement published in AHA Journal Circulation
Can Coronary Artery Calcium Scores Help to Personalize Risk Assessment and Tailor Treatment in Familial Hypercholesterolemia?
Heterozygous familial hypercholesterolemia (HeFH) is one of the most common genetic conditions associated with premature atherosclerotic cardiovascular disease (ASCVD) and is vastly underdiagnosed and undertreated.
Heterogeneity in ASCVD risk in patients with HeFH suggests an opportunity and need to tailor the treatment strategy using clinical data beyond LDL-C.
CAC testing may be able to further clarify the heterogeneity in ASCVD risk among FH patients and identify those who would derive the largest benefit from non-statin therapies.
Also discussed are:
- Heterogeneity in HeFH
- Potential for Personalization of FH Care with CAC
The Role of Diet in Regulating Inflammation & Heart Failure
- The Journal of Nutrition: A New Dietary Inflammatory Index Predicts Interval Changes in Serum High-Sensitivity C-Reactive Protein1–3
- A Potpurri of Physiologic & Psychosocial Factors Predicting CVD Outcomes: Scientific Sessions: P1574 - Proinflammatory Diet Independently Predicts Shorter Event-free Survival in Patients With Heart Failure
Typical Teen Diet of Ultra Processed Foods Increases Risk of Heart Disease
- Lifestyle & Behavioral Medicine - Nutrition: Novel Insights & Controversies AHA Journals: Abstract 10611: Association Between Ultra-Processed Food Intake and Cardiovascular Health Among US Adults: NHANES 2011-2016
- Nutrition Lifestyle & Cardiometabolic Health Epidemiology - Scientific Sessions AHA P1053: Association Between Ultra-processed Food Intake and Cardiovascular Health Among Us Adolescents: Nhanes 2007-2016
Many Patients With Type 2 MI Don't Get Cardiologist Evaluation
- Risk of recurrent cardiovascular events
- Hospital processed and management related to the risk of recurrent events
- A study published in the AHA Journal Circulation on Nov 9 - Cardiologist Evaluation of Patients with Type 2 Myocardial Infarction
Conclusion:
Conditions that can promote the culprit oxygen demand-supply mismatch can include sepsis, pneumonia, anemia, hypoxia, hypertension, and bleeding, along with cardiac issues such as atrial fibrillation.
So patients with type 2 MI tend to be "a broadly heterogeneous group," and it helps to consider that when trying to arrive at a diagnosis, Newby said. It also means that they may well not be seen as primarily cardiac patients, perhaps making cardiologist involvement less likely.
Combined OCT, Cardiac MRI Unravels Root Cause in Most MINOCA
Optical CT (OCT) plus cardiac MRI (CMR) provides a more specific diagnosis in the majority of women presenting with myocardial infarction with nonobstructive coronary arteries (MINOCA).
The multimodal imaging strategy identified the underlying cause of MINOCA in 85% of women in the HARP-MINOCA study. Overall, 64% of women had a true MI and 21% had an alternate nonischemic diagnosis, most commonly myocarditis.
- MINOCA occurs in 15% of patients with MI
- MINOCA is three times more common in women than men and disproportionately affects Black, Hispanic, Maori, and Pacific ethnicities.
- As part of the Women's Heart Attack Research (HARP) program, patients underwent OCT, followed by CMR within 1 week of the acute presentation.
Conclusion:
When the OCT and CMR results were combined, a cause of MINOCA was identified in 84.5% of women. Three-fourths of the causes were ischemic (64% MI) and one-quarter were nonischemic (15% myocarditis, 3% Takotsubo syndrome, and 3% nonischemic cardiomyopathy). In the remaining 15%, no cause of MINOCA was identified.
Do you have questions about a medical case or need help understanding treatment plans and options?
Health & Patient Advocacy | Medical Case Review
Medical Expert Witness
Dalawari Medical Services - Medical Consulting
Click here to Contact Us via email or Call + (804)-991-4109