Research Highlight |
Featured
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Review Article |
Mechanical antithrombotic intervention by LAA occlusion in atrial fibrillation
Percutaneous transcatheter mechanical occlusion of the left atrial appendage (LAA) is a nonpharmacological treatment option for stroke prevention in patients with atrial fibrillation who cannot receive anticoagulant drugs. In this Review, Cheuk-Man Yu and colleagues present the rationale for LAA occlusion in patients with AF, the available occlusion devices and the clinical evidence for their use, and discuss the role of imaging techniques in device implantation and the management of procedural complications.
- Cheuk-Man Yu
- , Ahmed A. Khattab
- & Bernhard Meier
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News & Views |
Polypills for cardiovascular prevention: a step forward?
The effect of a fixed-dose combination drug strategy ('polypill') on patients' adherence to medication was analysed in a series of 2,004 individuals with, or at high risk of, cardiovascular disease in the UMPIRE study. The polypill improved adherence by >20%, but the reduction in blood-pressure and cholesterol levels was modest.
- Ginés Sanz
- & Valentin Fuster
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Correspondence |
Reasons to recommend lifestyle changes in type 2 diabetes mellitus and obesity
- Rainer Spiegel
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Research Highlight |
Does preventive PCI reduce the risk of adverse events in patients with acute STEMI?
- Bryony M. Mearns
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Research Highlight |
Vitamin D supplementation lacks benefit in systolic hypertension
- Gregory B. Lim
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Review Article |
Pharmacotherapies for lipid modification: beyond the statins
Statins are the first-line therapy for the prevention and treatment of atherosclerotic vascular disease; however, various other lipid-lowering agents can provide additional beneficial effects when to statin therapy or alternatives for patients who are intolerant to statins. In this Review, Antonio Gotto Jr and Jennifer Moon discuss the mechanisms of action, indications, and clinical data for existing pharmacotherapies for lipid modification, as well as trials of investigational agents that are being developed for cardiovascular risk reduction.
- Antonio M. Gotto Jr
- & Jennifer E. Moon
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Research Highlight |
Addition of niacin to optimal statin therapy does not affect plaque regression
- Gregory B. Lim
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Reply |
The role of fibrates in chronic kidney disease and diabetes mellitus
- Mark R. Kahn
- , Michael J. Robbins
- & Valentin Fuster
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Research Highlight |
Air pollution linked with heart-failure-related hospitalization and mortality
- Bryony M. Mearns
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Correspondence |
Lipid-lowering agents in chronic kidney disease: do fibrates have a role?
- Yuli Huang
- & Yunzhao Hu
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Research Highlight |
BNP screening and collaborative care can help to prevent heart failure
- Bryony M. Mearns
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Correspondence |
Statins for primary prevention: identifying low-risk individuals
- Yu-li Huang
- , Yi Huang
- & Yan-xian Wu
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Research Highlight |
Look AHEAD published: weight loss not linked to fewer cardiovascular events in patients with type 2 diabetes
- Bryony M. Mearns
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Review Article |
Exercise: friend or foe?
Exercise is associated with reduced long-term morbidity and mortality but, in some individuals, can transiently increase the risk of fatal or nonfatal cardiac events. In this Review, Dangardt and colleagues discuss the benefits and risks of physical activity and exercise in the general population and in patients with various forms of cardiovascular disease. Strategies to promote physical activity and improve public health are proposed.
- Frida J. Dangardt
- , William J. McKenna
- & John E. Deanfield
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Review Article |
Statins in the primary prevention of cardiovascular disease
Lipid lowering with statins for the secondary prevention of cardiovascular disease (CVD) is well established, but the use of these drugs for primary prevention is controversial. Željko Reiner expertly reviews the evidence for the use of statins, and their potential adverse effects, in individuals without a history of CVD, and discusses selection according to age, sex, and level of cardiovascular risk.
- Željko Reiner
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News & Views |
Anticoagulation for AF: can we GRASP-AF patients?
Prevention of stroke in patients with atrial fibrillation (AF) requires oral anticoagulation therapy. We discuss the clinical utility of the GRASP-AF tool to identify patients with AF who are suitable for oral anticoagulation on the basis of their stroke risk profile, and propose assessment using the CHA2DS2–VASc score.
- Deirdre A. Lane
- & Gregory Y. H. Lip
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Review Article |
Position statement of the World Heart Federation on the prevention and control of rheumatic heart disease
Rheumatic fever (RF) and rheumatic heart disease (RHD) are neglected diseases, although RHD remains the most common cardiovascular disease among the young people. This position statement is a declaration of the World Heart Federation Working Group on RF and RHD strategic goal to reduce by 25% the number of premature deaths from RF and RHD among individuals aged <25 years by the year 2025. The Working Group affirms key strategic targets, reviews barriers to RF and RHD control, and identify the actions required to change the trajectory of control for these diseases.
- Bo Remenyi
- , Jonathan Carapetis
- & Bongani M. Mayosi
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Research Highlight |
Long-term dabigatran therapy reduces the risk of recurrent venous thromboembolism
- Megan Cully
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News & Views |
Looking back at Look AHEAD—giving lifestyle a chance
The Look AHEAD trial did not show that a lifestyle modification programme aimed at weight loss could reduce the incidence of cardiovascular disease events. We attempt to address why this trial was 'negative', and emphasize that further randomized lifestyle modification trials focusing on the effects of physical activity and exercise are needed.
- Jean-Pierre Després
- & Paul Poirier
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Opinion |
Adding a life-course perspective to cardiovascular-risk communication
Current algorithms for cardiovascular-risk prediction focus on identifying individuals who are at high short-term risk of experiencing a cardiovascular event. Drs Karmali and Lloyd-Jones advocate that lifetime-risk estimation should be used as an adjunct to 10 year risk prediction, to motivate individuals who have a low short-term, but substantial lifetime, risk (such as many women and young men) to adopt healthy, preventive behaviour.
- Kunal N. Karmali
- & Donald M. Lloyd-Jones
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Review Article |
The role of nutrition and body composition in peripheral arterial disease
Preliminary evidence suggests that therapies focused on nutrition and weight loss might reduce the incidence of peripheral arterial disease (PAD), as well as ameliorate functional impairment and improve ischemic outcomes in patients with PAD. The authors summarize the available data on the effects of nutrition and anthropometric factors on PAD incidence and risk, and discuss potential nutritional strategies for the prevention and treatment of the disease.
- Diana P. Brostow
- , Alan T. Hirsch
- & Mindy S. Kurzer
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Opinion |
CVD screening in low-risk, asymptomatic adults: clinical trials needed
Despite advances in prevention of cardiovascular disease, a high proportion of cardiac events occur in asymptomatic people who do not have a high level of risk. Much remains unknown about the value of novel risk markers for the identification of candidates for primary prevention. Here, Polonsky and Greenland argue that clinical trials of these markers in asymptomatic, low-risk populations are greatly needed to determine their effectiveness.
- Tamar S. Polonsky
- & Philip Greenland
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Research Highlight |
Cost-effectiveness of cardiovascular disease prevention and management in the developing world
- Alexandra King
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News & Views |
Aspirin in primary prevention—good news and bad news
The balance of benefits and risks of aspirin in primary prevention is far less clear than in secondary prevention; further data from randomized trials of individuals at intermediate cardiovascular risk are needed. Decisions about aspirin in primary prevention should be made on a case-by-case basis, and general guidelines are not justified.
- Charles H. Hennekens
- & Colin Baigent
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Review Article |
Oral direct factor Xa inhibitors for stroke prevention in atrial fibrillation
Oral direct factor Xa inhibitors, particularly apixaban and rivaroxaban, are novel and promising alternatives to warfarin for stroke prevention in patients with atrial fibrillation. Drs Cabral and Ansell review the data from clinical trials of these drugs, and also discuss the challenges of reversing their anticoagulant effects, interactions with other medications, patient compliance, and therapeutic monitoring.
- Katherine P. Cabral
- & Jack Ansell
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Research Highlight |
Study sheds light on importance of vitamin D in patients with HF
- Gregory B. Lim
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Review Article |
Cardiogenic shock in ACS. Part 1: prediction, presentation and medical therapy
In the first of their two Reviews on cardiogenic shock in acute coronary syndromes, Stephen Westaby and colleagues discuss the evolving epidemiology of this condition, its clinical presentation, and predictors of outcome. They also explore the options for medical therapy and the potential role of therapeutic hypothermia in these patients.
- Stephen Westaby
- , Rajesh Kharbanda
- & Adrian P. Banning
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News & Views |
Convergent communicable and noncommunicable heart disease
The 2011 United Nations summit on noncommunicable diseases (of which cardiovascular diseases are the major component) heralded a new era in global health priorities and strategy. However, clinicians and health administrators alike might overlook the potential convergence of communicable and noncommunicable pathways to heart disease in individuals and communities with cardiovascular risk factors.
- Jasmine G. Lyons
- & Simon Stewart
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Research Highlight |
Registry study shows link between high testosterone and reduced CV risk
- Bryony M. Mearns
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Review Article |
Restenosis after PCI. Part 2: prevention and therapy
In the second part of their Review on restenosis after PCI, Jukema and colleagues focus on the technological advances that have fueled revolutionary changes for optimizing outcomes of coronary stenting and the prevention and treatment of in-stent restenosis.
- J. Wouter Jukema
- , Tarek A. N. Ahmed
- & Paul H. A. Quax
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Research Highlight |
Small reductions in risk factors equal big savings in health-care costs
- Alexandra King
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Research Highlight |
Salt restriction might lower blood pressure, but are there any beneficial effects on mortality?
- Gregory B. Lim
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Review Article |
Dietary factors associated with hypertension
Several dietary components contribute to the development and progression of hypertension. Dong Zhao and colleagues review the available evidence for the association of various dietary factors with blood pressure and hypertension, the dietary recommendations of national and international guidelines on hypertension prevention and management, and the outcomes of diet-based public policy plans on hypertension control.
- Dong Zhao
- , Yue Qi
- & Jing Liu
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Research Highlight |
Terutroban does not out-PERFORM aspirin in secondary prevention
- Bryony M. Mearns
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Review Article |
Childhood obesity and cardiovascular disease: links and prevention strategies
The prevalence and severity of obesity among children has increased dramatically over the past 30 years. Strong evidence supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. In this Review, Nadeau and colleagues examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, and the development of CVD as well as the effects of obesity treatment strategies on risk factors and clinical outcomes.
- Kristen J. Nadeau
- , David M. Maahs
- & Robert H. Eckel
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News & Views |
Left atrial fibrosis—a promising stroke risk factor?
The pathophysiological properties of the left atrium are not usually considered for stroke risk stratification of patients with atrial fibrillation. The demonstration that left atrial fibrosis detected by delayed-enhancement MRI is associated with history of stroke highlights the need to take into account histopathological data, in addition to clinical data, in stroke risk stratification.
- Fiorenzo Gaita
- & Alessandro Blandino
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Research Highlight |
Could flu vaccine join the secondary prevention armamentarium for ACS?
- Alexandra King
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Research Highlight |
Long-term benefits of gastric bypass on cardiac structure and function
- Alexandra King
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Research Highlight |
CV risk assessment and education in community pharmacies work!
- Bryony M. Mearns