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Cold weather linked to increased stroke risk in atrial fibrillation patients

2015-08-30
London, UK - 30 Aug 2015: Cold weather is associated with increased risk of ischaemic stroke in patients with atrial fibrillation, according to research presented at ESC Congress today by Dr Tze-Fan Chao, cardiologist at Taipei Veterans General Hospital and the National Yang-Ming University in Taiwan.1 The study in nearly 290 000 patients suggests that cool climate may be an underrated issue for health that deserves more attention. "Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and it increases the risk of ischaemic stroke by four- to five-fold," ...

Treating left atrial appendage could dampen long standing persistent AF

2015-08-30
LONDON, UK - In patients with long-standing persistent atrial fibrillation (AF) despite standard treatment, additional electrical isolation of an area called the left atrial appendage (LAA) can improve freedom from AF without increasing complications, results of the BELIEF study show. The findings were presented today in a Hot Line session at ESC Congress 2015. "Empirical left atrial appendage isolation, along with the standard approach of pulmonary vein isolation (PVI) and ablation of extra-pulmonary triggers is superior to the standard approach alone in enhancing the ...

Patient education does not impact apixaban adherence

2015-08-30
LONDON, UK - Adherence to the oral anticoagulant apixaban among patients with atrial fibrillation (AF) was no better for those who received an educational program compared to those who did not, results of the international, randomised AEGEAN trial show. The results, presented today at ESC Congress 2015, were nevertheless "quite encouraging," according to lead investigator Gilles Montalescot, MD, PhD, from the Institut de Cardiologie, Centre Hospitalier Universitaire Pitié-Salpêtri?re, in Paris, France. "We used the best possible tools for the educational program, ...

Adenosine triphosphate does not improve efficacy of pulmonary vein isolation

2015-08-30
LONDON, UK - Late recurrence of atrial fibrillation (AF) is not reduced in patients whose pulmonary vein isolation (PVI) treatment incorporates the addition of adenosine triphosphate (ATP), according to results of the UNDER-ATP trial. Results of the trial, presented at ESC Congress 2015, add to the ongoing debate about ATP use in this setting. The major cause of AF recurrence after PVI has been reported to be electrical reconnection between the left atrium and pulmonary veins, which re-establishes abnormal rhythm, said study investigator Atsushi Kobori, MD, from Kobe ...

Leadless pacemaker study assesses safety and efficacy

2015-08-30
LONDON, UK - A leadless cardiac pacemaker showed "good safety and reliable function" during the initial six months of follow-up in the LEADLESS II study, investigators reported during a Hot Line presentation at the ESC congress 2015. The findings, published simultaneously in the New England Journal of Medicine, suggest the device is effective and safe, and can serve as an alternative to conventional transvenous pacemakers in patients with indications for permanent pacing, said principal investigator Vivek Reddy, MD. "Leadless cardiac pacemakers have the potential to ...

Antiarrhythmia drugs no impact on late AF recurrence

2015-08-30
LONDON, UK - In patients with atrial fibrillation (AF) treated with radiofrequency catheter ablation, the addition of antiarrhythmic drugs (AADs) for 90 days after the procedure did not reduce arrhythmia recurrence rates at one year, according to results of the Efficacy of Antiarrhythmic Drugs Short-Term Use after Catheter Ablation for Atrial Fibrillation (EAST-AF) trial. Results of the study, presented as a Hot Line at ESC Congress 2015 The study did show a temporary benefit of AAD, but the effect disappeared as soon as medication was stopped, suggesting no benefit to ...

Multiple risk factors cancel impact of atrial fibrillation on ischemic stroke risk

2015-08-30
London, UK - 30 Aug 2015: The impact of atrial fibrillation on ischaemic stroke risk in elderly patients is eliminated with multiple risk factors, according to an 11 year study in more than 425 000 patients presented at ESC Congress today.1 The findings suggest that stroke prevention in the elderly may need to focus on the concomitant effects of multiple risk factors rather than on a specific risk factor such as atrial fibrillation (AF). "The incidence of ischaemic stroke increases with greater numbers of cardiovascular risk factors," said principal investigator Dr Yutao ...

Rapid, more sensitive test speeds up chest pain triage

2015-08-30
LONDON, England - 30 August, 2015: Patients arriving at the emergency department with chest pain suggestive of acute myocardial infarction (AMI) can be triaged more quickly and more safely using a new rapid assay with refined cut-offs, German research suggests. The Biomarkers in Acute Cardiovascular Care (BACC) study, presented as a Hot Line at ESC Congress 2015, suggests this new algorithm can reduce mortality and cut triage times to one hour, compared to the standard three-hour approach. "There is an urgent need for fast decision-making for this growing patient population," ...

Antimineralocorticoids offer no benefit in heart attack patients without heart failure

2015-08-30
LONDON, UK - 30 August, 2015: Heart attack patients without heart failure derive no benefit from the addition of mineralocortoid receptor antagonists (MRA), to standard therapy, results of the ALBATROSS study show. The Hot Line findings, reported at ESC Congress 2015, "do not warrant the extension of MRA use" to such patients, said the study's principal investigator Gilles Montalescot, MD, PhD. MRAs, also known as aldosterone antagonists, inhibit sodium retention and excretion of potassium and magnesium, and therefore "there is an indication for MRA therapy in MI ...

Peri-infarct pacing does not improve outcomes in patients with large myocardial infarction

2015-08-30
LONDON, UK - In patients with a large myocardical infarction (MI), pacing, with the left ventricular (LV) lead placed in the area of the lesion (peri-infarct) did not prevent further enlargement of the heart (remodeling), nor did it improve functional or clinical outcomes after 18 months, according to results of the Pacing Remodeling Prevention Therapy trial (PRomPT) trial. In MI patients with large infarcts, medical therapy and rapid restoration of blood flow to the area is not always enough to prevent cardiac remodeling. One reason for remodeling may be the response ...

Cyclosporine does not improve outcomes after PCI

2015-08-30
LONDON, UK - 30 August, 2015: The immunosuppressant drug cyclosporine did not improve clinical outcomes compared to placebo in patients receiving percutaneous coronary intervention (PCI) for the more severe form of heart attack known as ST-segment elevation myocardial infarction (STEMI). Results of the CIRCUS trial, presented today in a Hot Line session at ESC Congress 2015, and published simultaneously in the New England Journal of Medicine. showed that the drug, administered prior to PCI, had no impact on a composite of all-cause death, hospitalisation for - or worsening ...

Surprise cardiac finding predicts future risk

2015-08-30
LONDON, UK - In patients with chronic ischemic heart disease, a small left ventricle with thick walls, is the strongest predictor of morphologic remodelling, which is generally considered a first step towards heart failure, according to unexpected findings presented today at ESC Congress 2015. Results of the DOPPLER-CIP (which stands for "Determining Optimal non-invasive Parameters for the Prediction of Left vEntricular morphologic and functional Remodeling in Chronic Ischemic Patients") study were not expected and, if confirmed by other studies, "could completely change ...

How can we prevent suicide? Major study shows risk factors associated with depression

2015-08-30
A major multi-national study of suicides has identified the behaviour patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts. The statistics for suicide are frightening. According to the WHO, more than 800,000 people commit suicide every year, with perhaps 20 times that number attempting suicide. Suicide is one of the leading causes of death in the young (in the UK for example, it is the leading cause of death ...

Scientists show how magnetic pulses change the brain in treatment for depressed patients

2015-08-30
A group of UK scientists have found a way of understanding how transcranial magnetic stimulation (TMS) can give relief to severely depressed patients. TMS is used as an alternative to Electro-Convulsive Therapy (ECT)*, but it is not known how it achieves its therapeutic effect. Understanding how it works may open the door to better, more targeted treatment for depression and other conditions. Transcranial magnetic stimulation works by applying a magnetic pulse to the frontal part of the brain of depressed patients. Like ECT, it seems to 'reset' the brain, but is easier ...

A single cocaine dose lowers perceptions of sadness and anger

2015-08-30
A single dose of cocaine can interfere with the ability to recognise negative emotions, according to new research presented at the ECNP conference in Amsterdam. In a placebo-controlled within subject study, researchers from the Netherlands and Germany took 24 students (aged 19 to 27) with light to moderate cocaine use, and gave them either 300mg of oral cocaine, or a placebo. After 1 to 2 hours, each participant was then subject to a series of biochemical tests, as well as the facial emotion recognition test to measure response to a series of basic emotions, such ...

Depression and extremes of blood pressure predict highest rates of harmful vascular events

2015-08-29
London, UK - 29 Aug 2015: Depressive symptoms and extremes of blood pressure predict the highest rates of harmful vascular events in patients with existing heart disease, diabetes or stroke, according to research presented at ESC Congress today by Dr Bhautesh Jani, clinical academic fellow in the Institute of Health and Wellbeing, University of Glasgow, UK.1 The study in more than 35 000 patients found that the risk of further stroke or heart attack, heart failure or dying due to heart disease at four years was 83% higher in depressed patients with high blood pressure ...

Prolonged television watchers have higher risk of fatal pulmonary embolism

2015-08-29
London, UK - 29 Aug 2015: Prolonged television watchers have a higher risk of fatal pulmonary embolism, a condition associated with long haul flights, reveals research presented at ESC Congress today by Mr Toru Shirakawa, public health research fellow in the Department of Social Medicine at Osaka University in Japan.1 The 18 year study in more than 86 000 people found that watching an average of five or more hours of television per day was associated with twice the risk of fatal pulmonary embolism as watching less than two and a half hours daily. "The association between ...

Midday naps associated with reduced blood pressure and fewer medications

2015-08-29
London, UK - 29 Aug 2015: Midday naps are associated with reduced blood pressure levels and prescription of fewer antihypertensive medications, according to research presented at ESC Congress today by Dr Manolis Kallistratos, a cardiologist at Asklepieion Voula General Hospital in Athens, Greece.1 "Although William Blake affirms that it is better to think in the morning, act at noon, eat in the evening and sleep at night, noon sleep seems to have beneficial effects," said Dr Kallistratos. "Two influential UK Prime Ministers were supporters of the midday nap. Winston Churchill ...

Coffee linked with increased cardiovascular risk in young adults with mild hypertension

2015-08-29
London, UK - 29 Aug 2015: Coffee drinking is associated with increased risk of cardiovascular events (mainly heart attacks) in young adults (18-45) with mild hypertension, according to research presented at ESC Congress today by Dr Lucio Mos, a cardiologist at Hospital of San Daniele del Friuli in Udine, Italy.1 The 12 year study in more than 1 200 patients found that heavy coffee drinkers had a four-fold increased risk while moderate drinkers tripled their risk. Future prediabetes attenuated the associations suggesting that the effect of coffee on cardiovascular events ...

Pollution and weather influence outcomes after heart attack

2015-08-29
London, UK - 29 Aug 2015: Pollution and weather influence outcomes after a heart attack, according to research presented at ESC Congress today by Ms Aneta Cislak, research fellow in the Silesian Centre for Heart Diseases, Medical University of Silesia in Zabrze, Poland.1 "Weather changes like rain or heat affect our daily activity and even our productivity at work," said Ms Cislak. "Since this influence is so noticeable we were interested to see if weather has any connection with cardiovascular diseases including acute coronary syndromes. Moreover, air pollution affects ...

Refractory cardiac arrest patients brought to hospital with ongoing CPR can recover

2015-08-29
London, UK - 29 Aug 2015: Refractory cardiac arrest patients brought to hospital with ongoing cardiopulmonary resuscitation (CPR) can survive with good brain function, according to research in nearly 4 000 patients presented at ESC Congress today by Dr Helle Søholm, a cardiologist at Copenhagen University Hospital Righospitalet in Denmark.1 "The faster a patient with cardiac arrest is resuscitated and brought back to life the better," said Dr Søholm. "The prognosis for patients with refractory cardiac arrest with long resuscitation attempts has previously been ...

ESC guidelines recommend radial approach for percutaneous coronary interventions in ACS

2015-08-29
London, UK - 29 Aug 2015: For the first time, ESC Guidelines published today give the highest degree of recommendation for the radial approach over the femoral one for coronary angiography and percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS). The ACS without persistent ST-segment elevation (NSTE-ACS) guidelines, drafted by an international multidisciplinary Task Force, are published online in European Heart Journal1 and on the ESC Website.2 "New data shows that the radial approach is superior to the femoral not only in terms of ...

ESC infective endocarditis guidelines boost role of imaging in diagnosis

2015-08-29
London, UK - 29 Aug 2015: ESC Guidelines published today on infective endocarditis boost the role of imaging in diagnosis of this deadly disease. "We emphasise the need for a multimodality imaging approach to diagnosing endocarditis," said Professor Gilbert Habib, Chairperson of the guidelines Task Force. "While the 2009 guidelines1 focused on echocardiography, the 2015 guidelines show the important role of other imaging techniques such as PET-CT. These new imaging techniques are increasingly useful for the diagnosis and management of infective endocarditis and we recommend ...

New ESC guidelines on pericardial diseases published today

2015-08-29
London, UK - 29 Aug 2015: New ESC Guidelines on pericardial diseases are published today. Until now there was insufficient evidence for strong recommendations in this group of conditions which can severely restrict quality of life. "Pericardial diseases include different clinical presentations and various aetiologies that require appropriate management," said Professor Yehuda Adler, Co-Chairperson of the guidelines Task Force. "We hope these new recommendations will help clinicians to manage these diseases with resulting improvements in outcomes and quality of life." The ...

Novel treatment algorithm launched in ESC/ERS pulmonary hypertension guidelines

2015-08-29
London, UK - 29 Aug 2015: A novel treatment algorithm for pulmonary arterial hypertension is launched today in new pulmonary hypertension guidelines from the European Society of Cardiology (ESC) and European Respiratory Society (ERS). The protocol aims to give patients the best chance of a good clinical outcome in a condition with dismal prognosis which puts severe limitations on patient choices including avoiding pregnancy, excessive physical activity and certain types of travel. The 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension are ...
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