Sex Differences in PAD Presentation, Progression and Response to Treatment
Treatment of PAD includes medication, exercise and surgery. It aims to manage symptoms and reduce the risks of ulceration, amputation, heart attack and stroke. Women are less likely to receive recommended medications than men and respond less well to supervised exercise therapy. Women have lower rates of surgery and are more likely to die after amputation or open surgery than men.
Why Peripheral Artery Disease (PAD) Remains Underdiagnosed in Women?
Women with PAD often have no symptoms or atypical ones such as minor pain or discomfort while walking or at rest. They are less likely to have intermittent claudication and twice as likely to have CLTI. Hormones appear to play a role, as women tend to show intermittent claudication post-menopause. And ankle brachial index test is less accurate in those with no symptoms or smaller calf muscles.
Heart Roundness Identified by AI Algorithm May Predict Risk for Atrial Fibrillation & Heart Failure
In an analysis of more than 30,000 cardiac MRIs using an AI algorithm, researchers found that sphericity may predict risk for certain CV conditions, even when heart size and function are normal. Healthy adults with spherical hearts, identified through a cardiac MRI images, are 31% more likely to develop atrial fibrillation and 24% more likely to develop cardiomyopathy, researchers reported.
Apixaban May Be Superior Than Other Anticoagulants for Older Patients With AF & Dementia
Among older patients with atrial fibrillation and dementia, apixaban lowers the risk for stroke and major bleeding vs. dabigatran, rivaroxaban or warfarin, researchers reported. The association was also detected in patients with AF but no dementia, but to a lesser degree. The prescribing decisions for oral anticoagulants need to be individualized according to comorbidities and frailty.
Short Night-time Sleep May Nearly Double the Risk of Peripheral Artery Disease
Over 200 million people globally have peripheral artery disease (PAD), where arteries in the legs are clogged, increasing the risk of stroke and heart attack.Sleeping less than five hours a night is associated with a 74% raised likelihood of developing peripheral artery disease (PAD) compared with seven to eight hours. In addition PAD is associated with an increased likelihood of short sleep.
Waist-to-height Ratio Is a Better Indicator of Outcomes in Patients With Heart Failure Than BMI
In a study, both BMI and waist-to-height ratio showed that more body fat is linked with increased risk of death or hospitalisation for heart failure, but this is more evident for waist-to-height ratio. When looking at waist-to-height ratio, the top 20% of people with the most fat had a 39% increased risk of HF hospitalization compared to people in the bottom 20% who had the least fat.
Women Have High Risk of Long-term Anxiety After Cardiac Arrest Than Men
A study assessed the prevalence of anxiety, depression and post-traumatic stress disorder (PTSD) in cardiac arrest survivors. Depression and anxiety scores were higher in women (3.3 and 6.1, respectively), vs. men (2.6 and 4.5, respectively). Anxiety scores of 8 or more were observed in 43% of women and 23% of men. Women had higher levels of PTSD vs. men (33 vs. 26, respectively).
High BP Damages Specific Regions of the Brain Causing a Decline in Mental Processes and Dementia
Researchers have found the parts of the brain affected by increase in BP. These includes 1. the putamen involved in movement and learning; 2. regions of white matter involved in planning of simple and complex daily tasks, decision-making and the management of emotions. Brain dysfunction at these location may lead to problems with cognitive function, memory, thinking and dementia.
High Salt Diet Is Linked to Hardening of the Arteries Even in People With Normal Blood Pressure
Eating excessive salt is linked with clogged arteries of the heart and neck which is known to be linked with raised risks of heart attack and stroke. The association was linear, meaning that each rise in salt intake was linked with more atherosclerosis. The findings applied even at normal blood pressure levels, suggesting that salt could be damaging even before the development of hypertension.
Clopidogrel Monotherapy 1 Month After PCI Lowers Bleeding Regardless of Diabetes Status
The pooled cohort from the STOPDAPT-2 and STOPDAPT-2 ACS trials showed that clopidogrel monotherapy after 1 month of DAPT in patients who had PCI was associated with reduced bleeding risk regardless of diabetes status compared with 12-month DAPT. Whereas clopidogrel monotherapy after 1 month was noninferior to 12-month DAPT for ischemic events and a composite of ischemic and bleeding events.
Long-term Insertable Cardiac Monitoring After Ischemic Stroke Improves AF Detection
Long-term insertable cardiac monitoring for atrial fibrillation among patients with ischemic stroke of atherosclerotic origin improved AF detection 10-fold compared with standard of care, a speaker reported. In addition, factors including chronic HF, left atrial enlargement and BMI were prognostic of post-stroke AF at 36 months, according to a secondary analysis of the STROKE AF trial.
How Alcohol Flushing Gene Variant May Raise Heart Disease Risk
8% people have an aldehyde dehydrogenase 2 variant called ALDH2*2 that is tied to higher risk of coronary artery disease (CAD). A new study of 29319 CAD cases found that only ALDH2*2 carriers had impaired vasodilation after light alcohol drinking, driven by increased oxidative damage and inflammation. SGLT2i, such as empagliflozin, reduced ALDH2*2-associated damage to endothelial cell function.
Aspirin Has Limited Role in Patients Without CAD
Among adults without CAD, the absolute risk for major bleeding with aspirin as primary prevention therapy exceeds the any absolute MI benefits for every level of atherosclerotic CVD risk, data from a meta-analysis show. Furthermore, if such patients are already on preventive statin therapy, adding aspirin to statin is unlikely to achieve additional meaningful cardiovascular benefits.
Irregular and Long Menstrual Cycles Associated With Elevated Risk for CVD
A cohort study found greater risk for CVD in women who reported irregular cycles, no periods or longer cycle length (40 days) compared with women reporting regular cycles. The risk increased as they aged. PCOS is likely a factor in many women with irregular or long menstrual cycles. They were more likely have hypercholesterolemia, chronic hypertension & T2D (attributable to underlying PCOS).
Intensive BP Control After Endovascular Thrombectomy For AIS May Affect Recovery
A blinded-endpoint, randomised controlled trial included 821 patients at 44 tertiary-level hospitals in China. It revealed that the intensive control of systolic blood pressure to lower than 120 mm Hg should be avoided to prevent compromising the functional recovery of patients who have received endovascular thrombectomy for acute ischaemic stroke due to intracranial large-vessel occlusion.
IV Potassium & Magnesium May Lessen the Need for Antiarrhythmic Therapy
A registry-based study found that the intravenous administration of potassium & magnesium was associated with a higher probability of SCV in patients with nonpermanent AF and plasma potassium levels of less than 3.50 mEq/L and 3.50-3.99 mEq/L but not in patients with AFL. This approach might lessen the need for pharmacologic intervention and adverse effects caused by antiarrhythmic therapy.
Is Extravascular Implantable Cardioverter–Defibrillator Safe?
A nonrandomized study included patients who received an extravascular ICDs. 92.6% patients was free from major system- or procedure-related complications at 6 months. 25 major complications observed in 7.3% patients. It concluded that extravascular ICDs were safe and were able to detect and terminate induced ventricular arrhythmias at the time of implantation.
Lp(a) Should be Measured in Adults to Identify High CV Risk
A study assessed >1100 patients who underwent endovascular therapy for symptomatic PAD. In patients with elevated Lp(a) (30 mg/dL), the rate of major adverse CV events and amputation, were 2 times and 4 times higher, respectively, than patients with lower Lp(a) (not influenced by LDL or statin administration). Thus, Lp(a) should be measured at least once in all adults to identify high CV risk.
Meth, Opiate & Cannabis Use May Increase Atrial Fibrillation Risk
A new study investigated the long-term effects of using addictive stimulant drugs in 23,561,884 California residents. It was found that methamphetamine increased AFib risk by 86%, opiate increased AFib risk by 74%, cocaine increased AFib risk by 61%, cannabis increased AFib risk by 35%. The increased risk may be linked to autonomic dysfunction and changes in the activity of specific ion channels.
Sleep Apnea Affects 50% of Hospitalized Patients With Heart Failure
A cohort study found that more than half of hospitalized HF patients had obstructive sleep apnea (OSA), and central sleep apnea (CSA). And CSA was the predominant type. OSA patients were more likely to be male, obese and have hypertension, diabetes, and HFpEF. CSA patients were more likely to be older, male and have hypocapnia, high heart rate, higherNT‐proBNP levels, and HFrEF.
