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.
Can Curcumin Supplementation be a Good Option for Weight Loss?
Meta-analyses of RCTs have shown that curcumin supplementation significantly reduced BMI, BW, and WC with mean differences (MDs) of −0.24 kg/m2, −0.59 kg, and −1.32 cm, respectively, especially in adults with obesity and diabetes. It also reduces anthropometric indices. Augmenting curcumin supplement with lifestyle modification should be an option for weight reduction.
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.
Tricuspid Valve Edge-to-Edge Repair For Tricuspid Regurgitation
TriClip therapy reduces tricuspid regurgitation in 87% patients, and reduction is sustained to 1- year follow-up. The degree of TR reduction is related to the degree of improvement in QOL. The 30-day MAE rate was only 1.7%, and death and pacemaker implant each occurred in 0.6%. Survival free of mortality and TV surgery are high at 1 year (~90%).
Effect of Weekly Subcutaneous Semaglutide vs Daily Liraglutide on Body Weight
Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity, resulted in significantly greater weight loss at 68 weeks.The mean weight change from baseline was –15.8% with semaglutide vs –6.4% with liraglutide (placebo was –1.9%).
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.
Proton Pump Inhibitors Increase CVD, Mortality Risk for Adults with Type 2 Diabetes
Data from 19,229 adults with type 2 diabetes who participated in the UK Biobank showed that adults who used PPIs had higher risks for coronary artery disease (aHR = 1.27), myocardial infarction (aHR = 1.34), heart failure (aHR = 1.35) and all-cause mortality (aHR = 1.3) than nonusers. Physicians should enhance monitoring of CV phenotypes among patients with type 2 diabetes during PPI therapy.
Aflibercept to Prevent Vision Complications of Diabetic Retinopathy
328 patients with Diabetic Retinopathy randomized to 2.0 mg intravitreal aflibercept or sham injections. Proliferative diabetic retinopathy with vision loss developed in 33.9% of those in aflibercept group vs 56.9% in sham group. Change in visual acuity was −2.7 vs −2.4 letters. Aflibercept resulted in significant anatomic improvement, but no improvement in visual acuity.
Adults With Type 2 Diabetes Lost 5% or More of Body Weight With GLP-1 Agonists
Reserachers analyzed electronic health records and health insurance claims data from 2,405 adults who were dispensed a GLP-1 RA from 2011 to 2018.At 8 weeks, adults lost a mean 1.1% of their body weight. That weight loss doubled to 2.2% at 72 weeks. At 72 weeks, 33.3% of GLP-1 RA users lost at least 5% of their body weigh, and 10.5% lost 10% or more of their body weight.
Year-long Aerobic Exercise Intervention Reduces Long-term Risk for Diabetes
The long-term effect of vigorous and moderate exercise on incident diabetes were assessed over a 10-year follow-up after a 12-month exercise intervention. Compared with the non-exercise group, diabetes risk was reduced by 49% in the vigorous aerobic exercise group; and 53% in the moderate aerobic exercise group. There were significant reductions in waist circumference and HbA1c.
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.
Body Weight may Influence Beneficial Effects of SGLT2 Inhibitors in Patients With Diabetes
Researchers coducted a meta-regression analysis of 5 studies (EMPA-REG, CANVAS, DECLARE TIMI-58, CREDENCE and VERTIS CV) including 46,969 patients. It clearly demonstrates that in CV outcomes trials with SGLT2 inhibitors for individuals with type 2 diabetes, body weight is a covariate that is integrally linked to cardiovascular death and heart failure. However, the hypothesis needs further study.
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.
Prolia (denosumab) May Increase the Risk of Hypocalcemia in Dialysis Patients
A preliminary FDA study suggests an increased risk of hypocalcemia in dialysis patients treated with osteoporosis medicine Prolia (denosumab). Physicians should consider the risks of using Prolia in patients on dialysis. When Prolia is used in such patients, calcium and Vit D supplementation may help decrease the severity. Advise patients to seek help if they have hypocalcemia symptoms.
