Pub Date : 2017-02-24DOI: 10.17554/J.ISSN.2309-6861.2017.04.125
Ram B. Singh, S. Shastun, S. Chibisov, A. Itharat, F. Meester, Douglas W. Wilson, G. Halabi
Increased demand for food security has made the he world blind about the utility and necessity of functional food security characterized with fooddiversity and adequacy of nutrients. Food diversity may have been the major factor causing adequacy of nutrients in the Paleolithic diet 40,000 years ago. The increased prevalence of cardiovascular diseases (CVDs) and type 2 diabetes, throughout the world, are closely linked to food security via westernized dietary patterns, physical inactivity, and rapid increase in the rate of obesity. The World Heart Federationand the World Health Organization are working hard to bring down the death rates due to CVDs, at least 25% by 2025.There is substantial evidence that increased intake of functional foods can bring about a significant decline in the epidemic of CVDs and type 2 diabetes, resulting in health promotion.It is possible that functional food security in conjunction with regular physical activity, can maintain the normal physiology and metabolism of our bodies, resulting into decline in CVDs and type 2 diabetes.
{"title":"Functional Food Security and The Heart","authors":"Ram B. Singh, S. Shastun, S. Chibisov, A. Itharat, F. Meester, Douglas W. Wilson, G. Halabi","doi":"10.17554/J.ISSN.2309-6861.2017.04.125","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.125","url":null,"abstract":"Increased demand for food security has made the he world blind about the utility and necessity of functional food security characterized with fooddiversity and adequacy of nutrients. Food diversity may have been the major factor causing adequacy of nutrients in the Paleolithic diet 40,000 years ago. The increased prevalence of cardiovascular diseases (CVDs) and type 2 diabetes, throughout the world, are closely linked to food security via westernized dietary patterns, physical inactivity, and rapid increase in the rate of obesity. The World Heart Federationand the World Health Organization are working hard to bring down the death rates due to CVDs, at least 25% by 2025.There is substantial evidence that increased intake of functional foods can bring about a significant decline in the epidemic of CVDs and type 2 diabetes, resulting in health promotion.It is possible that functional food security in conjunction with regular physical activity, can maintain the normal physiology and metabolism of our bodies, resulting into decline in CVDs and type 2 diabetes.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"20 1","pages":"599-607"},"PeriodicalIF":0.0,"publicationDate":"2017-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85257901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-24DOI: 10.17554/J.ISSN.2309-6861.2017.04.126
F. Ganie
Left ventricular pseudoaneurysm is a well-recognized complication of myocardial infarction and a frequent cause of death. A 48-year-old man with old myocardial infarction was diagnosed to have a left ventricular pseudoaneurysm on echocardiography. In addition, he had a unique, echocardiographic finding. He was successfully treated by Dor procedure and myocardial revascularization.
{"title":"Left Ventricular Pseudoaneurysm- A rare condition and its imaging","authors":"F. Ganie","doi":"10.17554/J.ISSN.2309-6861.2017.04.126","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.126","url":null,"abstract":"Left ventricular pseudoaneurysm is a well-recognized complication of myocardial infarction and a frequent cause of death. A 48-year-old man with old myocardial infarction was diagnosed to have a left ventricular pseudoaneurysm on echocardiography. In addition, he had a unique, echocardiographic finding. He was successfully treated by Dor procedure and myocardial revascularization.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"52 1","pages":"608-610"},"PeriodicalIF":0.0,"publicationDate":"2017-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74766592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-02-24DOI: 10.17554/J.ISSN.2309-6861.2017.04.123-2
Mariana Graça Gutierrez, Felipe Ribeiro, R. L. Gomes, V. Valenti, L. C. Vanderlei
AIM: To investigate the influence of musical auditory stimulation, through classical music, applied during and after submaximal aerobic exercise on vagal reentry in the immediate recovery period. MATERIALS AND METHODS: 33 adult volunteers young and healthy, between 18 and 30 years underwent a protocol divided into three phases: I) Maximal Test procedure for determining the load that was applied in stages II and III; II) Control Protocol: rest for 15 minutes in the supine position, followed by 30 minutes of aerobic exercise on a treadmill (5 minutes at a speed of 6.0 km/h followed by 25 minutes with 60% of Vmax + 1% slope) and finally recovery standing for 3 minutes on the treadmill; III) Music protocol: similar to the control protocol, but with exposure to musical auditory stimulation during exercise and recovery phase. For analysis of the vagal reentry were analyzed RMSSD index of 30 seconds and recovery heart rate. RESULTS: No differences were found between protocols and interaction moments vs. protocols (p > 0.05) both RMSSD index of 30 seconds and for recovery heart rate, but differences were found between the moments of each protocol (p <0.05). Regarding Δ1 and Δ2, significant differences were observed between Δ1 relative to Δ2 (p <0.05) in both protocols, between Δ1music and Δ1control and between Δ2music and Δ2control. CONCLUSION: The musical auditory stimulation, through classical music, applied during and after submaximal aerobic exercise was not able to influence the vagal reentry in the immediate recovery period.
{"title":"Impact of Musical Auditory Stimulation Applied during and after Aerobic Exercise on Vagal Reentry in Recovery Period","authors":"Mariana Graça Gutierrez, Felipe Ribeiro, R. L. Gomes, V. Valenti, L. C. Vanderlei","doi":"10.17554/J.ISSN.2309-6861.2017.04.123-2","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2017.04.123-2","url":null,"abstract":"AIM: To investigate the influence of musical auditory stimulation, through classical music, applied during and after submaximal aerobic exercise on vagal reentry in the immediate recovery period. MATERIALS AND METHODS: 33 adult volunteers young and healthy, between 18 and 30 years underwent a protocol divided into three phases: I) Maximal Test procedure for determining the load that was applied in stages II and III; II) Control Protocol: rest for 15 minutes in the supine position, followed by 30 minutes of aerobic exercise on a treadmill (5 minutes at a speed of 6.0 km/h followed by 25 minutes with 60% of Vmax + 1% slope) and finally recovery standing for 3 minutes on the treadmill; III) Music protocol: similar to the control protocol, but with exposure to musical auditory stimulation during exercise and recovery phase. For analysis of the vagal reentry were analyzed RMSSD index of 30 seconds and recovery heart rate. RESULTS: No differences were found between protocols and interaction moments vs. protocols (p > 0.05) both RMSSD index of 30 seconds and for recovery heart rate, but differences were found between the moments of each protocol (p <0.05). Regarding Δ1 and Δ2, significant differences were observed between Δ1 relative to Δ2 (p <0.05) in both protocols, between Δ1music and Δ1control and between Δ2music and Δ2control. CONCLUSION: The musical auditory stimulation, through classical music, applied during and after submaximal aerobic exercise was not able to influence the vagal reentry in the immediate recovery period.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"4 1","pages":"588-593"},"PeriodicalIF":0.0,"publicationDate":"2017-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89125726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.17554/j.issn.2309-6861.2017.04.123-1
Eliane Pires, Laysa Evelyn Ferreira, Thais Caringe, P. E. Andrade, V. Valenti, L. D. Abreu, R. Raimundo
{"title":"The Influence of Physical Activity on Quality Life in Patients With Stroke Sequel Performing Physical Therapy: Gutierrez MG et al. Physical Activity x Stroke","authors":"Eliane Pires, Laysa Evelyn Ferreira, Thais Caringe, P. E. Andrade, V. Valenti, L. D. Abreu, R. Raimundo","doi":"10.17554/j.issn.2309-6861.2017.04.123-1","DOIUrl":"https://doi.org/10.17554/j.issn.2309-6861.2017.04.123-1","url":null,"abstract":"","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"12 1","pages":"582-587"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80454547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-10-27DOI: 10.17554/J.ISSN.2309-6861.2016.03.122
G. Reyes, C. Calle
Full sternotomy aortic valve replacement has been the gold standard for the treatment of severe aortic stenosis. Now transcatheter aortic valve implantation is becoming a new procedure that has shown its efficacy in a high risk population with aortic stenosis. Minimally invasive aortic valve replacement, using a 7-9 centimeters incision with an upper sternotomy tries to obtain the advantages and open surgical field and the less aggression of transcatheter procedures. We review the pros and cons of the minimally invasive aortic valve replacement updating the information obtained in the literature.
{"title":"Minimally Invasive Aortic Valve Replacement: Is It Now the Best Surgical Approach?","authors":"G. Reyes, C. Calle","doi":"10.17554/J.ISSN.2309-6861.2016.03.122","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2016.03.122","url":null,"abstract":"Full sternotomy aortic valve replacement has been the gold standard for the treatment of severe aortic stenosis. Now transcatheter aortic valve implantation is becoming a new procedure that has shown its efficacy in a high risk population with aortic stenosis. Minimally invasive aortic valve replacement, using a 7-9 centimeters incision with an upper sternotomy tries to obtain the advantages and open surgical field and the less aggression of transcatheter procedures. We review the pros and cons of the minimally invasive aortic valve replacement updating the information obtained in the literature.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"67 1","pages":"578-580"},"PeriodicalIF":0.0,"publicationDate":"2016-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89292949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-08-10DOI: 10.17554/j.issn.2309-6861.2016.03.118
A. Berezin
Chronic heart failure (HF) is a leading clinical and public problem affected higher risk of morbidity and mortality in different population. HF appears to be in both phenotypic forms: HF with reduced left ventricular ejection fraction (HFrEF) and HF with preserved left ventricular ejection fraction (HFpEF). Although both HF phenotypes are distinguished in clinical features, co-morbidity status, prediction score, and treatment, the clinical outcomes in patients with HFrEF and HFpEF are similar. In this context investigation of various molecular and cellular mechanisms leading to development and progression of both HF phenotypes are very important. There is emerging evidence regarding that the epigenetic regulation may have a clue in the pathogenesis of HF. The review is represented current available evidence regarding an implication of epigenetic modifications in development of different HF phenotypes.
{"title":"Are Epigenetic Features Essential in Advance of Heart Failure Phenotypes","authors":"A. Berezin","doi":"10.17554/j.issn.2309-6861.2016.03.118","DOIUrl":"https://doi.org/10.17554/j.issn.2309-6861.2016.03.118","url":null,"abstract":"Chronic heart failure (HF) is a leading clinical and public problem affected higher risk of morbidity and mortality in different population. HF appears to be in both phenotypic forms: HF with reduced left ventricular ejection fraction (HFrEF) and HF with preserved left ventricular ejection fraction (HFpEF). Although both HF phenotypes are distinguished in clinical features, co-morbidity status, prediction score, and treatment, the clinical outcomes in patients with HFrEF and HFpEF are similar. In this context investigation of various molecular and cellular mechanisms leading to development and progression of both HF phenotypes are very important. There is emerging evidence regarding that the epigenetic regulation may have a clue in the pathogenesis of HF. The review is represented current available evidence regarding an implication of epigenetic modifications in development of different HF phenotypes.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"1 1","pages":"554-559"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85090430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-08-10DOI: 10.17554/J.ISSN.2309-6861.2016.03.116
F. Cacciapuoti
Folic acid and/or Vitamins B6-12 deficiency induces high-homocysteine (H-Hcy) serum levels for reduced activity of methylene-tetra hydro folate reductase (MTHFR). This metabolic derangement can be responsible for early and massive atherosclerosis, that could favour ischemic acute events. It can be assumed that vitamins’ supplementation, reducing the elevated Hcy serum concentration, could reduce atherosclerotic risk. In this review,we evaluated if, the reduction of the high Hcy values by the B-vitamins’ supplementation, is able to reduce the incidence of atherosclerotic events.Retrospective trials performed in patients already suffered of acute ischemic episodes, demonstrated that vitamins B6-9-12 supplementation was unable to reduce the incidence of new ischemic events, even if it lowers the high Hcy levels. On the contrary, perspective studies carried out in patients not previously suffered of cardiovascular acute events, evidenced that the vitamins’ supplementation significantly reduced both Hcy serum concentration and atherosclerotic risk. These conflicting results demonstrate that folic acid and vitamins B6/12 supplementation is effective in to reduce high Hcy serum concentration in patients with signs of previous atherosclerosis, but is unable to reduce the atherosclerotic risk. On the contrary, the supplementation is useful in to lower both high Hcy serum levels and atherosclerotic risk in patients without atherosclerotic marks. In addition, some experiences performed in this field demonstrated that these nutrients could favor some negative effects, as the growth of an unknown neoplastic mass, especially the cells of prostate cancer. Therefore, the supplementation with folates and other vitamins of B group can be performed cautiously in patients with increased Hcy serum concentration.
{"title":"High Homocysteine Serum Levels as A Cause of Early and Massive Atherosclerosis: Vitamins B-6-9-12 Supplementation: More Shadows Than Lights","authors":"F. Cacciapuoti","doi":"10.17554/J.ISSN.2309-6861.2016.03.116","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2016.03.116","url":null,"abstract":"Folic acid and/or Vitamins B6-12 deficiency induces high-homocysteine (H-Hcy) serum levels for reduced activity of methylene-tetra hydro folate reductase (MTHFR). This metabolic derangement can be responsible for early and massive atherosclerosis, that could favour ischemic acute events. It can be assumed that vitamins’ supplementation, reducing the elevated Hcy serum concentration, could reduce atherosclerotic risk. In this review,we evaluated if, the reduction of the high Hcy values by the B-vitamins’ supplementation, is able to reduce the incidence of atherosclerotic events.Retrospective trials performed in patients already suffered of acute ischemic episodes, demonstrated that vitamins B6-9-12 supplementation was unable to reduce the incidence of new ischemic events, even if it lowers the high Hcy levels. On the contrary, perspective studies carried out in patients not previously suffered of cardiovascular acute events, evidenced that the vitamins’ supplementation significantly reduced both Hcy serum concentration and atherosclerotic risk. These conflicting results demonstrate that folic acid and vitamins B6/12 supplementation is effective in to reduce high Hcy serum concentration in patients with signs of previous atherosclerosis, but is unable to reduce the atherosclerotic risk. On the contrary, the supplementation is useful in to lower both high Hcy serum levels and atherosclerotic risk in patients without atherosclerotic marks. In addition, some experiences performed in this field demonstrated that these nutrients could favor some negative effects, as the growth of an unknown neoplastic mass, especially the cells of prostate cancer. Therefore, the supplementation with folates and other vitamins of B group can be performed cautiously in patients with increased Hcy serum concentration.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"57 1","pages":"549-553"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77628587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-08-10DOI: 10.17554/J.ISSN.2309-6861.2016.03.115
A. Giordano, P. Ferraro, N. Corcione, S. Messina, G. Maresca, G. Giordano, R. Mancusi, Raffaella Avellino, M. Peruzzi, G. Biondi‐Zoccai
AIM: Carotid artery stenting (CAS) yields similar safety and efficacy results in comparison to carotid endarterectomy. There is however a plethora of devices for CAS, and selection remains problematic. We hypothesized that operators proficient with a single embolic protection device-stent combination can use it effectively for most CAS cases. METHODS: We collected data on all patients undergoing CAS at our institutions, distinguishing patients undergoing revascularization with or without the Angioguard-Precise embolic protection-stent combo.The primary outcome was the risk ofmajor adverse events (MAE), i.e. the composite of death, stroke, transient ischemic attack, or myocardial infarction. RESULTS: A total of 532 patients were treated on 562 lesions. Angioguard-Precise could be used in 447 (84%) patients [471 (84%) lesions], whereas other approaches were used in 85 (16%) patients [91 (16%) lesions]. The groups were similar for most characteristics, but prior carotid revascularization, brachial/radial access, common carotid target lesion, and predilation were less common in the single combo group, whereas stenting and use of embolic protection were less frequent in the other cases (all p < 0.05). Procedural success was achieved in 462 (98%) of cases in the combo group and 89 (98%) in the other group (p=0.695). No significant differences in MAE were found in-hospital [respectively 7 (2%) vs 0, p = 0.604], at 30 days [8 (1.7%) vs 1 (1.2%), p = 1], or at long-term [44 (10%) vs 11 (13%), p = 0.294]. CONCLUSIONS: Operators proficient with a specific embolic protection-stent combination can use it with favorable results in the vast majority of patients.
{"title":"Safety and Efficacy of A Single Embolic Protection Device-Stent Combo for Carotid Revascularization","authors":"A. Giordano, P. Ferraro, N. Corcione, S. Messina, G. Maresca, G. Giordano, R. Mancusi, Raffaella Avellino, M. Peruzzi, G. Biondi‐Zoccai","doi":"10.17554/J.ISSN.2309-6861.2016.03.115","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2016.03.115","url":null,"abstract":"AIM: Carotid artery stenting (CAS) yields similar safety and efficacy results in comparison to carotid endarterectomy. There is however a plethora of devices for CAS, and selection remains problematic. We hypothesized that operators proficient with a single embolic protection device-stent combination can use it effectively for most CAS cases. METHODS: We collected data on all patients undergoing CAS at our institutions, distinguishing patients undergoing revascularization with or without the Angioguard-Precise embolic protection-stent combo.The primary outcome was the risk ofmajor adverse events (MAE), i.e. the composite of death, stroke, transient ischemic attack, or myocardial infarction. RESULTS: A total of 532 patients were treated on 562 lesions. Angioguard-Precise could be used in 447 (84%) patients [471 (84%) lesions], whereas other approaches were used in 85 (16%) patients [91 (16%) lesions]. The groups were similar for most characteristics, but prior carotid revascularization, brachial/radial access, common carotid target lesion, and predilation were less common in the single combo group, whereas stenting and use of embolic protection were less frequent in the other cases (all p < 0.05). Procedural success was achieved in 462 (98%) of cases in the combo group and 89 (98%) in the other group (p=0.695). No significant differences in MAE were found in-hospital [respectively 7 (2%) vs 0, p = 0.604], at 30 days [8 (1.7%) vs 1 (1.2%), p = 1], or at long-term [44 (10%) vs 11 (13%), p = 0.294]. CONCLUSIONS: Operators proficient with a specific embolic protection-stent combination can use it with favorable results in the vast majority of patients.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"319 1","pages":"560-565"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76270587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-08-10DOI: 10.17554/J.ISSN.2309-6861.2016.03.114
Bo Xu, V. Nadurata, K. Avery, C. Chilvers, Shelene Laiu
AIM: The use of dual anti-platelet therapy prior to, or at the time of thrombolysis for ST-elevation myocardial infarction (STEMI) has been shown to reduce patient mortality. This is a class IA recommendation of international guidelines. In routine real-world clinical practice, it is unclear how well this evidence base is applied. The primary objective of this study was to assess the patterns of pharmacotherapy use, especially anti-platelet therapy, at the time of thrombolysis, and on discharge from hospital admission, and assess whether real-world clinical practice conforms to current guideline recommendations. METHODS: This was a retrospective study carried out in a large regional centre in Victoria, Australia. RESULTS: 58 STEMI patients were treated by thrombolytic therapy in a pharmaco-invasive model over a 12-month period. 28 of these patients belonged to the locally managed pharmaco-invasive subgroup, and 30 patients belonged to pharmaco-invasive transfer subgroup. At the time of thrombolysis, dual anti-platelet therapy was provided for only 44% of patients in the local subgroup and 50% of patients in the transfer subgroup. Various patterns of dual anti-platelet use were observed, which were not supported by evidence. On discharge from hospital admission, the prescription of dual anti-platelet therapy significantly increased to 88% of patients in the local subgroup (P = 0.02), and 90% of patients in the transfer subgroup (P = 0.002). CONCLUSION: Clinician adherence to evidence based use of anti-platelet therapy was poor at the time of thrombolysis in a contemporary cohort of Australian STEMI patients. This could represent opportunities to improve care for STEMI patients presenting to regional and rural centres.
{"title":"Clinician Adherence to Evidence Based Use of Anti-platelet Therapy at the Time of Thrombolysis for ST-elevation Myocardial Infarction","authors":"Bo Xu, V. Nadurata, K. Avery, C. Chilvers, Shelene Laiu","doi":"10.17554/J.ISSN.2309-6861.2016.03.114","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2016.03.114","url":null,"abstract":"AIM: The use of dual anti-platelet therapy prior to, or at the time of thrombolysis for ST-elevation myocardial infarction (STEMI) has been shown to reduce patient mortality. This is a class IA recommendation of international guidelines. In routine real-world clinical practice, it is unclear how well this evidence base is applied. The primary objective of this study was to assess the patterns of pharmacotherapy use, especially anti-platelet therapy, at the time of thrombolysis, and on discharge from hospital admission, and assess whether real-world clinical practice conforms to current guideline recommendations. METHODS: This was a retrospective study carried out in a large regional centre in Victoria, Australia. RESULTS: 58 STEMI patients were treated by thrombolytic therapy in a pharmaco-invasive model over a 12-month period. 28 of these patients belonged to the locally managed pharmaco-invasive subgroup, and 30 patients belonged to pharmaco-invasive transfer subgroup. At the time of thrombolysis, dual anti-platelet therapy was provided for only 44% of patients in the local subgroup and 50% of patients in the transfer subgroup. Various patterns of dual anti-platelet use were observed, which were not supported by evidence. On discharge from hospital admission, the prescription of dual anti-platelet therapy significantly increased to 88% of patients in the local subgroup (P = 0.02), and 90% of patients in the transfer subgroup (P = 0.002). CONCLUSION: Clinician adherence to evidence based use of anti-platelet therapy was poor at the time of thrombolysis in a contemporary cohort of Australian STEMI patients. This could represent opportunities to improve care for STEMI patients presenting to regional and rural centres.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"109 1","pages":"566-570"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79393330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2016-08-10DOI: 10.17554/J.ISSN.2309-6861.2016.03.113
Zhiqiang Qu, Bingxiang Wang, Zhen Zhang, Li Ma, Dan C. Li, L. Zhuang, J. Chi, Jiaxiu Liu
Since the molecule of Ca2+-activated Cl- channels (CaCC) had been identified as ANO1, major progresses have been made in recent studies on its roles in vascular functions. ANO1 has been confirmed to represent the CaCC channels in vascular smooth myocytes (VSMCs). Generally, ANO1 expresses more in resistance-size small arteries. When activated, it functions to control the VSMC membrane potentials by depolarization. As a result, the voltage-dependent Ca2+ channel is opened, leading to Ca2+ entry and VSMC contraction. Thus, the function of ANO1 is important for maintenance of normal blood pressure. Under influence of agonists, e.g., angiotensin II, ANO1 also participates in VSMC differentiation and remodeling which are mediated by KLF5, myocardin and SRF. The factors regulate the transcription of the ANO1 gene and other genes for VSMC differentiation and proliferation.
{"title":"Functions of ANO1/TMEM16A, Ca2+-activated Cl- channels in Regulation of Blood Pressure and Vascular Remodeling","authors":"Zhiqiang Qu, Bingxiang Wang, Zhen Zhang, Li Ma, Dan C. Li, L. Zhuang, J. Chi, Jiaxiu Liu","doi":"10.17554/J.ISSN.2309-6861.2016.03.113","DOIUrl":"https://doi.org/10.17554/J.ISSN.2309-6861.2016.03.113","url":null,"abstract":"Since the molecule of Ca2+-activated Cl- channels (CaCC) had been identified as ANO1, major progresses have been made in recent studies on its roles in vascular functions. ANO1 has been confirmed to represent the CaCC channels in vascular smooth myocytes (VSMCs). Generally, ANO1 expresses more in resistance-size small arteries. When activated, it functions to control the VSMC membrane potentials by depolarization. As a result, the voltage-dependent Ca2+ channel is opened, leading to Ca2+ entry and VSMC contraction. Thus, the function of ANO1 is important for maintenance of normal blood pressure. Under influence of agonists, e.g., angiotensin II, ANO1 also participates in VSMC differentiation and remodeling which are mediated by KLF5, myocardin and SRF. The factors regulate the transcription of the ANO1 gene and other genes for VSMC differentiation and proliferation.","PeriodicalId":92802,"journal":{"name":"Journal of clinical cardiology and cardiovascular therapy","volume":"82 1","pages":"543-548"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83964766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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