The purpose of this study is to compare 5-year mortality rates in diabetic individuals with multivessel coronary artery disease (CAD) who undergo either coronary artery bypass grafting (CABG) surgery or percutaneous coronary stenting.
Read more! Age, Race May Affect Type 2 Diabetes Screening Results6/21/2010 12:00:00 AM (CST)
The recommended A1c blood test cutoff didn't accurately diagnose elderly Asians, study found
Hide Article Age, Race May Affect Type 2 Diabetes Screening Results6/21/2010 12:00:00 AM (CST)
Age, Race May Affect Type 2 Diabetes Screening Results
MONDAY, June 21 (HealthDay News) -- Despite its endorsement last year by the American Diabetes Association as an effective way to diagnose type 2 diabetes, new research out of Singapore suggests that the hemoglobin A1c blood test may not accurately identify the disease among elderly Asians.
The American Diabetes Association's current recommendation is that this particular test -- not previously considered to be a gold standard screening method -- works well when physicians rely on a cutoff reading of 6.5 percent or more to indicate diabetes.
Yet, the new study found that, among a group of Asian participants ranging in age from 20 to 93 years, the 6.5 percent cutoff misses many instances of disease, and may lead to under-diagnosis of diabetes with increasing frequency as Asian patients get older.
"The hemoglobin A1c is a useful and convenient screening test for diabetes," Dr. Tunn Lin Tay, an endocrinology fellow at Singapore's Changi General Hospital, said in a news release from The Endocrine Society. "However, we may need age-specific reference ranges, rather than using a single cutoff level across the board."
The findings were to be presented Sunday at the Endocrine Society's annual meeting in San Diego.
Although A1c has long been used to monitor a diabetic's long-term blood sugar levels, the authors noted that the standard means for screening for the disease has been either the fasting plasma glucose test or, ideally, the oral glucose tolerance test.
The A1c test, however, does not require eight hours of pre-exam fasting, and is considered simpler and less time-consuming than the two-hour long glucose tolerance test.
But to see how A1c stacked up against the glucose tolerance test, Tay's team used both methods to screen 90 primarily Chinese patients with no previous history of diabetes.
The standard oral glucose test discovered 40 cases of type 2 diabetes, the researchers found. On the other hand, the A1c test was less and less accurate as the patients' ages rose, only diagnosing about 55 percent of the cases among participants over the age of 72.
Among such elderly Asian patients, 6 percent is the best cutoff point, the authors said. And among patients under 72 years of age, 6.2 percent may be best.
"If clinicians screen elderly patients -- especially Asians -- using the hemoglobin A1c test, they should confirm the diagnosis using the oral glucose tolerance test," Tay stated in the news release.
More information
The American Diabetes Association has details about type 2 diabetes.
SOURCE: The Endocrine Society, news release, June 20, 2010
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Double-Blind, Placebo-Controlled, Multicenter Acute Study of Clinical Effectiveness of Nesiritide in Subjects With Decompensated Heart Failure (ASCEND HF)
The purpose of this study is to find out if Nesiritide (a human B-type natriuretic peptide/hBNP) as compared to placebo, plus the usual treatment for acute decompensated heart failure, helps to improve breathing difficulties, reduce readmissions to hospitals, and helps patients live longer.
Read more! Clinical Guidelines for Good Heart Care2/6/2009 12:00:00 AM (MST)
As a patient, understanding the basics of the guidelines can help you take a more active role in your treatment.
Hide Article Clinical Guidelines for Good Heart Care2/6/2009 12:00:00 AM (MST)
Clinical Guidelines for Heart Failure
To receive the best care for heart failure, talking frankly with your health care team is a good place to start. It?s also helpful to know about a resource published by health experts that outlines treatment plans recommended for patients with chronic heart failure.
Since 1980, the American College of Cardiology and the American Heart Association have jointly published clinical guidelines to help health care providers create good care plans for their patients. The guidelines are based on scientific research and medical evidence. One set of guidelines is called Evaluation and Management of Chronic Heart Failure in the Adult.
An overview
The guidelines are written for medical people, so the language is technical and focuses on clinical information. As a patient, understanding the basics of the guidelines can help you take a more active role in your treatment. You?ll also be able to ask questions that can help you receive the best care.
The guidelines offer tips for health care providers on performing a thorough checkup to detect heart failure and to evaluate how serious it is. They guide the provider in what symptoms to look for and what screenings may be needed (such as lab or exercise tests) to gather more information.
According to the guidelines, a person who is at risk for or who has heart failure falls into one of the following stages of the disease:
Stage A: A person who is at high risk for heart failure, but has no problem with his or her heart structure and does not have symptoms of heart failure
Stage B: A person who has a problem with his or her heart structure, but does not have symptoms of heart failure
Stage C: A person who already has, or who has had in the past, heart failure symptoms, which have to do with structural heart disease
Stage D: A person who has end-stage heart disease; this is the most serious stage
The guidelines suggest specific treatments and actions for each stage. Once you know the stage you are in, you can learn which treatments the guidelines suggest. For example, for people in Stage A, suggested actions focus on treating risk factors, such as high blood pressure, smoking and drinking. For all stages, the guidelines suggest specific medicines and certain medical tests or procedures.
The guidelines also advise health care providers to take a ?multidisciplinary approach? to your care. This means that, rather than working alone to treat you, your provider teams up with other health care specialists, such as nurses, exercise physiologists and smoking-cessation experts. Your health care team may suggest that you participate in support groups or visit certain specialists to help you make lifestyle changes to manage heart disease.
Take a proactive role
The guidelines are designed to apply to most patients in most cases. They give health care providers a range of treatment options. The ultimate decisions rest with the provider and with you. Remember that you are the most important member of your health care team. Asking questions about your treatment is smart and responsible. It?s your right to know your health care team?s goals for you -- and how clinical guidelines compare with your care plan.
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Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions (CORAL)
This study will compare medical therapy plus stenting of hemodynamically significant renal artery stenoses versus medical therapy alone in patients with systolic hypertension and renal artery stenosis.
Read more! About High Blood Pressure2/5/2009 12:00:00 AM (MST)
High blood pressure is a sneaky ailment. The condition has no symptoms that you can see or feel. Having your blood pressure checked is the only way to know if it is high.
Hide Article About High Blood Pressure2/5/2009 12:00:00 AM (MST)
About High Blood Pressure
High blood pressure, or hypertension, is a condition that has no symptoms you can see or feel. Having your blood pressure checked is the only way to know if it is high.
Yet, untreated hypertension can result in serious illnesses, such as coronary artery disease, heart attack, stroke and kidney failure, according to the American Heart Association (AHA).
Diet and lifestyle changes may be enough to control mildly elevated blood pressure. But your doctor may prescribe blood pressure medication and lifestyle changes if your blood pressure is moderately to severely high.
The AHA says the following lifestyle choices can help reduce your blood pressure.
Don't smoke
Inhaling cigarette smoke stimulates your heart, making it beat faster. It also narrows your blood vessels, causing your blood pressure to rise temporarily. Smoking, however, does not cause high blood pressure. The reason smoking is bad if you have high blood pressure is because both contribute to heart disease, meaning hardening of the arteries and heart attacks.
Maintain a healthy weight
Studies have found people who lose weight also lower their blood pressure. To lose weight safely, eat fewer foods high in fat and calories and increase your physical activity.
Exercise regularly
Regular aerobic exercise tones your heart, blood vessels and muscles and keeps your blood pressure low. Consult your doctor before beginning an exercise regimen if you have high blood pressure.
Learn to cope with stress
Stress may temporarily raise blood pressure, but it is not a cause of chronic high blood pressure. Meditate, listen to stress-management tapes or do relaxation exercises daily.
Drink moderately
If you drink alcohol, do so only in moderation. Heavy, regular consumption of alcohol can increase blood pressure dramatically. Experts recommend no more than two drinks a day for a man and one drink a day for a woman.
Healthy eating and limit your salt intake
The DASH diet or Dietary Approaches to Stopping Hypertension is an effective eating plan proven to lower blood pressure. It doesn't require special foods, instead recommends a certain number of servings from a variety of food groups which include vegetables, fruits, fat-free or low-fat milk, whole grains, fish, poultry, beans, seeds, and nuts. It also calls for limiting sugar, fats, and red meat. Reducing salt (sodium) intake to 2,300 milligrams (about 1 teaspoon of table salt) or 1,500 milligrams (two-thirds teaspoon of table salt) daily. Following the DASH diet and keeping salt intake to 1,500 milligrams per day has shown the biggest benefit for blood pressure reduction in people with high blood pressure. The DASH eating plan combined with other lifestyle measures can help lower blood pressure. To learn more about DASH, talk with your health care provider.
Take your medicine
Follow these guidelines if your doctor prescribes blood pressure medication:
Take all your medication as prescribed.
Take your pills at the same time each day.
Never skip your pills because you have side effects or don't believe your blood pressure is high. Call your doctor to discuss your concerns.
Refill your prescription before it runs out.
Don't stop taking your medication because your blood pressure tests normal. It's normal because you're taking the medication.
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Human Recombinant Fibroblast Growth Factor-1 (FGF-1141), for the Treatment of Subjects with Severe Coronary Heart Disease, a Double-blind, Placebo-controlled, Dose-varying Study (ACORD)
Treatment for no-option heart patients with coronary artery disease. Procedure includes the injection into the heart of a protein growth factor, administered by the Cordis Corp. MyoStar injection catheter, to stimulate the growth of blood vessels around blocked coronary arteries.
Read more! Adult Stem Cells Can Repair Damaged Heart12/4/2009 12:00:00 AM (MST)
Small study found they spurred blood vessel growth after heart attack
Hide Article Adult Stem Cells Can Repair Damaged Heart12/4/2009 12:00:00 AM (MST)
Adult Stem Cells Can Repair Damaged Heart
FRIDAY, Dec. 4 (HealthDay News) -- Adult stem cells appear to help repair heart attack damage, a new study shows.
The phase 1 study of 53 patients found that stem cells from donor bone marrow promoted the growth of new blood vessels in heart tissue damaged by heart attack.
The patients received the stem cell injections within 10 days of having a heart attack. During follow-up, they were compared to patients who had received a placebo injection.
After six months, those who got the stem cells were four times more likely to be better off overall, pumped more blood with each heartbeat, and had one-quarter as many irregular heartbeats, when compared to the placebo group. There also were no serious side effects with the stem cell treatment, according to the report published in the Dec. 8 issue of the Journal of the American College of Cardiology.
This is the strongest evidence so far that adult stem cells can repair heart attack damage, the Rush University Medical Center researchers said. It had been believed that only embryonic stem cells could turn into heart or other organ cells.
"The results point to a promising new treatment for heart attack patients that could reduce [death] and lessen the need for heart transplants," Dr. Gary Schaer, head of the Rush Cardiac Catheterization Laboratory, said in a news release from the university.
More information
The U.S. National Heart, Lung, and Blood Institute has more about heart attack.
SOURCE: Rush University Medical Center, news release, Dec. 2, 2009
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PROTECT II: A Prospective, Multi-Center, Randomized Controlled Trial
The IMPELLA LP 2.5 system will be superior to the intra aortic balloon pump in preventing the composite rare on intra and post procedural major adverse events.
Read more! Air Pollution May Raise Blood Pressure9/14/2009 12:00:00 AM (CST)
Inhaling microscopic particles could raise risk of heart disease, study finds
Hide Article Air Pollution May Raise Blood Pressure9/14/2009 12:00:00 AM (CST)
Air Pollution May Raise Blood Pressure
MONDAY, Sept. 14 (HealthDay News) -- Breathing polluted air for even two hours can boost blood pressure, potentially raising the risk of cardiovascular disease in those exposed to smog, a new study suggests.
Although the increase may not mean much for healthy people, "this small increase may actually be able to a trigger a heart attack or stroke," study author Dr. Robert D. Brook, an assistant professor of medicine at the University of Michigan, said in a university news release.
An estimated nearly one in three Americans suffer from high blood pressure, meaning the heart is straining to push blood through the circulatory system.
In the study, which appears in a recent issue of Hypertension, researchers tested 83 people as they breathed levels of air pollution similar to those in an urban city near a roadway.
"We looked at their blood vessels and then their responses before and after breathing high levels of air pollution," study co-author Robert Bard, a University of Michigan clinic research coordinator, said in a news release.
The air pollution caused diastolic pressure -- the lower number in a blood pressure reading -- to rise within two hours. Blood vessels were impaired for as long as 24 hours.
Tests showed that microscopic particles in the air, rather than ozone gases, caused the rise in blood pressure and impaired blood vessel function.
"If air pollution levels are forecasted to be high, those with heart disease, diabetes or lung disease should avoid unnecessary outdoor activity," Brook said.
We are seeking individuals with significant narrowing or blockage in an artery in the heart to participate in a research study at Chandler Regional Medical Center.
