1. Individualized treatment reduces cardiovascular risk in patients with diabetes
The ACCORD study has led to a new understanding of individualized therapy to minimize cardiovascular risk in patients with diabetes. The study showed that intensive blood pressure lowering has no additional benefit for reducing CVD risk in patients with high-risk type 2 diabetes. Lipid modulation with statins in combination with fibrates is not superior to statin therapy alone, but may be effective in reducing cardiovascular risk in patients with type 2 diabetes who have low high-density lipoprotein cholesterol (HDL-C) levels and high triglyceride levels. Hou Chunfeng, Department of Emergency Medicine, Daqing Longnan Hospital
2. Transcatheter aortic valve replacement adds new evidence to replace traditional open-heart surgery
Transcatheter aortic valve replacement (TAVI) may be an alternative to traditional open-heart aortic valve replacement in patients with severe aortic stenosis who have other comorbidities that pose risks. Two recent studies support that TAVI improves patient symptoms and regression.
3. From ABC to CAB: Cardiopulmonary Resuscitation Procedure Improvement
In October 2010, the AHA published a new edition of the Cardiopulmonary Resuscitation and Emergency Cardiovascular Guidelines, which strongly recommends that general first responders perform CPR with chest compressions, i.e., changing the resuscitation procedure from ABC (airway-breathing-compressions) to CAB (compressions-airway-breathing).
4. Stroke prevention in patients with atrial fibrillation, warfarin is expected to be replaced
In October 2010, following the publication of positive results from the RE-LY trial, the US Food and Drug Administration (FDA) approved dabigatran for stroke prevention in patients with atrial fibrillation (AF). At the 2010 AHA Annual Meeting, the ROCKET-AF study showed that rivaroxaban was comparable to warfarin for stroke prevention in patients with AF. Studies currently available or underway may reveal good prospects for rivaroxaban, apixaban, edoxaban, and other oral anticoagulants.
5. Modification of pacemaker therapy improves regression in patients with heart failure
A study in the NewEngland Journal of Medicine showed that the addition of resynchronization pacing therapy (CRT-D) to a buried cardioverter-defibrillator (ICD) improved the outcome of patients with heart failure. In addition, another study in the journal showed that newer ICDs (e.g., electrodeless defibrillators) may reduce some of the risks associated with traditional devices.
6. Choice of bypass for congenital heart disease affects child’s prognosis
A Pediatric Heart Network randomized trial in the NewEnglandJournalofMedicine is the first large randomized trial involving congenital heart disease surgery in infants with single ventricle lesions who underwent Norwood bypass surgery. The study showed that the type of bypass surgery influenced outcome, and that selection of a better procedure may improve 12-month graft-free survival outcome in children.
7. New Exploration of Antiplatelet Drugs and Rational Dosing
The PLATO study suggests that ticagrelor may improve patient outcomes and reduce adverse events compared to clopidogrel, and the CURRENT-OASIS7 trial explored the optimal dose of clopidogrel and aspirin in patients with acute coronary syndromes undergoing invasive procedures. These studies suggest that new drugs and more reasonable doses may improve patient outcomes.
8. Stem cell research holds promise for clinical applications
A large sample of animal studies in CirculationResearch identified the underlying mechanisms by which specific types of stem cells initiate myocardial regeneration. The results suggest that stem cells repair scarred myocardium by promoting new myocardium and angiogenesis. Another study in the journal supports the hypothesis that the heart has the ability to regenerate large numbers of cardiomyocytes several times over. The direct differentiation of stem cells into working myocardium is a major advance in the field of stem cell therapy, and the STaR-Heart study showed that injecting patients’ autologous bone marrow stem cells into the heart improved hemodynamics and long-term survival in patients with chronic heart failure.
9. Study reaffirms importance of healthy lifestyles
A study in the NewEnglandJournalofMedicine on physical activity and dietary patterns in adults and children showed that reducing dietary sodium intake levels had a positive effect on reducing obesity and hypertension, among other things. Studies conducted within schools have shown that the earlier healthy lifestyles are initiated, the greater the impact on health transition. In addition, a study in JAMA confirmed that physical activity is an important lifestyle factor for improving heart and metabolism, especially for those trying to lose weight.
10. Follow the guidelines: Smoothing out quality of care disparities
A study in Circulation revealed for the first time that participation in quality of care improvement programs like GetWiththeGuidelines can eliminate racial and ethnic disparities in quality of care by promoting evidence-based care for patients with heart disease.