A universal consensus on the definition of myocardial infarction was released last month. Given the considerable advances in the diagnosis and treatment of myocardial infarction in recent years, the leadership of the European Society of Cardiology, the American College of Cardiology and the American Heart Association convened, together with the World Heart Federation, to update the 2000 consensus document.
Experts within the field of biomarkers, ECG, imaging, interventions, clinical investigations, public policy and implementation were all involved in the decision.
The first consensus committee recommended that myocardial infarction be qualified by reference to: the amount of heart muscle loss (infarct size); the circumstances leading to the infarct (spontaneous or procedure related); and the timing of the heart muscle cell death relative to the time of the observation (evolving, healing or healed).
The new report expands the criteria by adding new material on ECG criteria, imaging modalities, people who present with sudden death as the initial manifestation of the infarct and implications of the redefinition for clinical investigation.
The revised definition will be published this year in the European Heart Journal, the Journal of the American College of Cardiology and Circulation.
The new definition is important as it enables clinicians to make a diagnosis. Labelling an individual with a specific condition has implications with respect to their treatment and, in some circumstances, their ability to perform certain roles.
A unified definition will also allow comparison of the disease between countries that previously defined it differently.
European Society of Cardiology Press Office, 19 October 2007
Telmisartan reduces CV events in people with hypertension and diabetic neuropathy
A new head-to-head study, AMADEO, has shown that people with hypertension and diabetic neuropathy treated with the angiotensin receptor blocker telmisartan (Micardis) are 42% less likely to suffer a cardiovascular event than people treated with losartan.
During the 1-year study, only 5.1% of people in the telmisartan group suffered a cardiovascular event, compared with 8.7% in the losartan group (P=0.037).
In addition, telmisartan was more effective in reducing the amount of protein excreted in the urine. It reduced the protein:creatinine ratio by 29%, compared with 20% with losartan. These results suggest that telmisartan is more renoprotective than losartan, which is already licensed as a renoprotective agent.
Lead investigator, Professor Ellen Burgess, said: ‘The AMADEO results are encouraging for an increasing number of patients with type 2 diabetes because they suggest that telmisartan could improve renoprotection’.
Medical News Today, 19 June 2007
Successful fight against cholesterol with rosuvastatin
Recent data from 100 GP practices demonstrate that rosuvastatin (Crestor) 10mg enables a large proportion of people with diabetes and hypercholesterolaemia to achieve QOF target total cholesterol levels compared with prior statin treatment.
The target of <5mmol/l was achieved by 85% of people taking rosuvastatin, including those who had previously been unable to lower their cholesterol using various doses of atorvastatin or simvastatin.
‘The emphasis is on cost–effectiveness strategies for reaching cholesterol targets in an NHS setting,’ commented Dr George Kassinos, a GP from Bracknell and chair for the study. ‘This GP practice data from across the country goes beyond clinical trials to show what we can actually achieve in real-life practise when using rosuvastatin 10mg ‘second line’.’
CountryDoctor.co.uk, 23 October 2007
High risk of death or CVD events associated with atherothrombosis
UK results from REACH, a large global registry, have revealed that almost one in five people with peripheral arterial disease will die or suffer a non-fatal stroke or heart attack, or be hospitalised for a complication arising from the condition within a year.
Having atherosclerosis in two vascular beds doubled the risk of another event such as death, stroke, heart attack or hospitalisation.
The REACH (REduction of Atherothrombosis for Continued Health) registry is a worldwide health survey of 68236 people in 44 countries, including 600 in the UK, that aims to establish how people are affected by atherothrombosis and identify the burden of the disease in society.
Sanofi Aventis Press Office, 12 October 2007
Garlic’s cardioprotection revealed
Smelly garlic breath may soon be a medical recommendation. Researchers, who claim not to have any affiliations to France, have suggested that the key to why eating garlic can improve the health of the heart lies in allicin, a compound that is broken down into the foul-smelling sulphur famously associated with it.
When these sulphur compounds react with red blood cells, they produce hydrogen sulphide, which causes blood vessels to relax and reduces pressure on the heart.
Cardio Lite awaits results from the Transylvanian research team as to whether this effect is particularly potent during night-time or full moons.
BBC News, 15 October 2007
Amid accumulating evidence of benefits with new diabetes drugs, Vinod Patel asks whether the costs can be justified.
9 Nov 2023