New insight and intervention ideas to help reduce the number of heart attacks
People with a stable psychosocial life situation often delay in seeking help for their alcohol problems - even though they are serious. This is revealed in a new thesis from the University of Gothenburg. Working actively to intervene at an early stage in order to prevent alcohol problems and to thereby promote public health is
Full Post: Socially stable individuals delay seeking help for alcohol problems
A new national study has shown that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event, according to current national cholesterol guidelines.
Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL).
“Almost 75 percent of heart attack patients fell within recommended targets for LDL cholesterol, demonstrating that the current guidelines may not be low enough to cut heart attack risk in most who could benefit,” said Dr. Gregg C. Fonarow, Eliot Corday Professor of Cardiovascular Medicine and Science at the David Geffen School of Medicine at UCLA and the study’s principal investigator.
While the risk of cardiovascular events increases substantially with LDL levels above 40 mg/dL, current national cholesterol guidelines consider LDL levels less than 100� mg/dL acceptable for many individuals. The guidelines are thus not effectively identifying the majority of individuals who will develop fatal and non-fatal cardiovascular events, according to the study’s authors.
Researchers also found that more than half of patients hospitalized for a heart attack had poor high-density lipoprotein (HDL) cholesterol levels, according to national guidelines.
Published in the January issue of the American Heart Journal , the study suggests that lowering guideline targets for LDL cholesterol for those at risk for cardiovascular disease, as well as developing better treatments to raise HDL cholesterol, may help reduce the number of patients hospitalized for heart attack in the future.
“The study gives us new insight and intervention ideas to help reduce the number of heart attacks,” said Fonarow, who is also director of the Ahmanson-UCLA Cardiomyopathy Center.
“This is one of the first studies to address lipid levels in patients hospitalized for a heart attack at hospitals across the entire country.”
The research team used a national database sponsored by the American Heart Association’s Get with the Guidelines program. The database includes information on patients hospitalized for cardiovascular disease at 541 hospitals across the country.
Researchers analyzed data from 136,905 patients hospitalized for a heart attack nationwide between 2000 and 2006 whose lipid levels upon hospital admission were documented. This accounted for 59 percent of total hospital admissions for heart attack at participating hospitals during the study period.
Among individuals without any prior cardiovascular disease or diabetes, 72.1 percent had admission LDL levels less than 130 mg/dL, which is the current LDL cholesterol target for this population. Thus, the vast majority of individuals having their first heart attack would not have been targeted for effective preventative treatments based on the criteria used in the current guidelines.
The team also found that half of the patients with a history of heart disease had LDL cholesterol levels lower than 100 mg/dL, and 17.6 percent of patients had LDL levels below 70 mg/dL, which are guideline targets for LDL cholesterol in those at fair risk and at high risk for cardiovascular disease, respectively.
The study also showed that HDL cholesterol, or “good cholesterol,” levels have dropped in patients hospitalized for heart attack over the past few years, possibly due to increasing rates of obesity, insulin resistance and diabetes.
Researchers found that 54.6 percent of patients had HDL levels below 40 mg/dL. Developing more effective treatments to boost HDL levels may help reduce the number of patients hospitalized for heart attacks, according to the authors.
“We found that less than 2 percent of heart attack patients had both ideal LDL and HDL cholesterol levels, so there is room for improvement,” said Fonarow.
Fonarow said that only 59 percent of patients in the database had their lipid levels checked upon admission, which should be increased, since these early measurements can often help guide treatment decisions.
He also noted that only 21 percent of patients in the study were taking lipid-lowering medications before admission, despite almost half having a prior history of cardiovascular events, which would prompt treatment.
Men and women have about the same in-hospital death rate for heart attack - but women are twice as likely to die if hospitalized for a more severe type of heart attack, according to a report in Circulation: Journal of the American Heart Association. Among patients with ST elevation myocardial infarction (STEMI) in a recent
Full Post: Gender disparity gap in heart attack care still present
Individuals reporting a history of periodontal disease were more likely to have increased levels of inflammation, a risk factor for heart disease, compared to those who reported no history of periodontal disease, according to an American Journal of Cardiology report available online today. Led by investigators from Columbia University Medical Center and NewYork-Presbyterian Hospital, the
Full Post: Presence of gum disease may help dentists and physicians identify risk of cardiovascular disease
Despite substantial progress in the diagnosis and treatment of heart attack patients, prevention of recurrent heart attacks continues to be a major clinical challenge. A new study showed that patients who suffered a non-fatal heart attack within the first three months of hospitalization for chest pain had a significantly higher risk for dying or having
Full Post: Heart attack prevention within three months after hospitalization significantly averted future attacks
This year, about 450,000 Americans will die of coronary heart disease - the leading cause of death for both men and women. Although we have made great strides in preventing and treating heart disease, we continue to explore the complex mechanisms involved in cardiovascular disease, and we are eager to refine risk assessment tools and
Full Post: Simple blood test for high-sensitivity C-reactive protein is a useful marker for cardiovascular disease
Researchers estimate more than 11 million older Americans may be newly eligible for statin therapy if findings from a recently published large clinical trial are adopted into clinical practice guidelines, according to a new analysis of the trial data. The analysis is published online in Circulation: Cardiovascular Quality and Outcomes . Using data from the
Full Post: Numerical analysis estimates numbers of older US adults who may benefit from statin therapy