Heart stents and cvd news

The 2007 COURAGE study
This is a quote from the conclusions:
As an initial management strategy in patients with stable coronary artery disease,
PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy.

Stress Echo in Asymptomatic Revascularized Patients Not Useful : Cardiology News
Here's the first paragraph:
Routine exercise stress echocardiography may not be warranted in asymptomatic patients after coronary revascularization because even though it may identify those at high risk, this does not improve patient outcomes, according to a report published online May 14 in Archives of Internal Medicine. 


Plavix going generic May 17, 2012

April 27 2012
Alternative Dosing Regimens Work Around Statin Myalgia : Cardiology News
A warning from the article "It must be emphasized, however, that none of the alternative dosing regimens have proved to reduce cardiovascular events. The issue hasn’t been studied."
another quote from the article "Alternate-day dosing as an answer for statin-intolerant patients only can be carried out effectively with rosuvastatin or atorvastatin, drugs with half-lives markedly longer than the other statins. " 

March 2012
Functional Measurement of Coronary Stenosis
This is from the introduction of this paper
In this state-of-the-art paper, the basic concept of FFR and its application, characteristics, and use in several subsets of patients are discussed from a practical point of view.

March 2012
Questions to Ask Your Interventional Cardiologist About Angioplasty and Stents My mistake was to ask no questions. With hindsight the questions are obvious, but I failed to ask them.  The questions are:
Do I have a life-threatening blockage?
How will I know if I have a life-threatening blockage?
What will happen if I don’t undergo angioplasty and stenting? 
Would medication alone work just as well for me?
What should I do if I have more questions? 
Click on the link for discussions for these five questions.
 
February 23, 2012
Behavioral intervention helped increase physical activity after PCI
If you encourage patients to improve their physical activity, many more will exercise and benefit from the activity.  Patients in the intervention group suffered from less depression after 12 months compared to the control group.  Two thirds of the people chose walking as their form of exercise.

 Ties between companies and cardiac societies

Before getting a stent find out what medications will be prescribed for you afterwards. If you can't afford the medications, you had better have a serious conversation with the people who are suggesting a stent would be a good remedy for your problems.

FDA medical devices database  This is where to get information on the stent you will have inserted or the one you are stuck with.

More research needed to evaluate role of vitamin D in reducing CVD
Vitamin D may protect against stroke, cognitive impairment
This study did not measure blood levels of Vitamin D. It relied on a food frequency questionnaire of 26,309 people.

Drug-eluting stent use linked to lower mortality, repeat revascularization rates in elderly patients
In a study of more than 400,000 patients aged at least 65 years, drug-eluting stent use declined in patients aged 85 years and older, although drug-eluting stents were associated with lower adverse event rates compared with bare metal stents, according to study results.

Continuous dose of nitroglycerin increases severity of heart attacks, study shows

April 4, 2012
A link between atherosclerosis and autoimmunity
The long arm of the dendritic cell: A link between atherosclerosis and autoimmunity

FDA: Mortality Increased With Dronedarone and Permanent AF By: ELIZABETH MECHCATIE, Cardiology News Digital Network

 

Dronedarone increases the risk of death and serious cardiovascular events in people with permanent atrial fibrillation, and its use should be limited to the approved indication: the treatment of nonpermanent AF, the Food and Drug Administration has concluded.

In a statement issued Dec. 19, the FDA announced that its safety review of dronedarone (Multaq), an antiarrhythmic drug approved in July 2009, has been completed. "The FDA believes that Multaq provides a benefit for patients with nonpermanent AF and recommends that healthcare professionals who prescribe Multaq follow the recommendations in the revised Multaq drug label," the FDA statement said.

Dronedarone, marketed as Multaq by Sanofi-Aventis, is indicated to "reduce hospitalizations for AF in patients in sinus rhythm with a history of nonpermanent AF."

Late stent thrombosis is a condition that can kill you, years after a DES stent is inserted.


Definitions (work in progress)

ASA aspirin
FFR fractional flow reserve
ICD implantable cardioverter-defibrillator
TLR target lesion revascularization
stenticide killed by your stent

CTA coronary computed tomography angiogram, a useful description is on the Cleveland Clinic Site. 
PCI percutaneous coronary intervention
DAPT dual antiplatelet therapy
thienopyridine One of a group of compounds, including ticlopidine and clopidogrel, which prevent platelet aggregation (definition from Drugs.com)

Autobiographical Notes

I tried Crestor for two months.  I developed a severe pain in the achilles tendon of my right leg.  I switched back to simvastatin.