Sildenafil should be avoided in valve disease with residual pulmonary hypertension, study suggests

"Valvular disease is considered the next cardiac epidemic because of its strong association with age and the rapid aging of the population worldwide," said principal investigator Dr Javier Bermejo, a cardiologist at Hospital General Universitario Gregorio Marañon, Madrid, Spain. "The only established treatment is repair or replacement of the valve surgically or percutaneously," he continued. "But symptoms often remain or reappear in the long-term. Residual pulmonary hypertension is the most important risk factor for death and disability after successful correction of the valvular lesion." Pulmonary hypertension refers to increased blood pressure in the pulmonary artery. In patients with long-standing valvular disease, the high pressure in the left side of the heart is transmitted backwards to the lung vessels which react by thickening. This process may not revert after valve treatment, resulting in persistent pulmonary hypertension. Sildenafil (cen...
Post a Comment

Coronary artery bypass surgery effective in patients with type 1 diabetes

Coronary artery bypass surgery (CABG) is the best method of treating artherosclerotic coronary arteries in diabetes patients with multivessel disease, even in the presence of type 1 diabetes, a new study from Karolinska Institutet reports, clearing up a question in the current recommendation. The study is published in Journal of the American College of Cardiology (JACC).
International guidelines recommend coronary artery bypass surgery (CABG) over the use of balloon catheters (in a process called percutaneous coronary intervention, or PCI) to widen artherosclerotic coronary arteries in diabetes patients with two or more diseased coronary vessels. However, since the underlying research has not differentiated between patients with type 2 diabetes and the less common type 1 diabetes, it has been unclear whether the recommendation applies to both types.
"Since type 1 diabetes is a different disease with different complications, it's never been given that the treatment should be the same as with type 2 diabetes," says Martin Holzmann, researcher at Karolinska Institutet's Department of Medicine in Solna.
Dr Holzmann and his colleagues have now followed up all patients with type 1 diabetes who underwent so-called revascularization of two or more narrowed coronary vessels, a procedure for improving blood circulation in the heart, in Sweden between the years 1995 and 2013.
Their results show that patients who underwent revascularization using PCI ran a 45 per cent higher risk of fatal heart disease and a 47 per cent higher risk of myocardial infarction during the average 10-year follow-up time than patients who were treated with CABG. They were also five times more likely to need further PCI or CABG treatment.
"The results suggest that CABG should also be the preferred procedure for patients with type 1 diabetes and two or more diseased coronary vessels, as currently stated in guidelines for diabetes patients" says Dr Holzmann.
The researchers also found that the relative number of CAGB procedures declined dramatically over the study period. Between 1995 and 2000, CAGB accounted for 58 per cent of revascularizations in patients with type 1 diabetes and at least two diseased coronary vessels, a figure that was down to only 5 per cent between 2007 and 2013.
Dr Holzmann hopes that their findings will impact on medical practice.
"PCI is easier to perform and isn't so invasive for the patient, so there are arguments in favour of this method too," Dr Holzmann explains. "But both randomised studies and registry studies have shown unequivocally that CABG is the best revascularization method for diabetes patients with at least two diseased coronary vessels. We've now found corroborating evidence for this and confirmed that it applies to all diabetes patients."

for more information visit our product website:Buy Sildenafil Black 100mg Online
Location: United States

Comments

Post a Comment

Popular posts from this blog

Anti-inflammatory therapy cuts risk of lung cancer

In most clinical trials for cancer therapy, investigators test treatments in patients with advanced disease. But a recent cardiovascular secondary prevention study has given researchers a unique opportunity: to explore the effectiveness of giving a drug to patients before cancer emerges. At the European Society of Cardiology meeting, Paul M. Ridker, MD, director of the Center for Cardiovascular Disease Prevention at BWH, and colleagues presented findings from CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study). In addition to their cardiovascular results, Ridker and colleagues shared that patients who received the anti-inflammatory therapy canakinumab had a marked reduction in the incidence of lung cancer and lung cancer mortality. In this high-risk population, death from cancer was reduced by half in the group of people who received the highest dosage of the drug. These findings are detailed in a paper published simultaneously in  The Lancet . "As an inflammator...
Read more

Closure of left atrial appendage during heart surgery protects the brain

Image
Cumulative probability of an ischaemic incident in the brain in the closed versus not-closed groups. Credit: Image courtesy of European Society of Cardiology (ESC) Closure of the left atrial appendage during heart surgery protects the brain, according to late-breaking research presented today in a Hot Line LBCT Session at ESC Congress. The results suggest that closure should be routinely added to open heart surgery. "This is the first randomised study to show that closure of the left atrial appendage during open heart surgery effectively protects against brain infarctions and stroke," said Assoc Prof Helena Domínguez, the cardiologist who designed the study. "A stroke following open heart surgery can have devastating consequences for patients and their families," said principal investigator Dr Park-Hansen, from the Department of Cardiology at Bispebjerg/Frederiksberg University Hospital, Copenhagen, Denmark. "Expectations of returning to wor...
Read more

Reducing inflammation without lowering cholesterol cuts risk of cardiovascular events

Investigators from Brigham and Women's Hospital today announced results of a clinical trial culminating from 25 years of cardiovascular research work. At the European Society of Cardiology meeting and in a paper published simultaneously in the  New England Journal of Medicine , Paul M. Ridker, MD, director of the Center for Cardiovascular Disease Prevention at BWH, and colleagues presented findings from CANTOS (Canakinumab Anti-inflammatory Thrombosis Outcomes Study), a trial designed to test whether reducing inflammation among people who have had a prior heart attack can reduce risk of another cardiovascular event in the future. The team reports a significant reduction in risk of recurrent heart attacks, strokes and cardiovascular death among participants who received a targeted anti-inflammatory drug that lowered inflammation but had no effects on cholesterol. "These findings represent the end game of more than two decades of research, stemming from a critical observati...
Read more