Study shows both Mediterranean and vegetarian diets are heart healthy

A vegetarian diet, which includes dairy and eggs though not fish and meat (lacto-ovo-vegetarian), may be as effective as Mediterranean diet at reducing heart disease risk and stroke, suggested a study published in Circulation, a journal of the American Heart Association. The study included 107 participants aged 18 to 75 who were overweight though healthy, and were randomly picked to follow a low calorie vegetarian diet with eggs and dairy for three months, or a low calorie Mediterranean diet for three months. Participants then switched to the opposite diet. Researchers reported both groups were able to lose about three pounds of fat and four pounds of weight total, and had similar changes in body mass index. However, a vegetarian diet was more effective at decreasing LDL while a Mediterranean diet resulted in reduced triglycerides. The study, "Low-calorie vegetarian versus Mediterranean diets for reducing body weight and improving cardiovascular risk profile: CARDIVEG study (cardiovascular prevention with vegetarian diet)," was published online Feb. 26, 2018. Limitations were that participants were considered low risk for heart disease.

Heart attack linked to waist and hip circumference rather than obesity

Carrying weight at the waist and hip is more strongly tied to risk of heart attack than obesity overall, according to a study in the open access Journal of the American Heart Association, and suggesting the distribution of fat plays a role. The link between an increased waist and hip measurement and heart attack is more pronounced among women. "Our findings support the notion that having proportionally more fat around the abdomen (a characteristic of the apple shape) appears to be more hazardous than more visceral fat, which is generally stored around the hips (i.e., the pear shape)," said lead author Sanne Peters, Research Fellow in Epidemiology at the George Institute for Global Health at the University of Oxford in the United Kingdom. The study included 500,000 U.K. adults between ages 40 and 69 from the Biobank. Authors suggested that general obesity and weight around the abdominal area had a detrimental effect on heart attack risk. Women were most affected by increased waist circumference and increased waist to hip ratio. Additional study may provide treatment strategies. The study, "Sex differences in the association between measures of general and central adiposity and the risk of myocardial infarction: results from the U.K. Biobank," was published online Feb. 28, 2018.

Heartflow entered licensing agreement with Cedars-Sinai for plaque technology

Heartflow Inc., of Redwood City, Calif., has entered a licensing and technology transfer agreement with Cedars-Sinai in Los Angeles for a software system to detect and characterize coronary artery plaque. The Autoplaque technology uses coronary computed tomography angiography (CCTA) images to illuminate plaques and allow for better diagnosis and planning in treatment for patients with coronary artery disease (CAD). Such assessment of plaques that may rupture, referred to as vulnerable plaques, and lead to acute coronary syndrome is being researched as a method of determining which plaques are most at risk. A recent study, EMERALD (Exploring the MEchanism of the plaque Rupture in Acute coronary syndrome using coronary CT angiography and computationaL fluid Dynamics) indicated Heartflow FFRct (fractional flow reserveCT) analysis with coronary plaque assessment may pinpoint which plaques are at greatest risk of rupturing. FFRct is a noninvasive method that creates a 3-D model of a patient's heart to look at blockages as well as blood flow to determine treatment options and the greatest possible effectiveness. "In addition to assessing lesion-specific physiology, understanding and characterizing coronary artery plaque is important in determining the most appropriate treatment path for patients with suspected CAD. The power of utilizing the Autoplaque tool in the Heartflow analysis may accelerate our ability to analyze and characterize plaque in coronary arteries," said John Stevens, president and CEO, Heartflow. "Heartflow is committed to looking beyond our initial FFRct offering to additional novel products that can help clinicians address other important clinical factors in the diagnosis and treatment of CAD and develop solutions that we believe will benefit patients who may be most at risk for acute coronary syndrome." CAD occurs as a result of narrowed arteries and can result in chest pain, myocardial infarction and death. Acute coronary syndrome results from decreased blood flow in the heart, possibly due to ruptured plaque in a coronary artery.

Opt-out vs. opt-in increases cardiac rehab referral rate: study

Taking the simple action of setting the default option for patients as "opt-out" as opposed to "opt-in" for cardiac referral increased rates significantly, according to a study presented at the American College of Cardiology. Patients who are recovering after heart attack, heart failure, angioplasty or heart surgery have been known to benefit from medically supervised cardiac rehab, including reduced readmission rates, reduced deaths and increased quality of life. However, not all patients complete the exercise counseling and education, smoking cessation and other guidance provided in cardiac rehab. In the study, care teams were informed of the benefits of rehab and provided information to patients at discharge. More than 40 cardiac rehab locations in the area were chosen and confirmed to take patients and participate in the re-ferral process. Staff helped patients chose the facility and program and sent the referral to that facility. A transition coordinator then followed up with patients a week after discharge. In the 21 months preceding the program, the cardiac rehab referral rate was about 12 percent on average. That rate jumped to 75 percent for the next three quarters after the program began. Patients who were discharged from hospitals that had not participated in the full program but were simply provided more information on cardiac rehab also saw referral rates increase from 4.2 percent to 24.8 percent, and 4 percent to 25.4 percent at two separate hospitals. "Cardiac rehab gives patients an opportunity to get back to or begin exercising safely under the guidance of a specialist and helps them understand medications they've been placed on," said lead researcher Elizabeth Jolly, interventional cardiology transitions coordinator at the Hospital of the University of Pennsylvania in Philadelphia. "If a provider thought a patient would benefit from cardiac rehab, they would hand the patient a handwritten prescription but didn't have the tools to get them there," Jolly said. "At a big institution like ours, we have so many patients that it's not always evident who qualifies for cardiac rehab. Now we know in real time. We started bringing cardiac rehab into our conversations with patients and adding it to discharge documentation and conversations following discharge as well. Now this is part of our daily workflow."

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