Keeping you up to date on recent headlines in cardiovascular healthcare:
BARI2D trial: CABG better than PCI for diabetics . . . . Data from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial emphasizes the benefit of coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) for diabetic patients with stable angina. The study confirms the results from the previous BARI trial if 1996, demonstrating that diabetic patients treated with CABG survived much longer than those PCI-treated. The survival advantage of CABG was proven to continue at 10 year follow-up of the initial BARI trial. The researchers said, "Prompt revascularization significantly reduced major cardiovascular events as compared with intensive medical therapy, among patients who were selected to undergo CABG but not among those who were selected to undergo PCI." The study appears in the June 7 issue of the New England Journal of Medicine.
Liver disease 'shrunk' by BP drug . . . . A blood-pressure (BP) medicine has been shown to reverse the effects of early-stage liver failure in some patients. Researchers at Newcastle University (Newcastle Upon Tyne, UK) analyzed a small clinical trial of losartan, a drug normally prescribed for hypertension, on 14 patients in Spain, who had Hepatitis C. Half of the patients in the trial saw the scars in their liver shrink, allowing the organ to repair itself. Professor Derek Mann said, "This early stage trial has shown that we can shrink liver scarring in some patients and shows promise for a treatment . . . ." The researchers plan to carry out larger studies initially involving patients with liver disease caused by obesity and then, later, alcohol, hereditary and autoimmune diseases. The study appears in Gastroenterology.
Nanoparticle used to treat cardio disease in mice . . . . Researchers at UC Santa Barbara (Santa Barbara, California) and colleagues say they have developed nanoparticles that can attack arterial plaque, lipid-based collections of molecules that form a sphere called a micelle. The micelle has a peptide, a piece of protein, on its surface, and that peptide binds to the surface of the plaque. The researchers induced atherosclerotic plaques in mice and then intravenously injected them with the micelles, allowing them to circulate for three hours. The particles are described as "small particles, with sufficiently long circulation times and carrying peptides that target and treat pathological tissue," able to be constructed by self-assembly. The research appears in a recent issue of the Proceedings of the National Academy of Sciences.
Autogenous infrainguinal bypass inferior in Hispanics . . . . Researchers from the Brigham and Women's Hospital and Harvard Medical School (both Boston) have released indicating that Hispanic patients have poorer outcomes following infrainguinal bypass grafting for the treatment of peripheral arterial disease (PAD). Hispanics had a higher rate of bypass graft failure and amputation after revascularization compared to Caucasians, Hispanic ethnicity found independently predictive of eventual amputation. "Despite our attempts to treat all patients very aggressively for severe lower extremity ischemia through revascularization to prevent amputation, limb preservation at five years was 80% in Hispanics, 84% in African-Americans, and a 91% in Caucasians," said Michael Belkin, MD, chief of the division of vascular and endovascular surgery. He added that Hispanics often required a bypass at younger age and more commonly had diabetes in comparison to Caucasians. The study appears in the June issue of the Journal of Vascular Surgery.
Less than drop of blood needed by heart diagnostic device . . . . Researchers from Harvard and Northeastern University ( both, Boston) have developed a credit card-sized device requiring less than a drop of blood to test for heart disease. The device measures endothelial progenitor cells that build vascular tissue, using only 200 microliters of blood and working "like Velcro or magnetism." The inside is coated with antibodies that only bind to endothelial progenitor cells. Blood flows through a funnel-like opening, passes over the antibodies, and endothelial progenitor cells are "picked up" in the process. The development enables collection of these cells more easily and providing a new model for studying how blood flow effects cell binding (like clots form in arteries). The research appears online in the FASEB Journal.
Silver nanoparticles: potential for clot prevention . . . . At team of scientists from two universities in India have reported a potential new alternative to aspirin, ReoPro, and other anti-platelet agents. Their study involves particles of silver — 1/50,000th the diameter of a human hair — that are injected into the bloodstream. The scientists describe development and lab testing of silver nanoparticles that seem to keep platelets in an inactive state. Low levels of the nanosilver, injected into mice, reduced the ability of platelets to clump together by as much as 40 percent with no apparent harmful side effects. The nanoparticles "hold immense potential to be promoted as an antiplatelet agent," the researchers say. "Nanosilver appears to possess dual significant properties critically helpful to the health of mankind — antibacterial and antiplatelet — which together can have unique utilities, for example in coronary stents." The study appears in a recent issue of ACS Nano, a publication of the American Chemical Society.
Trans-radial approach promoted for catheterizations . . . . Memorial Hermann The WoodlandsHospital (The Woodlands, Texas) reported that one of its cardiologists, Sanjay Patel, MD, is offering a trans-radial approach for cardiac catheterizations, the use of the radial artery near the wrist as entry to the body, rather than through the femoral artery. The hospital said that the advantages include lower mortality than the femoral approach, less bleeding, increased patient comfort and fewer complications. The hospital said that Patel has performed more than 900 catheterizations via the wrist.
Shared genetic variant found for gum disease, heart disease . . . . Scientists at four German universities have identified a genetic link between coronary heart disease and periodontis. The discovery was presented at the recent meeting of the European Society of Human Genetics (Vienna, Austria) Arne Schaefer, MD, of the University of Kiel (Kiel, Germany), said "The genetic variation associated with [periodontitis] is identical to that of patients who suffer from cardiovascular disease and have already had a myocardial infarction." The genetic variant was found on chromosome 9. Schaefer said that "Aggressive periodontitis has shown itself to be associated not only with the same risk factors such as smoking, but it shares, at least in parts, the same genetic predisposition with an illness that is the leading cause of death worldwide."
Parathyroid hormone levels predict CV mortality in community . . . . A new analysis of a Swedish study of elderly men finds that plasma parathyroid hormone (PTH) levels predict cardiovascular mortality, even in individuals with normal levels of this hormone. Using data from the Uppsala Longitudinal Study of Adult Men (ULSAM), a community-based cohort of men (mean age 71), Emil Hagstr m, MD, of Uppsala Clinical Research Center (Uppsala, Sweden) and colleagues found that in a 10-year follow-up, 117 of 958 participants died of cardiovascular causes. In multivariate adjustment, higher plasma PTH was associated with a higher risk for CV mortality, the association essentially unaltered in those without previous CVD and in those with normal PTH, with no other signs of disturbed mineral metabolism. The study appears in the June 2 issue of Circulation.
— Compiled by Don Long, MDD National Editor