Posts Tagged ‘heart disease’

Non-Cardiac Surgery Too Soon After Cardiac Stenting Increases Risk of Complications

May 14, 2010

According to a recent study published in Circulation: Cardiovascular Interventions (an American Heart Association journal), patients should attempt to postpone having surgeries for at least six weeks after a coronary angioplasty procedure with stenting.  Researchers found that patients who wait at least six weeks before having another surgery are less likely to develop reduced blood flow to the heart (a.k.a. heart ischemia) and heart attacks.

The study data revealed that 42 % of patients who had other surgeries within the six-week period developed these complications. Only 13 % of patients who had surgeries beyond the six-week period developed the same complications. The study focused 1,953 patients with an average age of 64 who had cardiac angioplasty with stenting between 2003 and 2007.

According to the American Heart Association:

  • Over 70 percent of coronary angioplasty procedures in the United States also include stenting.
  • In 2006, approximately 65 percent of PCI procedures were performed on men, and approximately 50 percent were performed on people age 65 or older.
  • In 2006, an estimated 1,313,000 PCI procedures were performed in the United States.
  • In 2006, approximately 76% of stents implanted during PCI were drug-eluting, compared with 24 percent bare-metal stents.
  • In 2006, there were 652,000 PCI procedures with stents — 425,000 in men, 227,000 in women.

If you recently had cardiac stenting and require another surgery, make sure to ask your doctor about waiting to have the next surgery. This is particularly true if your next surgery is an elective one. If your doctor or surgeon is not a cardiologist, you may want to consider asking your doctor for a referral to a cardiologist.  You may also want to make sure that your physician or surgeon obtains cardiac clearance before proceeding with another surgery.   Don’t assume that your doctor will do these things for you. Be proactive; ask questions.

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Contributing author: Jon Stefanuca

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Angina : The Efficacy of Percutaneous Coronary Intervention vs. the Efficacy of Non-Surgical Treatment

March 28, 2010

Angina is characterized by chest pain resulting from insufficient blood flow to the heart. In this context, abnormal blood flow is caused by the build up of plaque in the coronary arteries or as a result of coronary artery stenosis. Consequently, angina symptoms are usually indicative of heart disease. It is estimated that nearly seven million people in the United States have angina and that nearly 400, 000 patients present with new cases of angina each year.

A recent study published by Annals of Internal Medicine compared the efficacy of percutaneous coronary intervention vs. the efficacy of non-surgical medical care in treating angina in patients with stable coronary artery disease. Percutanious coronary intervention refers to coronary angioplasty. The study in question involved cardiac angioplasties with and without cardiac stents. Non-surgical treatment refers to drug treatment of angina symptoms.

Researchers performed a comprehensive review of 14 previous trials, which compared the efficacy of coronary angioplasty (with and without stents) vs. non-surgical medical care. In total, the 14 trials involved 7818 patients. Researchers concluded that older trials suggest that percutaneous coronary intervention was only marginally more effective in the treatment of angina. This, however, did not appear to be true in more recent trials. The study suggests that coronary angioplasty may not be necessary or recommended to treat angina in patients with stable coronary artery disease if proper evidence-based medications are employed.

Contributing author: Jon Stefanuca

Cardiac Catheterizations Overused

March 11, 2010

According to an article published by WebMd, a recent study suggests that almost two-thirds of patients who undergo cardiac catheterizations do not have clogged arteries.

Researchers tracked about two million patients who had the procedure at about 663 hospitals across the nation between 2004 and 2008. Of the two million patients, researchers focused on about 400, 000 patients with stable chest pain and no previous history of heart disease. The study specifically excluded patients with a history of heart disease, angina, or heart attacks.  In this population of patients, about two-thirds did not have significant arterial blockage.

Cardiac catheterization is a commonly used invasive procedure to diagnose blockage in the arteries of the heart. The procedure is performed by inserting a catheter in an artery of the arm or the leg. The catheter is then guided into the coronary arteries of the heart.  At such time, a die is injected through the catheter and its flow is analyzed to determine whether the artery is blocked.

According to Pamela S. Douglas, professor of cardiology at Duke University:

We want to be clear that if someone is having a heart attack and their doctor sends them to a cath lab, they shouldn’t argue. … But a stable patient who has not been diagnosed with heart disease and who does not need catheterization for pain control may want to ask about the risks and benefits.

Contributing author: Jon Stefanuca

New BPA Research – Is Your Plastic Water Bottle Toxic?

February 20, 2010

According to an article published in WebMD Health News, two recent studies suggest that the plastic chemical bisphenol A (BPA) is not toxic to the brain and that it does not inhibit the development of the human reproductive system. One of the studies was funded by the plastics industry. Both studies were originally published in Toxicological Sciences.

BPA is an organic chemical compound, which is used as an additive or building block in several plastics. Its primary purpose is to harden plastic. For this reason, BPA is found in a wide variety of consumer products such as plastic bottles, cups, and even baby milk bottles.

“Some experts are concerned that exposure to BPA and its weak estrogen-like effects, especially during critical periods of development, may be linked to a range of health hazards, including behavioral effects, reproductive problems, cancers, heart disease, and diabetes.”

The two studies in question were designed to specifically study the impact of BPA on the brain and the reproductive system. Both studies used animal models.  The study that focused on neurotoxicity found that female rats and their litters did not develop neurological defects from exposure to BPA.  The study that focused on BPA’s impact on the reproductive system found that rats exposed to low doses of BPA in utero and throughout the breastfeeding period maintaind healthy reproductive systems.

Notwithstanding these new findings, many remain concerned about the toxicity of BPA. Even the FDA reversed its position regarding the safety of BPA in January 2010 and called for additional research on the subject. Previous studies appear to suggest that BPA is toxic. For example, in an article published in Reproductive Toxicology in 2007, 38 experts agreed that average levels of BPA in humans are above those that appear to cause harm in animals.  In 2009, an article publushed in Molecular and Cellular Endocrinology, sumarized past BPA research and concluded that:

“The potential for BPA to influence body weight is suggested by in vitro studies demonstrating effects of BPA on adipocyte differentiation, lipid accumulation, glucose transport and adiponectin secretion. Data from in vivo studies have revealed dose-dependent and sex dependent effects on body weight in rodents exposed perinatally to BPA. The mechanisms through which perinatal BPA exposure acts to exert persistent effects on body weight and adiposity remain to be determined.”

Another study published in the Journal of American Medical Association specifically addressed the impact of BPA on humans.  The study concluded that there was a strong positive correlation between the amount of  BPA in a person’s urine and the incidence of heart disease, diabetes, and enzyme abnormalities.  These are just a few of the many research studies suggesting a link between BPA and varous medical complications.

Contributing Author:  Jon Stefanuca