Cath Lab Digest - January 2008 - (Page 56)

56 CLINICAL AND INDUSTRY NEWS JANUARY 2008 Research Studies cont. This large Canadian study found that drug-eluting stents are effective in reducing the need for target-vessel coronary artery bypass in patients at the highest risk for re-narrowing of previously blocked arteries, without a significantly increased rate of death or heart attack. Source: New England Journal of Medicine, Oct. 7, 2007; N Engl J Med 2007; 14;357:1393–1402; www.nejm.org. Funding: The Ontario Ministry of Health and Long-Term Care to the Program for Assessment of Technology in Health, the CCN of Ontario and the Institute for Clinical Evaluative Sciences supported this study in part. 10. Underdiagnosis of hypertension in children and adolescents This study of more than 14,000 children found that hypertension and prehypertension were often undiagnosed in the pediatric population. Patient age, height, obesityrelated diagnoses, and magnitude and frequency of abnormal blood pressure readings all increased the odds of hypertension. Source: Journal of the American Medical Association, Aug 2007; JAMA 2007; 298(8):874–879; www.jama.org. Funding: This research did not receive funding support. Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect association policy or position. The American Heart Association makes no representation or warranty as to their accuracy or reliability. ■ Heart Attack Risk From Smoking Due to Genetics H eart attacks among cigarette smokers may have less to do with tobacco than genetics. A common defect in a gene controlling cholesterol metabolism boosts smokers’ risk of an early heart attack, according to a study in Annals of Noninvasive Electrocardiology. The findings also show that smokers without the defect normally have heart attacks no sooner than their nonsmoking peers. Although the link between smoking and heart disease was established decades ago, the reasons for that link were unclear. More recent studies suggest smoking interferes with cholesterol metabolism, lowering smokers’ levels of high-density lipoprotein, the good cholesterol that protects against heart-attack risk. An estimated 55 to 60 percent of smokers face the added risk of a defective gene that also lowers levels of the protective high-density lipoprotein. Therefore, the combination of smoking plus a defective gene substantially accentuates the risk of heart attacks in these patients. Researcher Ilan Goldenberg, MD, and colleagues were the first to evaluate both smoking history and the genetic trait in heart-attack patients. They found that smokers with the genetic defect had their first heart attack eight to nine years earlier than non-smokers. Smokers with a healthy version of the gene had their first heart attack only three years earlier than non-smokers, a difference the researchers considered non-significant. “Since the frequency of this ‘bad’ gene in the general population is about 60 percent, many people who smoke have a high risk of experiencing a heart attack at a young age,” Goldenberg said. “This finding should increase awareness for smoking cessation.”■ Cardiovascular Disease Death Rates Decline, but Risk Factors Still Exact Heavy Toll American Heart Association Statistical Update C ardiovascular disease (CVD) death rates are declining, but CVD is still the No. 1 cause of death in the United States, and risk factor control remains a challenge for many, according to the most recent data from the American Heart Association’s Heart Disease and Stroke Statistics — 2008 Update. The Update is available in the Dec. 17 online issue of Circulation: Journal of the American Heart Association at http://www.americanheart.org/statistics. The Update provides statistics about cardiovascular diseases, risk factors, treatments, quality of care and costs. The American Heart Association does not generate the data, but synthesizes it from many sources and provides it online without charge for government policymakers, physicians, researchers, educators and the public, making the Update a unique national — and even international — resource. Cardiovascular diseases include heart disease, stroke, high blood pressure, heart failure and several other conditions including arrhythmias, atrial fibrillation, cardiomyopathy and peripheral arterial disease. CVD has been the leading cause of death in the United States every year since 1900 except during the 1918 flu epidemic. In 2004, the most recent year for which final statistics were available for this report, the age-adjusted CVD death rate per 100,000 persons was 288.0, compared to 307.7 in 2003. CVD (the No. 1 overall cause of death) was listed as the underlying cause of death in 869,724 deaths, compared to 911,163 deaths in 2003. Cancer was the second-leading cause of death, responsible for 553,888 lives lost. Stroke, when considered separately from other cardiovascular diseases, was the nation’s third-leading killer (150,074 deaths), followed by accidents (112,012). Coronary heart disease, even when considered separately from other cardiovascular diseases, was still by far the nation’s single leading cause of death (451,326). “These statistics make it clear that cardiovascular disease remains, by far, our greatest public health challenge,” said Donald Lloyd-Jones, MD, ScM, chair of the association’s Statistics Committee, which, along with the association’s Stroke Statistics Subcomittee, is responsible for the Update. While CVD deaths appear to be decreasing, the prevalence of many related risk factors is holding steady or increasing. Overweight, in both adults and children, has been rising for several decades. Sixty-six percent of adults are overweight while 31.4 percent are obese. Seventeen percent of children and adolescents ages 12–19 are overweight, along with 17.5 percent of children ages 6–11, and 14 percent of children ages 2–5. “Although we have made some substantial strides in understanding the causes of cardiovascular disease, the data in this publication show that we have a long way to go to capture people’s attention and to implement the prevention and treatment programs we need,” said Lloyd-Jones, an associate professor in the Department of Preventive Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. Changing dietary habits appear to be fueling increased obesity, because many Americans are not consuming recommended levels of foods like fruits and vegetables. As cited in the Update, data from the Youth Risk Behavior Surveillance Study of the Centers for Disease Control and Prevention (CDC) shows that in 2005, among high school students, only 21.4 percent of males and 18.7 percent of females reported eating at least five daily servings of fruits and vegetables. http://www.jama.org http://www.nejm.org http://www.americanheart.org/statistics http://www.americanheart.org/statistics

Table of Contents Feed for the Digital Edition of Cath Lab Digest - January 2008

Cath Lab Digest - January 2008 Central Baptist Hospital Contrast Media Use in High-Risk Patients An Ergonomic Survey of Cath Lab Repetitive Stress Injuries Contents Clinical Editor’s Corner Takotsubo Cardiomyopathy, a.k.a., Transient Left Ventricular Apical Ballooning Syndrome: An Acute Coronary Syndrome Imposter Searching for the Key to D2B STEMI Intervention News STEMI Interventions: Commentary The Massachusetts Stent Study The Value of Educating Staff Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab SICP* Chapter Updates The Society of Invasive Cardiovascular Professionals Holds an RCIS Review Course at New Cardiovascular Horizons 18:20 To Denver — One Student’s First Clinical Experience CEU Education Center Meetings Calendar What Do You Think? Clinical & Industry News Classifieds The Ten-Minute Interview with…Heather Vardon, RN Advertisers Index

Cath Lab Digest - January 2008

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