In the largest multicenter clinical trial of children undergoing early-stage surgery for single-ventricle heart defects, differences in intraoperative management did not significantly affect neurodevelopmental outcomes at 14 months of age. Instead, the strongest influences were innate patient characteristics and general medical morbidity during the child's first year of life. Children born with hypoplastic left-heart syndrome (HLHS) and related single-ventricle defects have long been known to be vulnerable to developmental impairments, and researchers suspected that variations in heart shunts and in cardiopulmonary bypass might affect outcomes. However, the study leaders concluded that substantial improvements in neurodevelopmental outcomes are "likely to require interventions that occur outside the operating room.
A number of studies have shown that excess insulin circulating in the bloodstream is a major independent risk factor for cardiovascular disease. However, a new study from Joslin Diabetes Center finds that this condition, called hyperinsulinemia, is itself not a cause of atherosclerosis. In humans, insulin resistance, a condition in which insulin becomes less effective at lowering blood sugar levels, coexists with hyperinsulinemia. Both are associated with atherosclerosis, the buildup of cholesterol in blood vessels that causes coronary artery disease, heart attack, and stroke. In this condition, vascular cells could become dysfunctional because of hyperinsulinemia or because vascular cells themselves are insulin resistant, which is caused by increased insulin production from pancreatic beta cells as a compensatory mechanism to overcome insulin resistance.
Health care practitioners have long understood the importance of "door to balloon" time for heart attack patients - the faster they can get the patient from the door of the hospital to a catheterization lab to open a clogged artery, the better the patient will do. But a University of Cincinnati (UC) emergency medicine researcher says it's also important to study the "medical contact to balloon" time, acknowledging the role that emergency medical services (EMS) responders play in speeding patient care. In a paper published online in the journal Academic Emergency Medicine, assistant professor Jason McMullan, MD, found that EMS responders can play a significant role in reducing medical contact to balloon (MCTB) time by activating helicopter emergency medical services (HEMS) earlier in the patient care process.
Patients with high blood sugar run an increased risk of dying if they have a heart attack, and diabetics are less likely to survive in-hospital cardiac arrest than non-diabetics, reveals research at the Sahlgrenska Academy, at the University of Gothenburg, Sweden. Diabetes is common among patients with coronary artery disease, and this is a potentially lethal combination: a thesis from the University of Gothenburg's Sahlgrenska Academy reveals that diabetes in coronary artery disease patients brings a significantly increased risk of premature death. Smaller chance of surviving Doctoral student and researcher Petur Petursson investigated the connection between blood sugar disorders and survival following heart attacks and cardiac arrest. His thesis shows that patients with diabetes have a smaller chance of surviving in-hospital cardiac arrest.
Adding Vorapaxar to standard treatment for patients with a medical history of cardiovascular events or disease was found to reduce cardiovascular events, but also increased bleeding significantly, including intracranial hemorrhage. The researchers added that ICH (intracranial hemorrhage) risk was lower for those with no history of stroke. The trial, called the TRA-2P (Thrombin-Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events) TIMI 50 study, focused on the safety and efficacy of Vorapaxar, an experimental anti-thrombotic medication. The experimental drug was being tested for acute coronary syndrome chest pain caused by coronary artery disease. The human study showed that adding Vorapaxar to thienopyridine, aspirin, or both (standard care) considerably reduced the risk of composite cardiovascular death, stroke, heart attack, or urgent coronary revascularization.