A new study suggests that the high cost of angioplasty doesn’t seem to justify the marginal benefit.

Reporting at the American Heart Association’s annual scientific sessions in New Orleans, the researchers told that adding angioplasty to optimal medical therapy could improve angina-related symptoms in some patients, but at a very high cost.

Dr Sidney Smith, chairman of the AHA says: “It’s an important trial, but the cost is important too and we find that the use of stents and additional angina related to that was expensive.”

However, it doesn’t mean that the procedure shouldn’t be performed.

“Cost must not be a barricade, but to do things in a better way, it should be an incentive by targeting the population or by making it a less expensive procedure. Definitely we need to find a way to fix the cost.” Smith added.

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According to a Canadian study, vaccination against pneumonia almost halves the risk of a heart attack.

In this study the researchers from the University of Sherbrooke in Quebec compared 999 people (who were admitted to different Canadian hospitals for heart attacks) with those 3996 who were admitted for other reasons. The researchers didn’t find any difference in those who had or hadn’t the penumococcal vaccine in the previous year, but a 50 percent lower rate in those who were vaccinated two years earlier.

The study has been published in the current issue of the Canadian Medical Association Journal. …Click here to read more

According to experts, men and women of certain age can prevent heart attack by taking aspirin daily.

Researchers from Nottingham and Sheffield universities analyzed data on more than 12,000 patients and they found aspirin proved beneficial for men aged 48 and above and women aged 57 and above.

Usually, blood vessel blockage because of some clot causes heart attacks and aspirin helps to avoid the formation of these blood clots. …Click here to read more

A new study is on the way which would try to find out whether the standard approach to send a patient for “Percutaneous Coronary Intervention (PCI) only after the failure of clog-busting drugs after an hour or so or it should be observed on the routine basis to send the patients treated with the clog-busting drugs to a cardiac catheterization laboratory for follow-up PCI.

Percutaneous coronary intervention (PCI) is considered to be the best treatment for heart attack. It works on a combination of catheter-mounted balloons and stents to restore blood flow to the heart after unblocking the coronary artery. However the requisite is that PCI has to be performed rapidly which only few hospitals can achieve. Only the hospitals with a cardiac catheterization laboratory on site meet the 90-minute treatment goal.

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Charles Ross and Jeffery Dattilo, two Vanderbilt vascular surgeons, are studying the “Embolic Protection with Flow Reversal”, a new technique for carotid artery stenting. This new technique reverses blood flow to ease the risk of stroke during the minimally invasive procedure.Dattilo and Ross, both assistant professors of Surgery, are leading this clinical study as the principal investigator and co-investigator, respectively. This study is specifically focused on testing the safety and efficiency of the “GORE Neuro Protection System”.

It has been conducted in selected centers in the United States and ‘Vanderbilt Heart and Vascular Institute (VHVI)’ is one of those 30 sites which would be providing the patients, this new technique while undergoing the surgery with minimal invasive procedure.

During the first case study patients underwent the surgery for a block in carotid artery, the artery which supplies blood to the brain. The situation was grave as the block in the artery was located at the side of the neck, placing the patient at high risk for stroke. Blocks in the carotid artery are major cause of strokes. About 30% of strokes happen due to them.

Ross explained the significance of correction of carotid blockage as the risk of first-time and recurrent strokes could be reduced to a considerable extent.

The procedure involved insertion of a sheath or balloon system from the patient’s femoral artery in the groin into his carotid artery in the neck. After joining the system to the patient’s femoral vein, which contains a filter, the carotid balloons were inflated. This helped in reversing the flow of the blood naturally from the carotid artery to the low-pressure venous system, keeping it away from the blocked internal carotid artery and the brain. Blockage was treated then with balloon angioplasty and stenting.

Dattilo said that reversing the flow of the blood helps in filtering out of the system, all of the debris or fragments which have broken loose. This can be done with utmost safety by not letting it go towards the brain.  This system works well due to the physiology and hemodynamics of most people.

This technique can be seen as a major step in improving the safety of carotid artery stenting. It provides a major edge over the popular techniques like use of a miniscule basket above the blockage to function as a filter. Unlike these methods, this new system involves less changes of clogging of blood and can easily handle large volumes of plaque and debris, thereby reducing the risk of stroke to a minimum.

Besides this, surgeons are also testing the efficacy of other procedures like Carotid endarterectomy, second most commonly used procedure in removal of block. It is an open procedure in which the surgeon removes the plaque surgically.

Surgeons are evolving better ways to use these procedures most efficiently for the patients who are at high risk for complications.

Meals Matter Website Offers “Stress-Free Ways to Add Dairy Daily High Blood Pressure (hbp)” or “hypertension” means high pressure (tension) in the arteries and it is often known as silent killer as it might not have serious consequences in the beginning however it is associated with an increased risk of death and disability from heart disease, stroke, congestive heart failure, and end-stage renal disease. It affects one in three adults.

Andrea Garen, M.A., R.D., project manager at ‘Dairy Council of California’ has good news for the patients suffering from high blood pressure, informs, ” Making small, simple changes over time, such as eating low-fat yogurt for breakfast or drinking milk with meals, can increase calcium and vitamin D intake in a sustainable way.”

 A new study has proven that including low fat dairy products can reduce the risk of high blood pressure to a great extent. This has been recently discovered in one of the researches. Researchers at the ‘Brigham and Women’s Hospital’ in Boston when observed few women patients above the age of 45 found that the regular consumption of three or more daily servings of low-fat dairy products has been reducing the blood pressure. They were found 11 percent less likely to produce high blood pressure.

 The researchers had been giving the credit to the presence of calcium and vitamin D in these dairy products. The evidence was further strengthened by the fact as this defensive mechanism was found absent among other dietary supplements. This study results appeared in the February 7, 2008, special edition of the journal “Hypertension”.   

 The benefits from this study could be better utilized by using the website Meals Matter.  Meals Matter is a free, online family nutrition and meal-planning website.

Andrea Garen suggests that there is an interactive Calcium Quiz available on this site. This would help the patients to evaluate the current calcium intake. They can further search the database for recipes which would be rich in calcium and these could be easily added to the diet to add low-fat dairy foods every day. This site also has searchable databases to find diets rich in fruits, vegetables, whole grains and lean meats, regular dairy consumption can reduce the risk of osteoporosis, prevent certain cancers and help maintain a healthy weight.

Till now, the ‘CT Scan’ techniques enabled the doctors to detect diseased vessels and valves. A new technique has been devised which would not only allow the doctors to look at the heart vessels, heart function and heart blood flow with a single CT scan. This “Single Computerized Tomographic (CT) Scan” utilized by the doctors shared their experience of working with this new technique and found that it could enable all inclusive diagnosis of the heart disease.The researchers at ‘CT Research and Development’ claimed that his new CT scan not only can detect the poor blood flow in the heart muscle but also can now detect blocked arteries and narrowing of the blood vessels in the heart.

The ‘MUSC scanner’ uses the “dual energy technique” by adding two x-ray spectrums, each emitting varying degrees of energy like a series of x-rays, to gain a static image of the coronary arteries and the heart muscle. This enabled mapping the blood distribution within the heart muscle and pinpointing areas with decreased blood supply. The whole process could be accomplished within 15 seconds or less. Doctors could also diagnose for other ailments that might be affecting the lungs or chest wall.

In addition to promise considerable cost savings, it is also more convenient and reduces the chances of radiation exposure to the patients.

According to Dr. Schoepf, the lead investigator of the study, this new innovative technique could be established as a “long coveted ‘one-stop-shop’ test that allows us to look at the heart vessels, heart function and heart blood flow with a single CT scan and within a single breath-hold,”

Till present blockages or narrowing o the heart diseases were the only indicators held mainly for a heart attack, and the need of an invasive heart catheterization was never felt. MUSC, like other cardiovascular centers had also been relying upon conventional methods such as cardiac catheterization, nuclear medicine or magnetic resonance (MR) scanners to reach the completer diagnosis of coronary artery disease.

However this addition of a new technique has provided them to reach better results as compared to the old conventional methods for detecting decreased blood supply in the heart muscle.

A new study shows that the smokers who develop symptoms pertaining to depression during hospitalization for a heart attack will have a harder time giving up smoking.Dr. Anne N. Thorndike of ‘Massachusetts General Hospital’ and ‘Harvard Medical School’ in Boston, the study’s lead author said that the depression is common among heart attack patients and these issues are more important to be taken into consideration before one can expect them to show improvement in quitting smoking in real terms. Thorndike further added that the depressed smokers tend to pick up the habit within four weeks thus making it more important to address these concerns at an early stage. The smokers also show a mental reluctance to show seriousness towards the efforts for reducing the risk of cardiac troubles further.

During the study, 245 smokers had been followed up who had been in the hospital due to heart attack or unstable angina. “Unstable angina” is a type of acute chest pain that occurs when your heart doesn’t get enough oxygen. It can be a warning sign of a heart attack. They were undergoing the dame treatment comprising of smoking cessation counseling and medication which included either bupropion hydrochloride, an anti-smoking medication sold as ‘Zyban’, or an inactive placebo.

Thorndike added, “Quitting sharply reduces the death rate among smokers with heart disease”. She further observed that almost 40% of these smokers are more likely to “start again within a year of having a heart attack”.

During the study they observed that 22% of the patients showed moderate to severe depressive symptoms ranging from craving and withdrawal symptoms, scored higher on a test of their nicotine dependence. They had lower level of confidence on themselves towards giving up smoking. The researchers found that the depressed patients were 2.4 times more likely than their non-depressed peers to start smoking again.

The medical charts also had more facts to add to this study. The researchers observed that difference between the effect of ‘Zyban’ and ‘placebo’ on the depressed patients during the treatment cannot be called as a very significant difference statistically. Among the depressed patients, 19 percent on ‘bupropion’ were able to quit, compared to 3 percent on ‘placebo’. For non-depressed patients, by comparison, quit rates were 27 percent for those on placebo and 27 percent for those on the drug.

This study tries to win a more understanding and considerate attitude towards the smokers. The family should understand the toughness associated with quitting smoking. They depressive symptoms make it more difficult to succumb.

So it makes it mandatory to give attention to help the smokers with their depressive symptoms along with counselling, and medication, to optimize the effect of treatment.