Posts Tagged ‘heart attack’

The Prophetic Protein :: Who is at risk for heart attack?

June 25, 2010

Tense hours in the emergency room while tests confirm a heart attack may be rolled back to mere minutes, thanks to a telltale protein marker identified by Case Western Reserve University School of Medicine researchers. Better yet, a routine blood test for the nefarious protein could serve as an early warning to people at high risk :: Take steps now, and you may dodge the dangerous attack altogether.

When the proverbial elephant takes a seat on one’s chest, it is a decided hint: That person might be having a heart attack, or myocardial infarction (MI). Every 25 seconds, someone in the United States has one, according to the American Heart Association, but the oft-reported sensation of chest tightening or pain is just that-a clue. Even in the hospital, it can take eight to 12 hours for current tests to conclusively rule a heart attack in or out. Common alternative culprits in chest pain are intense heartburn or a gallstone attack.

Led by top physician-researcher Daniel I. Simon, MD, investigators at the School of Medicine, however, have discovered a marker of heart attack that promises to cuthours off the time for definitive MI diagnosis-to the tune of confirmation within 10 to 15 minutes of arriving at the emergency room. What’s more, a simple blood test for the novel myeloid-related protein-8/14 (MRP-8/14) marker could give long-used cholesterol screening a run for its money as a signal of MI in the making, years ahead of the cardiac attack.

“Though we gain great insight into patients’ potential risk for cardiovascular disease using conventional biomarkers, we are limited in identifying some people at risk,” says Douglas Vaughan, MD, professor of cardiology at Northwestern University’s Feinberg School of Medicine and chair of its Department of Medicine. “An additional marker measured in people’s blood could valuably refine our ability to take care of patients with coronary artery disease.”

To hone in on the up-and-coming predictive protein MRP- 8/14, researchers applied an unprecedented scientific approach that scoured entire human genomes for cardiac warning signs. “We were on the hunt. We wanted to know what genes turn on or off in heart attack patients,” explains Dr. Simon, the Herman K. Hellerstein Professor of Cardiovascular Research at the School of Medicine and director of University Hospitals Harrington-McLaughlin Heart & Vascular Institute. Dr. Simon and his team of researchers identified MRP-8/14 as their best-bet marker for heart attack for use in emergency settings and as a potential companion to routine cholesterol screening in the doctor’s office.

Dr. Simon’s account is a tale of finding a little molecule with big potential-a project born in a lab in New England that has grown on a campus in Cleveland.

Read the full story at Medicus.

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Impotence plus heart disease ups death risk – Dr. Sahil Parikh discusses the study

May 27, 2010

Reuters Report ::

Men with heart disease who also have erectile dysfunction die sooner than men who do not seek treatment for impotence, researchers reported on Monday.

They found that men who had both conditions were twice as likely to die from any cause and twice as likely to have a heart attack than men with heart disease alone.

The researchers expressed concern that using drugs such as Pfizer’s Viagra or Eli Lilly’s Cialis to treat erectile dysfunction could mask the symptoms that point to widespread heart and artery disease and said men complaining of impotence should be checked by a cardiologist.

“Erectile dysfunction is something that regularly should be addressed in the medical history of patients; it might be a symptom of early atherosclerosis,” Dr. Michael Bohm of the University of Saarland in Germany, who led the study, said in a statement.

His team studied 1,519 men in 13 countries taking part in some larger studies of various heart disease treatments. As part of the study the men were also asked about erectile dysfunction.

More than half of them, 55 percent, did, Bohm’s team said in a report published in the journal Circulation and also presented at a meeting of the American College of Cardiology.

During the two years of the study, 11.3 percent of the patients who reported erectile dysfunction died, compared to 5.6 percent of those with mild or no impotence problems.

“It has long been known that erectile dysfunction is a marker for cardiovascular disease,” said Dr. Sahil Parikh at University Hospitals Case Medical Center in Cleveland, Ohio, who was not involved in the study.

The first impotence drug, Pfizer’s Viagra, known generically as sildenafil, was at first developed to lower blood pressure, he said.

“They realized it had this other effect, which patients quite enjoyed,” Parikh said in a telephone interview.

HAPPY SIDE-EFFECT

Viagra and rival drugs such as Eli Lilly’s Cialis and Bayer AG’s BAYG.DE Levitra all work by increasing blood flow.

“In order to have proper erectile function, you have to have adequate blood flow to the genitals. If you have atherosclerosis, whether in the arteries on the neck, which can cause stroke, or the arteries of the heart, which can cause heart attack … it is the same disease.”

But while the erectile dysfunction drugs help blood flow all over the body, they do not treat the underlying hardening and narrowing in the arteries that is causing the problem.

“If patients have erectile dysfunction, we have to be very aggressive about screening and treating them for heart disease,” Parikh said.

When Viagra came onto the market, many health experts welcomed it as a way to get men who might otherwise neglect their health to go to a doctor. But Bohm and Parikh both agreed that patients — and their doctors — need to look hard at the hearts of men with erectile dysfunction.

“Men with ED going to a general practitioner or a urologist need to be referred for a cardiology workup to determine existing cardiovascular disease and proper treatment,” Bohm said.

“The medication works and the patient doesn’t show up any more,” he added. “These men are being treated for the ED, but not the underlying cardiovascular disease.”

The drugs are wildly popular. Viagra alone had sales of nearly $2 billion in 2009.

Uninsured heart attack victims delay ER trip :: Watch Dr James Fang as he discusses this issue with NBC

April 14, 2010

Uninsured heart attack victims delay ER trip

A new study of heart attack patients finds those without insurance or patients with very limited coverage are more likely to delay going to the emergency room when they’re having heart attack symptoms.

That’s a huge mistake, according to Arnold’s cardiologist, Dr. James Fang of University Hospitals Case Medical Center  in Cleveland.

“If you can get to somebody within what they call the golden hour, very first hour that this is occurring the chances of their long-term survival is very close to patients who never had a heart attack,” Fang said.

Watch the video :: http://bit.ly/amhEtS

Learn about the Clinical Role of Exercise Training in Management of Patients With Chronic Heart Failure

March 31, 2010

J Cardiopulm Rehabil Prev. 2010 Mar

Prior exercise research and the recently completed HF-ACTION (Heart Failure and A Controlled Trial Investigating Outcomes of Exercise Training) trial indicate that regular exercise represents an effective therapy in the management of patients with stable chronic heart failure (HF) due to left ventricular systolic dysfunction. This review summarizes the results from these studies and provides a guide for prescribing exercise. Regular aerobic-type exercise training improves exercise capacity; does not worsen and may, in fact, mildly improve cardiac function; and partially improves other physiological abnormalities that develop because of chronic HF (eg, autonomic and skeletal muscle function). Regular exercise is safe, improves health status, and modestly reduces ( approximately 15%) combined risk for cardiovascular death or HF-related hospitalization. Even greater physiological and clinical benefits appear likely in patients with HF who adhere to a higher volume of exercise (eg, 6 MET-hr per week). The exercise regimen should include an aerobic-type activity performed at least 30 minutes, 5 or more days per week, and at an intensity approximating 55% to 80% of heart rate reserve. Resistance training should be considered for patients who first demonstrate they are able to tolerate aerobic exercise training. Common to other interventions that also rely on human behavior, long-term adherence to exercise in patients with HF remains a challenge and requires additional research to determine strategies aimed at improving compliance. Areas of needed research include identifying which patient subgroup(s) benefits the most and determination of the optimal intensity, duration, and frequency of exercise needed to maximize clinical benefits and attenuate fatigue.

Read the full article on CWRUmedicine.org

Dr James Fang discusses the VAD Approach

March 24, 2010

An alternative one-on-one, patient-oriented approach to  heart disease and heart failure

According to James C. Fang, MD, Medical Director, Advanced Heart Failure & Transplant Center and Professor, Case Western Reserve University Department of Medicine, “The mission of the Advanced Heart Failure & Transplant Center is to provide the latest and most effective therapies to patients in Northeast Ohio and surrounding regions in a personalized one-on-one, patient-centered approach.”

With a high level of expertise in treating heart failure, performing heart transplants, and implanting VADs (also known as heart pumps), the Center offers another sophisticated site in Ohio for patients to consider for their heart and vascular health. One of the most important services provided by the physicians at the Center is their ability to review a patient’s current medical and device therapies and then to provide other treatment options to improve their prognosis and quality of life. “At University Hospitals Case Medical Center, we offer many options and a very personalized approach. We are proud of the fact that we offer very individualized care,” says Dr. Fang. “Many patients don’t recognize that they are suffering needlessly.”

The VAD Option
Patients seen at the Center have refractory congestive heart failure and continue to be short of breath despite medications, device therapy (such as biventricular pacemakers) and heart surgery. These patients find that even doing simple activities like taking a shower or sitting in a chair are difficult. In addition, they cannot stay out of the hospital for very long – they are often regularly admitted for shortness of breath and fluid buildup in the legs. Such patients may be candidates for heart transplantation or a VAD.

VADs are sophisticated, miniaturized pumps that help the heart to provide sufficient blood flow throughout the patient’s body. “VADs are the newest form of a mechanical heart,” says Dr. Fang. A healthy heart can normally pump about 5 L of blood per minute around the body at rest. If, for example, a patient’s heart can pump only 1 L of blood per minute, the VAD will pump an additional 4 L, for a total of 5 L of blood per minute. “The heart pump helps,” notes Dr. Fang, “without entirely taking over the function of the heart.”

Typically, heart pumps are used temporarily while a patient awaits a heart transplant. Current first generation VADs, such as the Thoratec Heartmate XVE, are also used as a “destination” therapy – a permanent solution for heart failure. These devices can function for 12 to 18 months before they must be replaced. It is anticipated that a new, second generation of heart pumps, now undergoing investigational study, will increase the duration of ventricular assistance to two to four years. Nationwide about 2,500 heart transplant operations are performed annually and the Advanced Heart Failure & Transplant Center’s heart surgeons have collectively performed hundreds of heart transplants.

Learn more about VADs at CWRUmedicine.org

CWRUmedicine’s Dr Sahil Parikh advises Men seeking ED drugs for heart checkups also

March 16, 2010

Men with heart disease who also have erectile dysfunction die sooner than men who do not seek treatment for impotence, researchers reported.

They found that men who had both conditions were twice as likely to die from any cause and twice as likely to have a heart attack than men with heart disease alone.

The researchers expressed concern that using drugs such as Pfizer’s (PFE.N) Viagra or Eli Lilly’s (LLY.N) Cialis to treat erectile dysfunction could mask the symptoms that point to widespread heart and artery disease and said men complaining of impotence should be checked by a cardiologist.

“It has long been known that erectile dysfunction is a marker for cardiovascular disease,” said Dr. Sahil Parikh at University Hospitals Case Medical Center in Cleveland, Ohio.

The first impotence drug, Pfizer’s Viagra, known generically as sildenafil, was at first developed to lower blood pressure, he said.

“They realized it had this other effect, which patients quite enjoyed,” Parikh said in a telephone interview.

HAPPY SIDE-EFFECT

Viagra and rival drugs such as Eli Lilly’s Cialis and Bayer AG’s BAYG.DE Levitra all work by increasing blood flow.

“In order to have proper erectile function, you have to have adequate blood flow to the genitals. If you have atherosclerosis, whether in the arteries on the neck, which can cause stroke, or the arteries of the heart, which can cause heart attack … it is the same disease.”

But while the erectile dysfunction drugs help blood flow all over the body, they do not treat the underlying hardening and narrowing in the arteries that is causing the problem.

“If patients have erectile dysfunction, we have to be very aggressive about screening and treating them for heart disease,” Parikh said.

To learn more visit CWRUmedicine.org