Atrial Fibrillation

ABSTRACT: Patients who experience an acute myocardial infarction (MI) are at very high risk for recurrent cardiovascular events. Both site-supervised and home-based cardiac rehabilitation programs can effectively reduce all-cause and cardiovascular mortality. Start risk factor reduction as soon as possible; pharmacotherapy is best initiated while patients are still in the hospital. All patients who have had an MI should receive aspirin, an angiotensin-converting enzyme inhibitor, and a ß-blocker, unless these agents are contraindicated or are not tolerated. Prescribe aggressive lipid-lowering therapy to bring patients' low-density lipoprotein cholesterol levels to below 70 mg/dL. For smokers, quitting is the single most important change they can make to reduce future risk of MI.

What is "normal" blood pressure (BP)? Is it different from optimal BP?

COLORADO SPRINGS, Colo. -- For prospective gastric bypass patients, surgeons may have a better tool to help gauge the risk of mortality from the procedure, researchers said here.

BOSTON -- The anti-angina drug ranolazine (Ranexa) is safe in patients with non-ST elevation acute coronary syndromes (ACS), but it doesn't reduce the occurrence of cardiovascular events.

A 24-year-old woman presents to the emergency department (ED) withgeneralized weakness, headache, and muscle cramping that have progressivelyworsened over the past week. Recently, she has also had nauseaand vomiting. She denies chest pain, palpitations, dyspnea, cough, fever,chills, diarrhea, and urinary symptoms. She has a history of type 1 renaltubular acidosis.

A 29-year-old sailor presented with a painless, enlarging, reddish, mobile lump under his left nipple. Four months earlier, while on deployment in the South Pacific, he had his nipples pierced on a whim.

SEATTLE -- Nearly a third of Americans with type 2 diabetes have chronic kidney disease, and about 20% have diabetic eye disease and foot problems, a surveillance report shows.

MONTRÉAL -- Restless legs syndrome may boost nocturnal blood pressure and exacerbate cardiovascular disease risks, particularly among older patients, investigators here suggested.

KUOPIO, Finland -- Intravenous hydrocortisone after cardiac surgery led to a 37% lower relative risk of post-op atrial fibrillation compared with placebo, researchers here reported.

NEW ORLEANS -- The potential impact of the COURAGE trial -- the headline-making study that matched medicine to stenting in patients with chronic stable angina -- appears to be in the eye of the clinical beholder.

NEW YORK -- When low-dose aspirin is taken for cardiovascular risk reduction and ibuprofen for the pain of osteoarthritis, the heart may be the loser, found investigators here.

NEW ORLEANS -- Nurse-led education and counseling in disease-management programs may improve outcomes for heart failure patients, but setting and patient age may be determining factors, according to separate studies.

The role of anticoagulation in the treatment of patients who have been permanently immobilized as a result of neurological impairments is unique. Patients with spinal injuries have been comprehensively studied, and the data are very clear: the risk of DVT falls sharply 4 to 6 months after the injury and onset of immobility.

Since his twenties, a 71-year-old man had had multiple tiny, pinhead, whitish yellow papules on his palms. They were asymptomatic but made his skin feel like sandpaper. Other members of his family had similar lesions.

NEW ORLEANS -- Office-based use of the biomarker pro-B-type natriuretic peptide (proBNP) to help diagnose the cause of dyspnea in the general population may be feasible, Danish researchers said here.

NEW ORLEANS -- Investigational non-embryonic stem cell therapies found promise for repairing both new and old cardiac damage, researchers reported here.

NEW ORLEANS -- Intravenous sodium chloride and sodium bicarbonate appear equivalent in preventing renal failure from injection of contrast dye used in cardiac catheterization, researchers said here.

NEW ORLEANS -- In the largest trial of stage D heart failure, nesiritide (Natrecor) showed no benefit as outpatient therapy, yet there was no evidence of renal safety concerns with the drug, researchers here reported.

NEW ORLEANS -- In the first mouth-to-mouth comparison between the omega-3 heavy Mediterranean and the AHA's low-fat diets for secondary prevention, outcomes didn't seem to differ so long as MI patients stuck with dietary intervention.

NEW ORLEANS -- Heart failure patients who develop clinical depression have a significantly worse survival than those who are not depressed, found a large record review.

NEW ORLEANS -- An investigational oral thrombin receptor antagonist led to a trend toward reduced fatal and non-fatal cardiac events, with a low bleeding risk, in a phase II trial of patients with percutaneous coronary interventions, mostly stenting.

PARIS -- Atherosclerotic arterial disease seems to predict relatively high rates of myocardial infarction, stroke, or cardiovascular death within a year, according to a large, international registry study.

GRENOBLE, France -- Nearly 60% of patients with pacemakers have undiagnosed sleep apnea, according to a small European study.

LOS ANGELES -- The higher the body mass index, the lower the likelihood that patients hospitalized for ischemic stroke would be discharged directly home, found UCLA researchers.

ROCKVILLE, Md. -- For the second time in two weeks, the FDA has informed physicians of an excess fracture risk in women taking an oral diabetes drug in the thiazolidinedione class. This time the drug is pioglitazone (Actos).