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<br /> CARDIOLOGY<br /> ISSN 2054-3174 October 2013 • emjreviews.com<br /> INSIDE<br /> Review of the 61st<br /> Annual ESC Congress 2013<br /> Amsterdam, the Netherlands<br /> COMORBIDITIES<br /> HISTORY OF<br /> NONCOMPLIANCE<br /> ELDERLY<br /> USE OF CONCOMITANT<br /> MEDICATIONS<br /> LOW BODY<br /> WEIGHT<br /> RENAL<br /> DYSFUNCTION<br /> EVERY PATIENT IS DIFFERENT.<br /> BUT DO ORAL ANTICOAGULANTS ADDRESS THIS?<br /> ORAL ANTICOAGULATION SHOULD<br /> CONSIDER INDIVIDUAL PATIENT<br /> DIFFERENCES AND NEEDS<br /> Patient-related factors are important considerations for<br /> determining an individual's response to oral anticoagulation<br /> therapy.1-2 Despite advances in oral anticoagulation,<br /> questions still remain about how patient-related<br /> factors complicate the decision of which agent to use<br /> and at what dose.3,4 These factors inc<a title="EMJ - Cardiology page 1" href="http://viewer.zmags.com/publication/21e43266?page=1"> CARDIOLOGY ISSN 2054-3174 </a> <a title="EMJ - Cardiology page 2" href="http://viewer.zmags.com/publication/21e43266?page=2"> COMORBIDITIES HISTORY OF NONCOMPLIANCE EL</a> <a title="EMJ - Cardiology page 3" href="http://viewer.zmags.com/publication/21e43266?page=3"> EVERY PATIENT IS DIFFERENT. BUT DO ORAL ANTICOAGU</a> <a title="EMJ - Cardiology page 4" href="http://viewer.zmags.com/publication/21e43266?page=4"> CONTENTS EDITORIAL BOARD.......................</a> <a title="EMJ - Cardiology page 5" href="http://viewer.zmags.com/publication/21e43266?page=5"> CARDIOLOGY CONSISTENCY VERSUS EQUITY - CARDIOVA</a> <a title="EMJ - Cardiology page 6" href="http://viewer.zmags.com/publication/21e43266?page=6"> EDITORIALBOARD CARDIOLOGY Dr Fernando Alfonso</a> <a title="EMJ - Cardiology page 7" href="http://viewer.zmags.com/publication/21e43266?page=7"> Reduce Stroke Risk Protect Your Patients One tab</a> <a title="EMJ - Cardiology page 8" href="http://viewer.zmags.com/publication/21e43266?page=8"> Ischaemic stroke: the most common thromboembolic </a> <a title="EMJ - Cardiology page 9" href="http://viewer.zmags.com/publication/21e43266?page=9"> European Medical Journal Cardiology - October 2</a> <a title="EMJ - Cardiology page 10" href="http://viewer.zmags.com/publication/21e43266?page=10"> Now NICE Treat PE and DVT f rtrr t ti</a> <a title="EMJ - Cardiology page 11" href="http://viewer.zmags.com/publication/21e43266?page=11"> Foreword Dr Carl J. Lavie Professor of Medic</a> <a title="EMJ - Cardiology page 12" href="http://viewer.zmags.com/publication/21e43266?page=12"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 13" href="http://viewer.zmags.com/publication/21e43266?page=13"> Welcome to the European Medical Journal review of</a> <a title="EMJ - Cardiology page 14" href="http://viewer.zmags.com/publication/21e43266?page=14"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 15" href="http://viewer.zmags.com/publication/21e43266?page=15"> Ongoing issues were approached with both open- mi</a> <a title="EMJ - Cardiology page 16" href="http://viewer.zmags.com/publication/21e43266?page=16"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 17" href="http://viewer.zmags.com/publication/21e43266?page=17"> Music can help rehabilitation process of CAD A N</a> <a title="EMJ - Cardiology page 18" href="http://viewer.zmags.com/publication/21e43266?page=18"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 19" href="http://viewer.zmags.com/publication/21e43266?page=19"> ventricle. The retrieval is done through </a> <a title="EMJ - Cardiology page 20" href="http://viewer.zmags.com/publication/21e43266?page=20"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 21" href="http://viewer.zmags.com/publication/21e43266?page=21"> Tour de France riders have better mortality rates</a> <a title="EMJ - Cardiology page 22" href="http://viewer.zmags.com/publication/21e43266?page=22"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 23" href="http://viewer.zmags.com/publication/21e43266?page=23"> an epidemic of AF-related strokes if nothing is d</a> <a title="EMJ - Cardiology page 24" href="http://viewer.zmags.com/publication/21e43266?page=24"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 25" href="http://viewer.zmags.com/publication/21e43266?page=25"> Professor Näbauer added: “A CHADS score </a> <a title="EMJ - Cardiology page 26" href="http://viewer.zmags.com/publication/21e43266?page=26"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 27" href="http://viewer.zmags.com/publication/21e43266?page=27"> PaceWave a positive step for sleep-disordered br</a> <a title="EMJ - Cardiology page 28" href="http://viewer.zmags.com/publication/21e43266?page=28"> ESC ANNUAL CONGRESS 2013 AMSTERDAM RAI EXHIBITION</a> <a title="EMJ - Cardiology page 29" href="http://viewer.zmags.com/publication/21e43266?page=29"> It recommends that patients should partake i</a> <a title="EMJ - Cardiology page 30" href="http://viewer.zmags.com/publication/21e43266?page=30"> NEW INSIGHTS INTO THE DEFINITIVE MANAGEMENT OF </a> <a title="EMJ - Cardiology page 31" href="http://viewer.zmags.com/publication/21e43266?page=31"> Studies suggest that extending treatment wit</a> <a title="EMJ - Cardiology page 32" href="http://viewer.zmags.com/publication/21e43266?page=32"> Prof Lip presented data from his research group c</a> <a title="EMJ - Cardiology page 33" href="http://viewer.zmags.com/publication/21e43266?page=33"> antidotes. However, a phase II study of the Porto</a> <a title="EMJ - Cardiology page 34" href="http://viewer.zmags.com/publication/21e43266?page=34"> Prof Büller concluded that low molecular weight </a> <a title="EMJ - Cardiology page 35" href="http://viewer.zmags.com/publication/21e43266?page=35"> venous thromboembolism. N Engl J Med. therapy </a> <a title="EMJ - Cardiology page 36" href="http://viewer.zmags.com/publication/21e43266?page=36"> ACE-INHIBITORS AND CARDIOPROTECTION OPEN ISSU</a> <a title="EMJ - Cardiology page 37" href="http://viewer.zmags.com/publication/21e43266?page=37"> The evidence base for this is comprehe</a> <a title="EMJ - Cardiology page 38" href="http://viewer.zmags.com/publication/21e43266?page=38"> cardiac uptake, and a greater rate of conversion </a> <a title="EMJ - Cardiology page 39" href="http://viewer.zmags.com/publication/21e43266?page=39"> endothelium (+100%).10 This demonstrates</a> <a title="EMJ - Cardiology page 40" href="http://viewer.zmags.com/publication/21e43266?page=40"> of lactate and creatinine phosphokinase from the </a> <a title="EMJ - Cardiology page 41" href="http://viewer.zmags.com/publication/21e43266?page=41"> activation of the β-2 receptor has ben</a> <a title="EMJ - Cardiology page 42" href="http://viewer.zmags.com/publication/21e43266?page=42"> treated with an ACE inhibitor plus a calci</a> <a title="EMJ - Cardiology page 43" href="http://viewer.zmags.com/publication/21e43266?page=43"> In Watanabe heritable hyperlipidaemic </a> <a title="EMJ - Cardiology page 44" href="http://viewer.zmags.com/publication/21e43266?page=44"> groups; prodrugs (captopril, lisinopril, Zofenopr</a> <a title="EMJ - Cardiology page 45" href="http://viewer.zmags.com/publication/21e43266?page=45"> shown that one of the enhanced benefits </a> <a title="EMJ - Cardiology page 46" href="http://viewer.zmags.com/publication/21e43266?page=46"> Comparison Hazard ratio (95% CI) Zofenopril vs</a> <a title="EMJ - Cardiology page 47" href="http://viewer.zmags.com/publication/21e43266?page=47"> inhibitors is that Zofenopril appears to produce </a> <a title="EMJ - Cardiology page 48" href="http://viewer.zmags.com/publication/21e43266?page=48"> A Concentrations of Lisinopril Drug concentrati</a> <a title="EMJ - Cardiology page 49" href="http://viewer.zmags.com/publication/21e43266?page=49"> Question: Nebivolol has advantages in terms of or</a> <a title="EMJ - Cardiology page 50" href="http://viewer.zmags.com/publication/21e43266?page=50"> REFERENCES 1. Mancia G et al. 2013 E</a> <a title="EMJ - Cardiology page 51" href="http://viewer.zmags.com/publication/21e43266?page=51"> 32. GISSI-3: effects of lisinopril and trans</a> <a title="EMJ - Cardiology page 52" href="http://viewer.zmags.com/publication/21e43266?page=52"> THE CHANGING LANDSCAPE IN ORAL </a> <a title="EMJ - Cardiology page 53" href="http://viewer.zmags.com/publication/21e43266?page=53"> or a patient requires urgent surgery or intervent</a> <a title="EMJ - Cardiology page 54" href="http://viewer.zmags.com/publication/21e43266?page=54"> the adequacy of anticoagulation is usually better</a> <a title="EMJ - Cardiology page 55" href="http://viewer.zmags.com/publication/21e43266?page=55"> confusion rather than help. The documen</a> <a title="EMJ - Cardiology page 56" href="http://viewer.zmags.com/publication/21e43266?page=56"> relates to clinical factors.15 The dosing r</a> <a title="EMJ - Cardiology page 57" href="http://viewer.zmags.com/publication/21e43266?page=57"> Table 1: Bleeding complications and possible meas</a> <a title="EMJ - Cardiology page 58" href="http://viewer.zmags.com/publication/21e43266?page=58"> Table 2. Cessation of NOACs before planned surger</a> <a title="EMJ - Cardiology page 59" href="http://viewer.zmags.com/publication/21e43266?page=59"> ENGAGE AF-TIMI (Thrombolysis in Myocardial Infa</a> <a title="EMJ - Cardiology page 60" href="http://viewer.zmags.com/publication/21e43266?page=60"> the duration of the trial. Patients were at moder</a> <a title="EMJ - Cardiology page 61" href="http://viewer.zmags.com/publication/21e43266?page=61"> Table 3. Phase III AF trials - dose comparisons. </a> <a title="EMJ - Cardiology page 62" href="http://viewer.zmags.com/publication/21e43266?page=62"> One of the common challenges across these three t</a> <a title="EMJ - Cardiology page 63" href="http://viewer.zmags.com/publication/21e43266?page=63"> those who had been randomised to warfarin. </a> <a title="EMJ - Cardiology page 64" href="http://viewer.zmags.com/publication/21e43266?page=64"> mg actively, at randomisation or during the trial</a> <a title="EMJ - Cardiology page 65" href="http://viewer.zmags.com/publication/21e43266?page=65"> The efficacy outcomes during the on-treatmen</a> <a title="EMJ - Cardiology page 66" href="http://viewer.zmags.com/publication/21e43266?page=66"> disease (45% in the NOAC treatment group and 47% </a> <a title="EMJ - Cardiology page 67" href="http://viewer.zmags.com/publication/21e43266?page=67"> Panel Discussion Question: What are the numbers</a> <a title="EMJ - Cardiology page 68" href="http://viewer.zmags.com/publication/21e43266?page=68"> Question: How did you define non-valvular AF in th</a> <a title="EMJ - Cardiology page 69" href="http://viewer.zmags.com/publication/21e43266?page=69"> Question: Were any patients treated with thrombol</a> <a title="EMJ - Cardiology page 70" href="http://viewer.zmags.com/publication/21e43266?page=70"> Question: How are you going to handle the analysi</a> <a title="EMJ - Cardiology page 71" href="http://viewer.zmags.com/publication/21e43266?page=71"> Abstract P529. Eur Heart J. 2013;34:S95. 17. Para</a> <a title="EMJ - Cardiology page 72" href="http://viewer.zmags.com/publication/21e43266?page=72"> PRACTICAL GUIDANCE FOR STROKE PREVENTION IN ATRIA</a> <a title="EMJ - Cardiology page 73" href="http://viewer.zmags.com/publication/21e43266?page=73"> TTR is <50%, these outcomes are in fact worse tha</a> <a title="EMJ - Cardiology page 74" href="http://viewer.zmags.com/publication/21e43266?page=74"> warfarin. It was highlighted that, from the resul</a> <a title="EMJ - Cardiology page 75" href="http://viewer.zmags.com/publication/21e43266?page=75"> Optimising Periprocedural Protection </a> <a title="EMJ - Cardiology page 76" href="http://viewer.zmags.com/publication/21e43266?page=76"> REFERENCES 1. Gallagher AM et al. Risks of strok</a> <a title="EMJ - Cardiology page 77" href="http://viewer.zmags.com/publication/21e43266?page=77"> MANAGING THROMBOEMBOLIC RISKS OF ATRIAL FIB</a> <a title="EMJ - Cardiology page 78" href="http://viewer.zmags.com/publication/21e43266?page=78"> range – this was demonstrated in multiple clinica</a> <a title="EMJ - Cardiology page 79" href="http://viewer.zmags.com/publication/21e43266?page=79"> models simulating drug use in patients with event</a> <a title="EMJ - Cardiology page 80" href="http://viewer.zmags.com/publication/21e43266?page=80"> most other agents, independent of </a> <a title="EMJ - Cardiology page 81" href="http://viewer.zmags.com/publication/21e43266?page=81"> REFERENCES 1. Go AS, Mozaffarian D, Roger </a> <a title="EMJ - Cardiology page 82" href="http://viewer.zmags.com/publication/21e43266?page=82"> ATRIAL FIBRILLATION IN CHILDHOOD WITH FAMILIAL </a> <a title="EMJ - Cardiology page 83" href="http://viewer.zmags.com/publication/21e43266?page=83"> well as mild pulmonary valve stenosis. At 2 years</a> <a title="EMJ - Cardiology page 84" href="http://viewer.zmags.com/publication/21e43266?page=84"> </a> <a title="EMJ - Cardiology page 85" href="http://viewer.zmags.com/publication/21e43266?page=85"> anticoagulation in hyperthyroid patients with AF,</a> <a title="EMJ - Cardiology page 86" href="http://viewer.zmags.com/publication/21e43266?page=86"> CONSISTENCY VERSUS EQUITY - CARDIOVASCULAR DISEAS</a> <a title="EMJ - Cardiology page 87" href="http://viewer.zmags.com/publication/21e43266?page=87"> for more established migrant groups, such a</a> <a title="EMJ - Cardiology page 88" href="http://viewer.zmags.com/publication/21e43266?page=88"> among South Asian patients. Whilst it is o</a> <a title="EMJ - Cardiology page 89" href="http://viewer.zmags.com/publication/21e43266?page=89"> be counter-productive in promoting a sense </a> <a title="EMJ - Cardiology page 90" href="http://viewer.zmags.com/publication/21e43266?page=90"> Diabetes Care. 2006;29(6):1383-5. 22. Chaturvedi</a> <a title="EMJ - Cardiology page 91" href="http://viewer.zmags.com/publication/21e43266?page=91"> From a host of fourteen therapeutical areas, EURO</a> <a title="EMJ - Cardiology page 92" href="http://viewer.zmags.com/publication/21e43266?page=92"> PRESCRIBING PHYSICAL ACTIVITY FOR THE P</a> <a title="EMJ - Cardiology page 93" href="http://viewer.zmags.com/publication/21e43266?page=93"> managed in order to minimise their risk of</a> <a title="EMJ - Cardiology page 94" href="http://viewer.zmags.com/publication/21e43266?page=94"> prescription of resistance programmes wit</a> <a title="EMJ - Cardiology page 95" href="http://viewer.zmags.com/publication/21e43266?page=95"> 2012;19(5):1005-33. 24. Reybrouck T, Mertens </a> <a title="EMJ - Cardiology page 96" href="http://viewer.zmags.com/publication/21e43266?page=96"> INITIAL EVIDENCE IN THROMBOANGIITIS OBLITERANS (</a> <a title="EMJ - Cardiology page 97" href="http://viewer.zmags.com/publication/21e43266?page=97"> pathologies by exerting various deleterious effec</a> <a title="EMJ - Cardiology page 98" href="http://viewer.zmags.com/publication/21e43266?page=98"> versus aspirin27 has shown that the healing of ul</a> <a title="EMJ - Cardiology page 99" href="http://viewer.zmags.com/publication/21e43266?page=99"> Fig. 1 ET - 1 •Vasoconstrictive Mediator effect</a> <a title="EMJ - Cardiology page 100" href="http://viewer.zmags.com/publication/21e43266?page=100"> REFERENCES 1. Olin JW. Thomboangiitis obliter</a> <a title="EMJ - Cardiology page 101" href="http://viewer.zmags.com/publication/21e43266?page=101"> CALL FOR PAPERS IF YOU ARE INTERESTED IN SUBMITT</a> <a title="EMJ - Cardiology page 102" href="http://viewer.zmags.com/publication/21e43266?page=102"> NATIONWIDE FAMILY STUDIES OF CARDIOVASCULAR DISEA</a> <a title="EMJ - Cardiology page 103" href="http://viewer.zmags.com/publication/21e43266?page=103"> At the moment, clinicians usually have to rely on</a> <a title="EMJ - Cardiology page 104" href="http://viewer.zmags.com/publication/21e43266?page=104"> Table 1. Swedish nationwide familial relativ</a> <a title="EMJ - Cardiology page 105" href="http://viewer.zmags.com/publication/21e43266?page=105"> NATIONWIDE FAMILY STUDIES Coronary Heart Disease </a> <a title="EMJ - Cardiology page 106" href="http://viewer.zmags.com/publication/21e43266?page=106"> Stroke Epidemiologic evidence supports a </a> <a title="EMJ - Cardiology page 107" href="http://viewer.zmags.com/publication/21e43266?page=107"> Atrial Fibrillation A large number of genetics st</a> <a title="EMJ - Cardiology page 108" href="http://viewer.zmags.com/publication/21e43266?page=108"> Rate per 100,000 person years 120 100 80 6</a> <a title="EMJ - Cardiology page 109" href="http://viewer.zmags.com/publication/21e43266?page=109"> Table 4. Familial relative risks (FRRs) for sever</a> <a title="EMJ - Cardiology page 110" href="http://viewer.zmags.com/publication/21e43266?page=110"> disease and they represent the overall interactio</a> <a title="EMJ - Cardiology page 111" href="http://viewer.zmags.com/publication/21e43266?page=111"> REFERENCES 1. World Health Organi</a> <a title="EMJ - Cardiology page 112" href="http://viewer.zmags.com/publication/21e43266?page=112"> 46. Forsberg L, Rydh H, Jacobsson A, et al. Kvali</a> <a title="EMJ - Cardiology page 113" href="http://viewer.zmags.com/publication/21e43266?page=113"> thrombosis: a nationwide epidemiological study </a> <a title="EMJ - Cardiology page 114" href="http://viewer.zmags.com/publication/21e43266?page=114"> THE BENEFITS OF RIVAROXABAN (XARELTO®) ACROSS </a> <a title="EMJ - Cardiology page 115" href="http://viewer.zmags.com/publication/21e43266?page=115"> always includes the clinical scenarios </a> <a title="EMJ - Cardiology page 116" href="http://viewer.zmags.com/publication/21e43266?page=116"> levels of ≥2 g/dl and transfusions were mo</a> <a title="EMJ - Cardiology page 117" href="http://viewer.zmags.com/publication/21e43266?page=117"> Acute Coronary Syndrome Major determinants of</a> <a title="EMJ - Cardiology page 118" href="http://viewer.zmags.com/publication/21e43266?page=118"> patient, including regular assessment of ren</a> <a title="EMJ - Cardiology page 119" href="http://viewer.zmags.com/publication/21e43266?page=119"> 16. Wallentin L et al. Ticagrelor versus clopidog</a> <a title="EMJ - Cardiology page 120" href="http://viewer.zmags.com/publication/21e43266?page=120"> ADVERTORIAL Safe, fast, copeptin-based rule-out o</a> <a title="EMJ - Cardiology page 121" href="http://viewer.zmags.com/publication/21e43266?page=121"> ADVERTORIAL Suggested new process based on BIC-</a> <a title="EMJ - Cardiology page 122" href="http://viewer.zmags.com/publication/21e43266?page=122"> WHAT’S NEW Intercourse from the bedroom to the do</a> <a title="EMJ - Cardiology page 123" href="http://viewer.zmags.com/publication/21e43266?page=123"> CARDIOLOGY 3D holography: The future of cardiolog</a> <a title="EMJ - Cardiology page 124" href="http://viewer.zmags.com/publication/21e43266?page=124"> WHAT’S NEW Lab-grown human heart tissue beats on </a> <a title="EMJ - Cardiology page 125" href="http://viewer.zmags.com/publication/21e43266?page=125"> CARDIOLOGY Ranexa® reduces angina in patients wit</a> <a title="EMJ - Cardiology page 126" href="http://viewer.zmags.com/publication/21e43266?page=126"> WHAT’S NEW New drugs that target cell nucleus may</a> <a title="EMJ - Cardiology page 127" href="http://viewer.zmags.com/publication/21e43266?page=127"> CARDIOLOGY Children still risk mutations regardl</a> <a title="EMJ - Cardiology page 128" href="http://viewer.zmags.com/publication/21e43266?page=128"> WHAT’S NEW Cardiovascular screening every 5-10 ye</a> <a title="EMJ - Cardiology page 129" href="http://viewer.zmags.com/publication/21e43266?page=129"> SUBSCRIBE TO THE EMJ NEWSLETTER www.news.emjrevie</a> <a title="EMJ - Cardiology page 130" href="http://viewer.zmags.com/publication/21e43266?page=130"> Bayer HealthCare is among the world’s foremost in</a> <a title="EMJ - Cardiology page 131" href="http://viewer.zmags.com/publication/21e43266?page=131"> ABBOTT ACCUMETRICS INC. 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