Atrial fibrillation as a risk factor for myocardial infarction

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We all know that ischaemic heart disease is a risk factor for AF, through multiple mechanisms, however how about AF as a risk factor for having an MI?

Turns out AF doubles your risk (1.7 after adjustment for major risk factors). This association was stronger in women, and not significant in the older age group.

It’s not just strokes – AF is becoming a serious public health issue, and one we don’t know enough about. Read more at JAMA Internal Medicine.

 

image | Wikimedia Commons

source | JAMA Internal Medicine

 

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Statins in the prevention of heart disease in people on dialysis

 

Statins are the wonder drug – their arrival was like the iPhone for mobile phones. They revolutionised not only cholesterol levels but cardiac events overall, and now are widely prescribed.

Despite their benefits in the general population, this review from the Cochrane Foundation published last month suggests that although statins lowered cholesterol in people treated with dialysis, they did not prevent death, heart attack or stroke.

Check out the updated review here.

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Enoxaparin tops heparin for outcomes post PCI – and especially for STEMI

For your stock standard NSTEMI, the go to drug of choice is enoxaparin – easy to administer, only twice a day, no ongoing APTT to continually monitor – and effective. Some people, particularly for a STEMI, prefer the old school unfractionated heparin – partly because of previous equivocal evidence, past experience, and because it can be monitored and you can be sure it’s working (remind anyone of the upcoming warfarin vs. the new anticoagulants?). The current ACC/AHA guidelines still have heparin as a class 1 recommendation – but how effective is it? This systematic review and meta-analysis from the BMJ compared the two. Continue reading