Annals of medicine
-
Background: Acute coronary syndrome (ACS) patients are widely treated with long-term beta-blocker therapy after cardiac event. Especially for low-risk patients, the benefits of beta-blockers on survival and the optimal therapy duration remain unclear. We investigated the effect of adherence to beta-blockers on long-term survival of ACS patients. ⋯ Key messagesAdherence to secondary prevention medications diminishes drastically over the years after an ACS event. Non-adherence to β-blockers is associated with increased long-term mortality of ACS patients, and the effect on survival extends beyond the first year after an ACS event. Our follow-up was exceptionally lengthy with median follow-up period of 8.6 years.
-
Introduction: Partial and advanced interatrial block (IAB) in the electrocardiographic (ECG) represents inter-atrial conduction delay. IAB is associated with atrial fibrillation (AF) and stroke in the general population. Material and methods: A representative sample of Finnish subjects (n = 6354) aged over 30 years (mean: 52.2 years, standard deviation: 14.6) underwent a health examination including a 12-lead ECG. ⋯ Key messagesBoth partial and advanced interatrial block are associated with increased risk of atrial fibrillation in the general population. Advanced interatrial block is an independent risk factor for stroke and transient ischaemic attack. The clinical significance of interatrial block is dependent on the subtype classification.
-
Aim of the study: To assess serum sclerostin in transfusion-dependent beta-thalassaemia patients versus healthy controls and to examine its associations with bone mineral density, bone metabolism markers and beta thalassaemia alterations. Material and methods: Sixty-two transfusion-dependent beta-thalassaemia (TDßT) patients and 30 healthy controls were evaluated for serum sclerostin, osteocalcin, beta-cross laps, osteoprotegerin and serum level of receptor activator of nuclear factor kappa-Β ligand (sRANKL). Bone mineral density was measured at the lumbar spine and femoral neck. ⋯ Serum sclerostin is negatively associated with bone mineral density and the bone synthesis markers and positively with the bone resorption indices. Serum sclerostin is significantly associated with pre-transfusion haemoglobin, liver iron concentration, splenectomy status and fragility fracture events in adult patients with transfusion-dependent beta-thalassaemia. Serum sclerostin could serve as a marker of severe osteoporosis in beta-thalassaemia patients.
-
Atrial fibrillation (AF) is the most common heart arrhythmia and is associated with poor outcomes. The adverse effects of AF are mediated through multiple pathways, including endothelial dysfunction, as measured by flow-mediated dilatation. Flow-mediated dilatation has demonstrated endothelial dysfunction in several conditions and is associated with poor outcomes including mortality, yet can be improved with medical therapy. ⋯ Endothelial dysfunction is associated with poor outcomes such as stroke, myocardial infarction and death, yet is a reversible condition. Flow-mediated dilatation is a reliable tool to assess endothelial function in patients with atrial fibrillation. Patients with atrial fibrillation should be considered for endothelial function assessment and attempts made to reverse this condition.