New research, guidelines expand thrombectomy timing in stroke | Study: Patients with chronic ischemic CVD at high risk of death, hospitalization | Fatty liver index tied to diabetes risk, study finds
January 31, 2018
Cardiometabolic Health SmartBrief
Top Story
New research, guidelines expand thrombectomy timing in stroke
A study in The New England Journal of Medicine suggests that the window of time between a stroke and a thrombectomy may be as long as 16 hours in many cases, and new guidelines from the American Stroke Association and American Heart Association extend that window to 24 hours for certain patients. Patients who had a CT scan showing dead and damaged tissue and received a thrombectomy up to 16 hours post-stroke, along with usual medical care, were less likely to die than those who received medical care alone.
The Washington Post (tiered subscription model) (1/24),  Healio (free registration)/Cardiology Today (1/24) 
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Science & Research
Study: Patients with chronic ischemic CVD at high risk of death, hospitalization
Patients with chronic ischemic cardiovascular disease have high mortality and hospitalization rates at six months follow-up, particularly if they require percutaneous coronary intervention within 72 hours of symptom onset, according to a study of the European Society of Cardiology's CICD Pilot Registry. The researchers reported in the European Journal of Preventive Cardiology that older age, previous peripheral revascularization, chronic kidney disease and chronic obstructive pulmonary disease were also independent predictors of death and hospitalization in the study population.
Medscape (free registration)/Reuters (1/26) 
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Fatty liver index tied to diabetes risk, study finds
Japanese researchers analyzed data on 4,439 individuals from the general population and found that those who had high fatty liver index but without impaired fasting glucose, as well as those with IFG and low, moderate or high FLI, were significantly more likely to develop diabetes, compared with those who had low FLI and no IFG. The findings in Hepatology Research revealed a significantly higher diabetes risk among those with high FLI but without IFG who did not currently drink alcohol, compared with non-drinkers in the low FLI without IFG group.
Healio (free registration) (1/25) 
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Study: Obesity tied to increasing rates of diabetes in southern US
Black adults with morbid obesity were at a fourfold increased risk of incident type 2 diabetes, while their white counterparts were 12 times more likely to develop the disease over an average of 4.5 years, compared with those who had a normal body mass index, according to a study in PLOS ONE. Researchers analyzed data from the Southern Community Cohort Study involving 38,064 adults without diabetes at baseline and living in southern US states that make up the obesity belt, ages 40 to 79, and found that the rate of new-onset diabetes was more common among those who had low household income and education level and no private insurance.
Medscape (free registration) (1/29) 
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Lifestyle & Wellness
Study shows most stroke survivors fail to meet heart health goals
A study presented at an American Stroke Association meeting showed that among stroke survivors, fewer than 1 in 100 achieved all seven heart-health goals determined by the American Heart Association, namely eating a healthy diet, not smoking, having a healthy weight, doing regular physical activity and controlling cholesterol, high blood pressure and blood glucose levels. Researchers found increases in the proportion of survivors who achieved one or none of the goals and in obesity rates between 1988-1994 and 2011-2014, although rates of high cholesterol and high blood pressure dropped.
HealthDay News (1/25) 
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Even light smoking raises cardiovascular risk
Smoking just one cigarette a day raises the excess risk of stroke by 41% in men and 34% in women, and coronary heart disease by 46% in men and 31% in women, researchers reported in The BMJ. The study also showed smoking one cigarette a day was associated with a 48% increase in CHD risk for men and 57% in women, compared with never smoking.
Medscape (free registration) (1/25) 
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Regular dental care may help prevent stroke, study finds
A study published in Stroke found a correlation between gum disease and stroke risk, with the risk rising along with periodontitis severity, and found that people who receive regular dental care may have a lower stroke risk than those who do not. "Our results emphasize the need for good regular dental care, including a thorough home cleaning routine with brushing and flossing and then regular dentist and hygienist visits," said lead author Souvik Sen.
Medscape (free registration) (1/19) 
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Study: Pain tolerance improves after bariatric surgery
Obese patients who had bariatric surgery not only lost an average of 29% of their baseline body weight, they also reported reductions in both knee and wrist pain, suggesting that pain reduction was due at least in part to changes in peripheral or central sensitization, researchers reported in Arthritis Care & Research. Changes in pain tolerance may be due to hormonal or genetic changes in response to bariatric surgery, study coauthor Dr. Caroline Apovian said.
Medscape (free registration) (1/26) 
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Practice Trends & Technology
Aspirin use not tied to better outcomes in HF without AFib
A study in JACC: Heart Failure found patients with heart failure but without atrial fibrillation who used low-dose aspirin did not have a significantly lower risk of all-cause mortality or hospital admission for stroke or myocardial infarction. However, low-dose aspirin treatment was tied to a slightly higher risk of readmission for heart failure and to an elevated risk of myocardial infarction, according to the findings, based on nearly 12,300 individuals with new-onset heart failure enrolled in a Danish registry.
MedPage Today (free registration) (1/30) 
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Study shows efficacy of consultation model in diabetes care
Dutch researchers found that a consultation model -- comprised of setting personal goals, determining required care, inventory of disease and patient-related factors, and choosing treatment -- was applicable in 72.4% of cases, according to physicians, who often spent less than 25 minutes in consultation. The findings in Diabetes Care, based on a survey of 74 physicians and 31 nurses reporting on 1,366 consultations with type 2 diabetes patients, revealed that the model resulted in more patient involvement, including shared decision-making, and 52.5% of patients saw an improvement in their consultation.
Physician's Briefing/HealthDay News (1/29) 
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Fear doesn't need doors and windows. It works from the inside.
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