Cardiovascular Daily wraps up the top cardiology news of the week
Epinephrine and norepinephrine are not interchangeable for the treatment of cardiogenic shock in myocardial infarction (MI), according to the results of a 57-person trial.
Epinephrine was associated with "very transient" improvement in cardiac index but more refractory shock, French researchers reported in the Journal of the American College of Cardiology.
Additionally, epinephrine was linked to increases in heart rate and cardiac double product -- a proxy for myocardial oxygen consumption -- and lactic acidosis in the early hours after administration.
This is the first randomized trial comparing the two agents in patients with cardiogenic shock-complicated MI.
See the rest of the story on MedPage Today.
LDL Aggregation in Atherosclerosis
It's not just the concentration of low-density lipoprotein (LDL) particles that counts -- whether those particles are prone to accumulation is another factor in the progression of atherosclerotic cardiovascular disease, researchers suggested.
Measured by human recombinant secretory sphingomyelinase, aggregation-prone LDL was found to be an independent predictor of future cardiovascular events among patients with established cardiovascular disease, one group reported in the European Heart Journal.
"Aggregation-prone LDL contained more sphingolipids and less phosphatidylcholines than did aggregation-resistant LDL," the study authors noted, adding that PCSK9 inhibition and healthy diet lowered this kind of LDL in humans.
Hypertension in Pregnancy
Women who experience gestational hypertension or preeclampsia during their first pregnancies were more likely to develop chronic hypertension, hypercholesterolemia, and type 2 diabetes later in life, a large prospective study showed in the Annals of Internal Medicine.
The risk was greatest in the first 5 years after giving birth. For example, those who had gestational hypertension had more than four times the risk of chronic hypertension in the first 5 years following their first birth. Additionally, peers with preeclampsia had almost quadrupled odds of chronic hypertension.
The study was based on Nurses Health Study II participants who responded to a 2009 questionnaire, self-reporting their pregnancy history, risk factors for cardiovascular disease, lifestyle characteristics, and medical history.
In Other News
Some physicians have a role in helping patients with legacy cardiovascular implantable electronic devices that haven't earned magnetic resonance (MR)-conditional labeling from the FDA get access to MR imaging (MRI) procedures, clinicians argued.
These patients can still undergo MRI in many cases, according to Collin Culbertson, MD, and Carl Gold, MD, MS, of Stanford University in California. The support from studies and guideline recommendations is there -- it's now up to institutions to reconsider their policies to ensure appropriate access to and supervision of MRI procedures in patients with legacy cardiac devices, the duo wrote in JAMA Neurology.
Read the original article on Medpage Today: Epinephrine Questioned; Sticky LDL; HTN in Pregnancy