17/March/2022 Top Medical Bulletin

Here are top medical stories for today:

Polypill Shows LDL-Lowering Advantage in High-risk Primary Prevention Patients 

Cardiovascular polypills are important as a fixed-dose combination of medications with proven benefits for the prevention of cardiovascular diseaseby combining different drug classes in a single pill to simultaneously target more than one risk factor. Whetherthe treatment with the CNIC-polypill was at least non-inferior to usual care in terms of low-density lipoprotein cholesterol (LDL-c) and systolic BP (SBP) values in subjects at high or very high risk without a previous cardiovascular event. The switch from conventional treatment to the CNIC-polypill approach in patients at high Cardiovascular risk without a previous event was safe and appears a reasonable strategy to control risk factors and prevent cardiovascular diseases.

Anterior-lateral positioning of electrodes better for biphasic cardioversion of AF

According to a recent study published in Circulation, Anterior-lateral positioning is superior to anterior-posterior electrode positioning in biphasic cardioversion of atrial fibrillation.

Smaller randomized studies have reported conflicting results regarding the optimal electrode position for cardioverting atrial fibrillation. However, anterior-posterior electrode positioning is widely used as a standard and believed to be superior to anterior-lateral electrode positioning. Therefore, we aimed to compare anterior-lateral and anterior-posterior electrode positioning for cardioverting atrial fibrillation in a multicenter randomized trial.

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Anterior-Lateral Positioning Of Electrodes Better For Biphasic Cardioversion Of AF

 Atrial fibrillation after cardiac surgery tied to increased thromboembolic stroke risk

A recent study reveals that postoperative atrial fibrillation (POAF) within 7 days following cardiac surgery is tied to a three-fold increased risk of thromboembolic stroke during hospital admission. The findings of the study, published in the Journal of Cardiothoracic and Vascular Anesthesia, therefore, suggests that speedy treatment of POAF may reduce early stroke risk after cardiac surgery.

Atrial fibrillation and atrial flutter are the most common cardiac arrhythmias in both the general population and preoperatively in cardiac surgery patients admitted to the ICU. In the ICU environment, the subclinical variant may have short episodes and few symptoms an can be missed. A a result, the condition may be underestimated and left untreated. POAF, preexisting or as a new-onset manifestation, occurs often after cardiac surgery. Its reported incidence is said to vary from 10%-to-50%, and is associated with a two-fold increase in long-term cardiovascular mortality and morbidity.

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Atrial Fibrillation After Cardiac Surgery Tied To Increased Thromboembolic Stroke Risk

 Metformin use lowers risk of neurodegenerative diseases in diabetes patients

Findings from a recent meta-analysis showed that metformin use, especially long-term use is tied to a lower risk of neurodegenerative disease (ND) in diabetes patients. However, the researchers add, "owing to a substantial heterogeneity among studies, there is a need for high-quality randomized controlled trials to confirm the finding."

There has always been a controversy on the association between metformin use and neurodegenerative disease onset. To clarify the same, Zubing Mei, Anorectal Disease Institute of Shuguang Hospital, Shanghai, China, and colleagues aimed to determine the relationship between metformin use and ND risk based on data from population-based cohort studies in a systematic review and meta-analysis published in the journal Diabetic Medicine.

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Metformin Use Lowers Risk Of Neurodegenerative Diseases In Diabetes Patients