Biomarkers to predict PAD. Extreme exercise does not increase Afib. Experience with dabigatran in real world confirms benefits.
In this week’s cardiology countdown we have biomarkers for predicting pa d and two studies of atrial fibrillation so to begin with we have a search for biomarkers to predict development of peripheral arterial disease a relatively novel area certainly we use biomarkers all the time in coronary disease and so it’s a expansion there in and and so two markers that
Were looked at involved oxidized phospholipids and a po be related to ldl as well as lp little a and two of the biomarkers were identified to predict risk with about a 35 to 40 percent higher risk of developing pid with elevated oxidized phospholipids to a po be ratio as well as lp little a and so not that surprisingly these are related to atherosclerosis and
Pa d being part of that process but useful to have exact levels etc to help predict pa d the next study looked at whether extreme exercise would be an increased risk of developing atrial fibrillation there had been some studies showing that those who exercise very regularly and a lot might increase their risk of developing atrial fibrillation and so group did a
Meta-analysis of for prospective cohorts involving just under a hundred thousand subjects and found there was really no increase in the extreme high exercising group as compared with those who carried out regular amounts of exercise and so that should not keep us away from doing a marathon as we entered boston marathon season or other extreme sports the number one
Pick this week is a registry analysis to look in a real world analysis as to how dabigatran performs as compared with warfarin this was paper published in jack where they did a two-to-one matching of about forty nine hundred patients treated with dabigatran and twice that number with warfarin propensity matched and looked at outcomes they found very consistent with
The randomized trials a lower rate of intracranial hemorrhage with both dabigatran 110 milligram twice a day dose and 150 milligrams twice a day dose as compared with warfarin also mortality was lower with each of the dabigatran groups interestingly pulmonary embolism was also lower and myocardial infarction was also lower and that had been a concern that it might
Be higher with a direct thrombin inhibitor overall stroke that is non hemorrhagic stroke was not significantly different in either of the two groups but again intracranial hemorrhage was and so while this is an observational study i think adds some real-world experience to see no increase in bleeding as has been worried about with the higher dose and actually lower
Rates of bleeding with the lower dose and so reassuring real-world experience with this new oral anticoagulant so for this week’s cardiology countdown and chris cannon you you
Transcribed from video
Cardiology Countdown | Biomarkers, Afib and Exercise, Dabigatran in Real World By American College of Cardiology Video Archive 2
