Heart Beat: March 2015
RESEARCH RAISES QUESTIONS ABOUT DRUG COMBINATION FOR AFIB PATIENTS
Long-term use of the anti-clotting drug warfarin (Coumadin) and an antiplatelet medication, such as aspirin or clopidogrel (Plavix), may raise the risk of dementia in people with atrial fibrillation (AF). A study presented at the American Heart Association Scientific Sessions suggests that the threat may be due to abnormal effects on blood circulation in the brain caused by improper warfarin dosing. Patients who take warfarin to prevent blood clot formation must undergo frequent testing to make sure the medication isn’t making their blood clot too quickly or too slowly. Researchers say that it’s not uncommon for warfarin patients to be outside the ideal clotting range as much as 40 percent of the time. They also suggest that over the years, the cumulative effects of that unhealthy circulation could lead to dementia. One contributing factor could be overmedication caused by a combination of warfarin and antiplatelet therapy. If you have AF and you’re taking warfarin and antiplatelet medications, talk with your doctor about whether you could reduce your medication intake.
AN AVOCADO A DAY MAY HELP REDUCE “BAD” CHOLESTEROL LEVELS
Eating one avocado a day, as part of a heart-healthy diet, may help overweight or obese individuals lower their levels of “bad” LDL cholesterol. A study published in the Journal of the American Heart Association found that individuals who ate a moderate-fat diet (34 percent of daily calories from fats, half of which were monounsaturated fats) and one avocado daily had lower LDL levels than study participants who ate a low-fat diet (24 percent from fats, about half from monousaturated fats). It’s important to remember, however, that one avocado has about 230 calories. So if you’re watching your caloric intake, you’ll want to be aware of what an avocado can do to your daily calorie total. The researchers also noted that many people know how to incorporate avocados into their diet only through guacamole. That can be dangerous if you’re consuming guacamole with processed corn chips that are high in sodium and unhealthy fats. Researchers encouraged Americans to incorporate avocados into salads and on sandwiches, as well as stand-alone side dishes.
NONCARDIAC SURGERY RISK DROPS SIX MONTHS AFTER STENT PLACEMENT
Individuals who receive coronary stents are at a higher risk of cardiac events if they undergo noncardiac surgery in the weeks and months immediately following stent implantation. But a recent study shows that from six to 24 months after receiving a stent, patients’ risk of a heart attack or of needing an additional stent is considerably lower than it is in the first six weeks after stent implantation. The study, published in the Journal of the American College of Cardiology, notes that the patients most at risk of major adverse events were “high-risk” patients undergoing complicated surgeries. However, the researchers found that if individuals could delay such operations at least six months, without risking additional health complications, their odds of having a heart attack or other adverse event were substantially reduced. If you need an operation, such as knee replacement or cancer surgery, be sure to tell your surgeon about your stent implantation. If your surgery can be delayed, discuss that option with your doctors. If noncardiac surgery is necessary soon after receiving a stent, discuss precautions that may help lower your risk of adverse events.
STROKE DROPS TO NO. 5 CAUSE OF DEATH IN THE UNITED STATES
The stroke death rate has dropped slightly in recent years, and that decline has moved stroke to the fifth-leading cause of death in the U.S. Stroke had held the number four spot for a long time behind heart disease, cancer and chronic lower respiratory diseases, which are still the top three causes of death. Stroke is now also behind unintentional injuries, such as car accidents and accidental poisoning. The decline in stroke deaths is due primarily to improvements in prevention and treatment of stroke, according to the American Heart Association. However, stroke remains a serious threat. Quitting smoking and managing your weight, blood pressure and cholesterol should remain among your top health priorities.