Heart Beat January 2017 Issue

Bioabsorbable Stents; Caffeine and Heart Failure; Proton Pump Inhibitors

Bioabsorbable Stents Among Cleveland Clinic Innovations for 2017

Every year Cleveland Clinic doctors and other health experts compose a list of treatments, tools, and trends that are likely to be medical breakthroughs in the year ahead. Among the items on Cleveland Clinic’s Top 10 Medical Innovations for 2017 are a few that affect cardiovascular health. One of them is the bioabsorbable stent. In the U.S. every year, hundreds of thousands of people have stents placed in their coronary arteries to help open up blocked blood vessels. Most of these stents are made of flexible metal materials, and are designed to stay in the arteries permanently. In July 2016, however, a new type of stent was approved for limited use in the United States. It’s a bioasorbable stent made of material that slowly dissolves into the body, similar to the way some kinds of sutures can dissolve without having to be removed. Unlike a metal stent, which requires medications to help prevent blood clots forming around the stent, a bioabsorable stent does not require a blood-thinning drug once it has been absorbed by the body. Currently, only one type of bioabsorbable stent has been approved. That is expected to change, as bioabsorbale stents become breakthrough innovations in 2017 and beyond. Other items on the Innovations list include two diabetes drugs: empglifozin and liraglutide. These drugs are already starting to improve mortality rates in people with type 2 diabetes. Research suggests they can help lower blood glucose levels, while protecting against heart-related mortality. Cleveland Clinic health experts also see big changes and advances in digital record-keeping and communication, which should allow patients to have easier access to their records and allow doctors and medical centers to more easily share patient information with other healthcare providers.

Caffeine Consumption May Be Safe If You Have Heart Failure

A small study of heart failure patients found that drinking caffeinated coffee every day didn’t raise their risk of abnormal heart rhythms (arrhythmias). Concerns about how caffeine affects heart rate, blood pressure and heart health in general are common among heart patients. In this study, published in JAMA Internal Medicine, two groups of heart failure patients drank five cups of coffee in five hours. One group drank regular coffee with caffeine—for a total of 500 milligrams (mg) and the other group drank decaffeinated coffee. The participants then did a treadmill test while their heart rates were monitored. Blood samples were also taken to measure caffeine levels in the bloodstream. Researchers found no significant difference in arrhythmias among the caffeine group compared with the caffeine-free group. Participants who had higher levels of caffeine in their systems were not at greater risk of having abnormal heart rhythms, either. The researchers pointed out that the heart failure patients all had left ventricular systolic dysfunction, so some caution is urged in applying the results to other types of patients. They also noted that 500 mg of caffeine equates to three to five cups of coffee, depending on the strength of the coffee. The findings shouldn’t be taken to mean that unlimited caffeine consumption must be safe for heart failure patients. Moderate consumption, however, may be safe. If you have doubts, discuss them with your doctor, and pay attention to how your heart responds to caffeine consumption.

High Doses of Proton Pump Inhibitors May Increase Stroke Risk

If you take a proton pump inhibitor (PPI) for heartburn, you may be putting yourself at a higher risk for an ischemic stroke, according to a study presented at the most recent American Heart Association conference. PPIs have previously been associated with higher risks of heart attacks, kidney problems and dementia. Researchers wanted to see if the popular heartburn drugs also raised the odds of having an ischemic stroke, the type of brain attack caused by blockage of an artery carrying blood to brain tissue. In the six-year observational study, researchers found that taking the highest recommended doses of a PPI was associated with a 21 percent higher stroke risk, compared with similar adults who did not take PPIs for heartburn. At the lowest doses, there was little or no increased risk of a stroke. Researchers suggest that you review your PPI use with your doctor. The other common heartburn medications, H2 blockers, did not appear to raise the risk of ischemic stroke.

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