By Chris Kaiser, Cardiology Editor, MedPage Today Eating habits of preschool children apparently have an influence on cholesterol levels. Also in the news this week, a novel acute heart failure drugs moves quickly toward approval and statins and CRP.
Preschool Diet Impacts CV Risk Later
Eating behaviors during early childhood -- from 3 to 5 years of age -- may determine future cardiovascular risk, according to a cross-sectional study.
In 1,076 preschool-age children, each unit increase in an eating behaviors subscore, suggesting greater nutritional risk, translated into a significant increase of 0.02 mmol/L in non-HDL cholesterol, according to Navindra Persaud MD, MSc, of the University of Toronto, and colleagues.
The eating behaviors subscore was also associated with LDL cholesterol and apolipoprotein B, but not with HDL cholesterol or apolipoprotein A1, they wrote in an study published online in CMAJ.
In addition, male sex and parental body mass index were also significantly related to serum non-HDL cholesterol levels.
No other subscales of the nutritional risk questionnaire -- dietary intake, parental concern about food, screen time, or supplements -- were associated with non-HDL cholesterol levels.
"The eating behaviors subscale included whether children were allowed to decide how much they ate, whether they ate while watching television, the number of meals they ate per day, the presence of gagging or trouble swallowing while eating, and whether the child is not hungry at meal time because of frequent drinking," according to the study.
FDA Gives Serelaxin Special Approval Pathway
The FDA has granted Breakthrough Therapy designation to serelaxin (RLX030), an investigational drug for acute heart failure, according to drug maker Novartis.
Breakthrough Therapy designation is intended to expedite the development and review of drugs for serious or life-threatening conditions.
The FDA based its decision on the results of the RELAX-AHF trial, which were a mixture of statistical hits and misses, and with a pattern of benefit in some prespecified efficacy endpoints.
The RELAX-AHF trial created a buzz at the 2012 American Heart Association meeting where many in attendance said the drug would be a game-changer, but others questioned some of the trial's methods.
Outflow Tract Surgery in Cardiomyopathy Safe
Adults with symptomatic hypertrophic cardiomyopathy can expect a low event rate following surgery for relief of left ventricular outflow tract obstruction, researchers found.
In 86 patients (mean age 47), the rate of death, defibrillator discharge, and resuscitated sudden death at 30 days was 0%, and at 1 and 2 years, rates were 1.5% and 3%, respectively, according to Milind Y. Desai, MD, of the Cleveland Clinic, and colleagues.
After a mean follow-up of 6.2 years, 12% of patients met the composite endpoint of death, successful resuscitation from sudden death, appropriate ICD discharges, stroke, and congestive heart failure admission.
Of these, 7% met the hard endpoint of death, appropriate ICD discharges, and revival from sudden death, researchers wrote online in Circulation: Journal of the American Heart Association.
Multivariate analysis found older age and presence of residual atrial fibrillation to be predictors of worse outcomes.
Statin-Reduced CRP Weak Signal of CV Risk
Baseline C-reactive protein (CRP) levels were more associated with future cardiovascular risk than CRP levels after initiation of statin therapy, researchers found.
During 5.5 years of following 488 people with no previous history of CV disease, LDL cholesterol levels below the median following atorvastatin therapy was associated with a relative 42% decrease in CV risk, according to Peter S. Sever, FRCP, of the Imperial College London, and colleagues.
However, the concomitant reduction in CRP levels below the median did not confer a decreased risk in CV events, researchers wrote in the study published online in Journal of the American College of Cardiology.
Even among participants who achieved LDL-C levels below the median, CV risk did not differ when their CRP levels were below or above the median.
Extended Study of Dabigatran Shows Safety
Longer-term data from the RELY-ABLE trial showed similar safety results for the oral anticoagulant dabigatran (Pradaxa) as in the pivotal RE-LY trial.
In 5,851 patients who participated in this extension study, rates of major bleeding were 3.74% and 2.99% per year for the BID 150 mg and 110 mg, respectively, not statistically different from the pivotal trial, according to Stuart J. Connolly, MD, of McMaster University and Hamilton Health Sciences in Hamilton, Canada, and colleagues.
Other bleeding metrics -- including major gastrointestinal bleeding, total bleeding, and life-threatening bleeding -- showed similar rates as in RE-LY, with as expected higher rates for 150 BID, researchers reported online in Circulation: Journal of the American Heart Association.
Rates of stroke and death also were similar between the two doses.
These results provide "additional safety information for a large cohort of patients continuing the same dose of dabigatran as assigned in the RE-LY trial," researchers wrote in conclusion.
Chris Kaiser
Cardiology Editor
Chris has written and edited for medical publications for more than 15 years. As the news editor for a United Business Media journal, he was awarded Best News Section. He has a B.A. from La Salle University and an M.A. from Villanova University. Chris is based outside of Philadelphia and is also involved with the theater as a writer, director, and occasional actor.
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