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Cardiovascular

Identifying and treating iron deficiency in patients hospitalized for heart failure

Identifying and treating iron deficiency in patients hospitalized for heart failure

By Hans Haag and Dr. Ricky Turgeon on July 5, 2023

Heart failure is the third leading cause of hospitalization in Canada and leads to readmission in 1 in 5 patients within 30 days after discharge. Iron deficiency (with or without anemia) is an important comorbidity in patients with HF and is associated with worse outcomes. Assess iron deficiency for all patients with HFrEF and HFmrEF admitted for acute HF.

Identifying Advanced Heart Failure in your patient

Identifying Advanced Heart Failure in your patient

By Dr. Michael Diamant on April 19, 2022

The prevalence of ambulatory patients with advanced or end-stage heart failure (HF) is increasing over time, and now comprises as much as 14% of all patients with HF. Patients may be eligible for advanced therapies, including durable mechanical circulatory support (MCS) and heart transplantation, that can change their trajectory and markedly improve long-term survival.

Practice tips for heart failure with reduced ejection fraction (HFrEF): supporting patients with medications and self-monitoring

Practice tips for heart failure with reduced ejection fraction (HFrEF): supporting patients with medications and self-monitoring

By Shari Hurst on April 6, 2022

There are a few tips and tricks to improve medication tolerance and adherence, and improve quality of life for patients with HF-rEF. Multiple studies have shown that a focus on patient education and empowerment along with clinical follow-up for HFrEF medical treatment improves survival, reduces hospitalizations, and improves quality of life.

Heart

Icosapent Ethyl to Reduce Atherosclerotic Events in Patients with Hypertriglyceridemia

By Omid Kiamanesh, MD, FRCPC on August 26, 2020

Despite intensive lowering of LDL-C using lipid-modifying therapy, residual ASCVD risk persists, particularly in those with hypertriglyceridemia. Icosapent ethyl has been shown to reduce residual ASCVD risk and cardiovascular death in select patients with hypertriglyceridemia while on statin therapy.

Surgery

Baby aspirin for extended DVT prophylaxis after elective hip and knee arthroplasty

By Drs. Terence Yung and Tony Wan on July 24, 2018

For those who had an elective hip or knee arthroplasty who have no other risk factors for VTE, after initial 5 days of DVT prophylaxis with rivaroxaban 10mg a day, I complete the remaining DVT prophylaxis with aspirin 81mg once daily for an additional 30 days for hip arthroplasty and 9 days for knee arthroplasty. Those who already were on once-daily 81mg aspirin prior to surgery will receive 162mg aspirin once daily instead in this period.

Management of Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation

Management of Perioperative Bridging Anticoagulation in Patients with Atrial Fibrillation

By Drs. Christopher Cheung and Kenneth Gin on August 9, 2017

Perioperative management of anticoagulation is challenging as physicians must consider the risks of stroke, systemic embolism, and perioperative bleeding.

Heart

Elevated Lipoprotein (a) is a common reason for unexplained premature or recurrent coronary heart disease and stroke

By Dr. Gordon Francis on April 26, 2017

High Lp(a) is a major CVD risk factor that should be measured and acted upon in patients and families where there is history of premature CV events but lack of clear risk factors, and in patients with known CVD and recurrent events despite treatment to LDL-C target.

Surgery

First Canadian guideline on perioperative cardiac risk assessment and management for patients undergoing non-cardiac surgery

By Drs. Terence Yung and Erin Morley on March 22, 2017

Physicians who see patients for preoperative assessment often face the dilemma of accurately determining a patients’ cardiac risk. Patients may have limited mobility and thus do not necessarily elicit cardiac symptoms even if there is significant flow-limiting coronary artery disease.

Blood-pressure

Comparing intensive versus standard blood-pressure control: The SPRINT Trial

By Drs. Christopher Cheung and Kenneth Gin on June 22, 2016

Hypertension affects over 1 in 5 Canadians and is one of the leading causes of cardiovascular disease, including coronary artery disease and heart failure. Uncontrolled hypertension is a risk factor for stroke (both ischemic and hemorrhagic), retinopathy, chronic kidney disease (CKD), and peripheral vascular disease. Epidemiologic studies show that the risk of cardiovascular disease increases above a blood pressure of 115/75 mmHg.

Cardiology

Cardiovascular outcomes and blood pressure, glucose, and cholesterol numbers

By James McCormack on September 16, 2015

Numerous observational studies have consistently shown in many (but not all) patient populations a correlation between people with higher blood pressure, glucose, and cholesterol numbers, and a greater risk of cardiovascular events such as heart attacks, strokes, and other unwanted outcomes.

Heart

Mineralocorticoid Receptor Antagonists in Heart Failure with Preserved Ejection Fraction: The TOPCAT and ALDO-DHF trials

By Dr. Mustafa Toma and Dr. Christopher Cheung on May 27, 2015

There are approximately 500,000 Canadians living with heart failure, and more than 10% in patients older than 65. Up to 50% of patients presenting with signs and symptoms of heart failure will have a preserved ejection fraction (HFpEF or diastolic dysfunction). However, there is a lack of evidence for effective therapies in the management of HFpEF.

What blood pressure should I target in my patients with chronic kidney disease?

What blood pressure should I target in my patients with chronic kidney disease?

By Dr. Nadia Zalunardo on September 15, 2014

The most common cause of death among individuals with chronic kidney disease is cardiovascular disease. For most people with CKD, the risk of cardiovascular death exceeds the risk of developing end stage kidney disease.

Update on the guidelines for Subacute Bacterial Endocarditis (SBE) prophylaxis

Update on the guidelines for Subacute Bacterial Endocarditis (SBE) prophylaxis

By Dr. Natasha Press on March 5, 2014

The most recent AHA guidelines (2007) have limited antibiotic prophylaxis to those patients at highest-risk for developing endocarditis and who are undergoing high-risk invasive procedures.

Effects of glucocorticoids on cardiovascular risks in patients with rheumatoid arthritis

Effects of glucocorticoids on cardiovascular risks in patients with rheumatoid arthritis

By Drs. Kam Shojania and Neda Amiri on September 23, 2013

Rheumatoid arthritis has been described to be associated with an increased risk of cardiovascular disease. This risk appears to be multifactorial in nature. However, there is emerging evidence that glucocorticoids play a role.

What's new in dyslipidemia by Dr. Jiri Frohlich

What’s new in dyslipidemia

By Dr. Jiri Frohlich on August 20, 2012

Several studies established that apo B is a better predictor of risk both at baseline and on treatment than LDL-C due to the fact that small dense LDL particles are much more atherogenic as they easily penetrate the endothelial space.

Advance care plan (ACP) for patients with multiple co-morbidities

Monitoring of cardiovascular disease risk in people with chronic mental illness

By Dr. Randall White on January 17, 2011

The evidence has become impossible to ignore that people with chronic mental illness are dying from heart attacks and strokes at a higher rate than the general population.


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