CARDIOVASCULAR JOURNAL OF AFRICA: VOLUME  21, ISSUE 6, NOVEMBER 2011
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  1. Title: Associations of serum C-reactive protein with physical activity, fitness and fatness in South African adolescents : editorial
    Authors: Kruger, H. Salome
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 309-310
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    Abstract: Globally the prevalence of overweight is increasing significantly, not only in economically developed regions, but also in developing countries. In South Africa, the prevalence of combined overweight and obesity among high-school children increased from 21.2% in 2002 to 25% in 2008, with 35% of high-school girls being overweight or obese.
     
  2. Title: Outcomes of stenting with overlapping drug-eluting stents versus overlapping drug-eluting and bare-metal stents for the treatment of diffuse coronary lesions : cardiovascular topics
    Authors: Kassaian, S.E.; Salarifar, M.; Dehkordi, M. Raissi; Alidoosti, M.; Nematipour, E.; Poorhosseini, H.R.; Hajizeinali, A.M.; Kazemisaleh, D.; Sharafi, A.; Mahmoodian, M.; Paydari, N.; Farahani, A.V.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 311-315
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    DOI: 10.5830/CVJA-2010-004
    DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-004
    Abstract: Introduction : We investigated the outcomes of stenting with overlapping drug-eluting stents (DES) versus overlapping stenting with a combination of drug-eluting and bare metal stents (BMS) in very long coronary lesions (≥ 25 mm).
    Methods and Results : Fifty-two patients treated with either overlapping DES-DES (n = 22) or DES-BMS (n = 30) were selected from a registry of 588 patients with very long coronary lesions. Patients with acute myocardial infarction (MI) within the preceding 48 hours were excluded. The DES-DES combination was more frequently used for longer lesions compared with the DES-BMS group (47.95 ± 9.25 vs 39.98 ± 9.15 mm, p = 0.003). Left anterior descending artery lesions were also more frequently treated with the DES-DES combination (95.5 vs 66.7%, p = 0.02). In four patients in the DES-BMS group, overlapping stents were used for the coverage of dissections. Peri-procedural non-Q-wave MI occurred in one patient in the DES-BMS group. On follow up, only one case of non-fatal MI occurred in a patient with overlapping DES-DES.
    Conclusion : Overlapping a BMS in the proximal part of a long DES instead of exclusive deployment of two or more overlapped DES seems to be a safe and feasible therapeutic strategy in our practice.
     
  3. Title: Significant differences between serum CRP levels in children in different categories of physical activity : the PLAY study : cardiovascular topics
    Authors: Harmse, B.; Kruger, H.S.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 316-322 Full text: Click here to order »
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    Abstract: Low-grade systemic inflammation is emerging as a component of the metabolic syndrome. The purpose of this study was to assess the association between serum C-reactive protein (CRP), physical activity and body composition in 193 black children aged 13 to 18 years from a South African township. Demographic information and anthropometric measurements were taken, and fasting blood samples were analysed for high-sensitivity serum CRP. Body fat was measured by air displacement plethysmography.
    There was a trend towards higher serum CRP in the boys with a higher percentage body fat. After multiple regression analyses, waist circumference in the girls was significantly associated with serum CRP. In the boys, there was an inverse correlation between percentage body fat and fitness, and between fitness and serum CRP. Significant differences were found between serum CRP in the different physical activity categories, with lower serum CRP in the girls in the higher physical activity group. Obesity should be prevented in South African children by encouraging physical activity.

  4. Title: New anti-coagulant therapies set to revitalise clinical haemotology practice : special report - annual meeting of the Southern African Society of Thrombosis and Haemostasis
    Authors: Aalbers, J.; Wagenaar, P.; Klug, Eric
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 323-326, 337
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    Abstract: Clinical and laboratory-based haematologists are likely to experience more requests for advice and support from their colleagues in cardiology, orthopaedics and neurology as the impact of newly registered anti-coagulant therapies unfolds. This is because the new anti-thrombotic and anti-platelet agents will need to be understood on the basis of their individual attributes and not as inter-changeable drugs within their respective class. Also, usage of the new factor Xa inhibitors such as rivaroxaban, and direct thrombin inhibitors such as dabigatran, while not requiring monitoring for routine clinical practice, have different effects on standard coagulation tests which may require expert interpretation prior to surgery or percutaneous coronary interventions (PCI), or to assess compliance with medication or suspected over-dosing.

  5. Title: Mitral valve prolapse and conduction disturbances : the forgotten association : case report
    Authors: D'Aloia, A.; Vizzardi, E.; Antonioli, E.; Chiari, E.; Curnis, A.; Dei Cas, L.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 327-329
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    Abstract: Various cardiac arrhythmias and conduction defects have been described in patients with mitral valve prolapse. We describe a case of a young woman affected by a mitral valve prolapse, involving the posterior mitral leaflet, with mild mitral regurgitation and an episode of syncope due to asystolia. It is hoped that this short communication will once again focus attention on the as yet unexplained association between mitral valve prolapse and various cardiac conduction disorders.
     
  6. Title: Post-infarction ventricular septal defect : triggered by Valsalva manoeuvre? : case report
    Authors: Baskurt, M.; Turhan, N.; Hatemi, A.; Canikoglu, M.; Karadag, B.; Kucukoglu, S.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 329-332
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    DOI: 10.5830/CVJA-2010-011
    DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-011
    Abstract: Post-infarction ventricular septal defect (VSD) is a fatal mechanical complication of myocardial infarction. Although the incidence has decreased to less than 1% after the extensive use of reperfusion strategies, post-infarction VSD still carries a high mortality risk. Management is controversial, whether to wait for surgery after a stabilisation period or to perform emergency surgery when diagnosed. We report on a case of post-infarction VSD that was detected with severe haemodynamic instability, beginning immediately after the patient's Valsalva manoeuvre on the sixth day of a non-reperfused inferior myocardial infarction. In the early period, the post-infarction VSD was repaired via a trans-aneurysmal approach.

  7. Title: Contemporary insights into the pathogenesis, diagnosis and therapy of pulmonary arterial hypertension : review article
    Authors: Essop, Mohammed R.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 334-337
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    DOI: 10.5830/CVJA-2010-088
    DOI Citation Reference Link: dx.doi.org/10.5830/CVJA-2010-088
    Abstract: Current data challenge the concept that pulmonary arterial hypertension (PAH) is purely a disorder of impaired vasomotor tone. Instead, we recognise today that the phenotype of PAH represents the complex and disordered regulation of expression of key signalling molecules and abnormal molecular trafficking. Discovery of mutations of the ubiquitous receptors of the transforming growth factor beta (TGF-β) superfamily in many patients with PAH has been instrumental in unravelling the pathobiology of this otherwise fatal disorder. Much still needs to be learnt before we are able to substantially alter the natural history of PAH. Until such time, therapies that fundamentally attempt to restore vasomotor tone continue to be developed and tested.
    Current clinical research in the therapeutic arena is focused on defining the best permutation of the three major groups of drugs - prostacyclin analogues, phosphodiesterase type-five inhibitors and the endothelin receptor antagonists. However, if we are to make any significant impact on the otherwise dismal outcome of PAH, we have to recognise that even more important than the challenge of new therapies, is the challenge in diagnosing the condition early in the course of its relentless progression to right heart failure and eventual death.
     
  8. Title: Opinions in Hypertension Management
    ARBs and risk of cancer : international and South African expert comment
    Authors: Lombard, C.; Nosworthy, Adam; Aalbers, J.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 338-341
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    Abstract: The suggestion from a recent meta-analysis that angiotensin receptor blockers (ARBs) are associated with an increase in new cancer occurrence but not cancer deaths, has resulted in the initiation of a safety review of this class of drugs by both the FDA (Federal Drug Administration) and the EMA (European Medicines Authority) in accordance with good regulatory practice. This was also advocated by Dr Steve Nissen in his editorial comment. In the interim, a review of the published meta-analysis plus input from Boehringer-Ingelheim is pertinent to clinical practice.
     
  9. Title: FDA committee unanimously recommends approval of dabigatran etexilate for stroke prevention in atrial fibrillation : drugs trends in cardiology
    Authors: Aalbers, J.; Bryer, A.; Klug, E.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 341
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    Abstract: The US Food and Drug Administration (FDA) Cardiovascular and Renal Drugs Advisory Committee recently voted 9 to 0 in favour of recommending dabigatran etexilate for stroke prevention in patients with atrial fibrillation (AF).

  10. Title: Rivaroxaban equals warfarin treatment in atrial fibrillation patients at high risk of stroke : drug trends in cardiology
    Authors: Aalbers, J.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 342-343
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    Abstract: Rivaroxaban has met its primary objective in the ROCKET trial of non-inferiority to warfarin in the treatment of atrial fibrillation (AF) patients at high risk of stroke. In fact the study included a majority of patients who had already experienced either a stroke or transient ischaemic event, therefore needing warfarin for secondary prevention.

  11. Title: Development of new anticoagulant highly honoured : Bayer's Xarelto® recognised with 2010 international Prix Galien award : drug trends in cardiology
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 343-344
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    Abstract: The highly distinguished Awards Committee of the Galien Foundation has honoured Bayer's Xarelto® (rivaroxaban) with the Prix Galien International 2010 in the category Best Pharmaceutical Agent. Xarelto® had previously already been recognised with national Prix Galien awards in Belgium, France and Switzerland.
     
  12. Title: Myocardial salvage after myocardial infarction depends on early therapy : drug trends in cardiology
    Authors: Aalbers, J.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 344
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    Abstract: In a thought-provoking session on triple anti-platelet therapy in acute coronary syndromes, Prof Marco Valgimigli, Ferrara, Italy, argued that the effect of clopidogrel is negligible if given too late to ST-segment elevation myocardial infarction (STEMI) patients. 'Clopidogrel is not fully absorbed during STEMI. This impaired bio-availability of both the active and inactive metabolite, combined with late administration of clopidogrel, results in minimal anti-platelet inhibition. In fact, there is limited clinical evidence supporting the upstream use of clopidogrel', he said.

  13. Title: Vitamin D is a prognostic marker in heart failure : your life and your heart
    Authors: Aalbers, J.
    From: Cardiovascular Journal of Africa, Vol 21, Issue 6, Nov / Dec
    Published: 2010
    Pages: 348
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    Abstract: A Dutch study of vitamin D levels in patients with heart failure, presented at the 2010 European Society of Cardiology (ESC) congress in Stockholm, provoked considerable interest among cardiologists as it suggests that they advise their patients to maintain appropriate vitamin D levels. 
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