CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 2, May – August 2024 AFRICA 81 7. Badiu CC, Schreiber C, Hörer J, et al. Early timing of surgical intervention in patients with Ebstein’s anomaly predicts superior long-term outcome. Eur J Cardiothorac Surg 2010; 37: 186–192. 8. Geerdink LM, Kapusta L. Dealing with Ebstein’s anomaly. Cardiol Young 2014; 24(2): 191–200. 9. Delhaas T, Sarvaas GJ, Rijlaarsdam ME, et al. A multicenter, long-term study on arrhythmias in children with Ebstein anomaly. Pediatr Cardiol 2010; 31: 229–233. 10. Roten L, Lukac P, DE Groot N, et al. Catheter ablation of arrhythmias in Ebstein’s anomaly: a multicenter study. J Cardiovasc Electrophysiol 2011; 22(12): 1391–1396. 11. Attenhofer Jost CH, Connolly HM, Dearani JA, Edwards WD, Danielson GK. Ebstein’s anomaly. Circulation 2007; 115(2): 277–285. 12. MacLellan-Tobert SG, Driscoll DJ, Mottram CD, Mahoney DW, Wollan PC, Danielson GK. Exercise tolerance in patients with Ebstein’s anomaly. 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Comparison of the outcome of porcine bioprosthetic versus mechanical prosthetic replacement of the tricuspid valve in the Ebstein’s anomaly. Am J Cardiol 2009; 103(4): 555–561. 21. Garatti A, Nano G, Bruschi G, et al. Twenty-five-year outcomes of tricuspid valve replacement comparing mechanical and biologic prostheses. Ann Thorac Surg 2012; 93: 1146–1153. 22. Brown ML, Dearani JA, Danielson GK, et al.; Mayo Clinic Congenital Heart Center. The outcomes of operations for 539 patients with Ebstein anomaly. J Thorac Cardiovasc Surg 2008; 135(05): 1120–1136; 1136. e1–1136.e7. 23. Li X, Wang SM, Schreiber C, et al. More than valve repair: effect of cone reconstruction on right ventricular geometry and function in patients with Ebstein anomaly. Int J Cardiol 2016; 206: 131–7. 24. Khorsandi M, Banerjee A, Singh H, Srivastava AR. Is a tricuspid annuloplasty ring significantly better than a De Vega’s annuloplasty stitch when repairing severe tricuspid regurgitation? Interact Cardiovasc Thorac Surg 2012; 15(1): 129–135. 25. Lange R, Burri M, Eschenbach LK, et al. Da Silva’s cone repair for Ebstein’s anomaly: effect on right ventricular size and function. Eur J Cardiothorac Surg 2015; 48: 316–321. … continued from page 74 In other words, as many as four million people in the US who currently take statins for primary prevention, meaning they have not had a cardiovascular event such as a stroke or heart attack, may not need them, said Anderson, lead author of the study. How is the new calculator different? Among other factors: • It removes race from the calculation, replacing it with a person’s residential code, which serves as an indicator of socio-economic status. • It includes factors that can increase heart disease risk, such as kidney disease, obesity and a marker of poor blood sugar control (haemoglobin A1c). • It calculates risk separately for men and women. The latest findings are an opportunity for people who are taking statins for primary prevention to ask their doctor if they need to continue the medication, Anderson said. While it’s important to treat heart disease risks before a first event, statins can cause side effects for some, including muscle pain, headaches, sleep problems and digestive problems. ‘For patients who are right on the edge, they should know there are other things not captured by these calculators, such as family history, so it’s very important to discuss this with their physician,’ Anderson added. However, some cardiovascular disease experts were concerned that the findings might convince some patients to stop taking their medications, especially considering many people already discontinue statins against their doctors’ advice. The new risk calculator will need guidelines to go with it, said Dr Sadiya Khan, who was chair of the committee for PREVENT development and a professor of cardiovascular epidemiology at the Northwestern University Feinberg School of Medicine. ‘Risk models don’t determine who is recommended to take statins: guidelines do,’ she said. ‘I think the most important thing is the determination of when it will be recommended to initiate statins. That has not been decided yet.’ Dr Robert Rosenson, director of lipids and metabolism for the Mount Sinai Health System in New York City, warned that the small number of participants in the study wasn’t representative of the US population. ‘Their main point, that fewer patients should be eligible for statins, is based on the limited numbers of people in the NHANES database,’ he said. ‘That is alarming.’ And Dr Shaline Rao, director of heart failure services at the NYU Langone Hospital-Long Island, was concerned that patients who actually need anti-cholesterol drugs might take the wrong message. ‘We see a lot of benefits of statins across many populations,’ Rao said. Source: MedicalBrief 2024
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