New research was presented at AHA 2016, the annual scientific sessions of the American Heart Association, from November 12 to 16 in New Orleans. The features below highlight some of the studies presented at the conference.
Poor Sleep Linked With AF
Obstructive sleep apnea has been identified as a risk factor for atrial fibrillation (AF) in previous studies. Whether or not disrupted sleep without sleep apnea is also linked with AF remains unclear. Researchers conducted an analysis of previous studies to isolate and confirm the effects of poor sleep on AF. They found that disrupted sleep, including insomnia, may be independently associated with AF. People who reported awakening frequently during the night had about a 26% higher risk of developing AF than those who did not wake up often. Patients with diagnosed insomnia had a 29% higher risk of developing AF than those without insomnia.
Healthy Lifestyle, Genetic Risk, & CAD
Prior research indicates that genetic and lifestyle factors both contribute to an individual’s risk of coronary artery disease (CAD). However, little is known about the extent to which a healthy lifestyle may offset higher genetic risks for CAD. Study investigators quantified genetic risk for CAD among participants of four large studies. Adherence to a healthy lifestyle—defined as no current smoking, no obesity, regular physical activity, and a healthy diet—was also assessed. Genetic and lifestyle factors were independently associated with susceptibility to CAD. However, among participants with high genetic risk of CAD, having a healthy lifestyle was associated with a 46% lower relative risk of CAD than having an unhealthy lifestyle.
Aggressive BP Therapy & AF Recurrences
Few studies have assessed if aggressive blood pressure (BP)-lowering therapy prior to a scheduled ablation of atrial fibrillation (AF) can provide sustained protection against AF recurrence. For a study, patients with hypertension were randomized to aggressive or standard BP treatment for up to 6 months prior to a scheduled AF ablation. Participants had an average BP of 123 mm Hg at 6 months post-ablation, and about 75% achieved a BP of less than 120 mm Hg. However, both groups had an incidence rate of about 60% for recurrent symptomatic AF/atrial tachycardia/atrial flutter when assessed 24 months after ablation.
Major Disparities in Statin Use
Data are lacking on current trends in statin use and out-of-pocket expenditures among adults in the United States. Researchers examined demographics, medical conditions, and prescribed medicine information of adults aged 40 and older between 2002 and 2013 from the Medical Expenditure Panel Survey database. Among the study group, statin use increased by 79.8% during the study period. Across all subgroups, statin use was significantly lower in women, racial and ethnic minorities, and the uninsured. The average annual out-of-pocket costs for statins decreased from $348 in 2002-2003 to $94 in 2012-2013. Brand-name statins were used by 18.2% of statin users, accounting for 55.0% of total costs in 2012-2013.
Preventing Bleeding During PCI in AF Patients
Standard anticoagulation has been shown to reduce the risk of thrombosis and stroke, but these therapies can also increase risks for bleeding in patients with atrial fibrillation (AF) who undergo PCI. For a study, patients with non-valvular AF were randomized to receive low-dose rivaroxaban plus a P2Y12 inhibitor for 12 months (group 1), very-low-dose rivaroxaban plus dual antiplatelet therapy (DAPT) for 1, 6, or 12 months (group 2), or standard therapy with a dose-adjusted vitamin K antagonist plus DAPT for 1, 6, or 12 months (group 3). Rates of clinically significant bleeding were 16.8% in group 1, 18.0% in group 2, and 26.7% in group 3. The findings suggest that standard therapy with a dose-adjusted vitamin K antagonist plus DAPT appears to be beneficial for patients with AF who undergo PCI.
Dangers Spotted With Yo-Yo Dieting
Evidence suggests that yo-yo dieting—the repeated loss and regaining of weight—is an emerging global health concern associated with attempts at weight loss. However, study findings on the health hazards for those who yo-yo diet have been inconsistent. For a study, Brown University researchers examined the self-reported weight history of more than 150,000 postmenopausal women. Participants were categorized as having stable weight, steady weight gain, maintaining weight loss, and having weight that cycled. At more than 11 years of follow-up, the authors found that women with normal weights at baseline who then lost and regained weight were nearly 3.5 times more likely to experience sudden cardiac death than those with stable weight. Weight cycling among normal-weight women was associated with a 66% higher risk of coronary heart disease (CHD)-related mortality. However, weight cycling was not associated with sudden cardiac or CHD-related mortality among overweight and obese women. In addition, women who steadily gained weight and those who maintained weight loss had no higher risks of sudden cardiac or CHD-related mortality.
NEWS FROM AHA 2016
MORE FROM AHA 2016