Pharmacological treatment for Type 2 diabetes integrating findings from cardiovascular outcome trials: an expert consensus in the UK

This is the final version. Available on open access from Wiley via the DOI in this recordIn people with Type 2 diabetes, cardiovascular disease is a leading cause of morbidity and mortality. Thus, as well as controlling glucose, reducing the risk of cardiovascular events is a key goal. The results of cardiovascular outcome trials have led to updates for many national and international guidelines. England, Wales and Northern Ireland remain exceptions, with the most recent update to the National Institute for Health and Care Excellence (NICE) guidelines published in 2015. We reviewed current national and international guidelines and recommendations on the management of people with Type 2 diabetes. This article shares our consensus on clinical recommendations for the use of sodium-glucose co-transporter 2 inhibitors (SGLT-2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs) in people with Type 2 diabetes and established or at very high risk of cardiovascular disease in the UK. We also consider cost-effectiveness for these therapies. We recommend considering each person's cardiovascular risk and using diabetes therapies with proven cardiovascular benefits when appropriate to improve long-term outcomes and cost-effectiveness.Novo Nordis

Assessment of acute myocardial infarction: current status and recommendations from the North American society for cardiovascular imaging and the European society of cardiac radiology

There are a number of imaging tests that are used in the setting of acute myocardial infarction and acute coronary syndrome. Each has their strengths and limitations. Experts from the European Society of Cardiac Radiology and the North American Society for Cardiovascular Imaging together with other prominent imagers reviewed the literature. It is clear that there is a definite role for imaging in these patients. While comparative accuracy, convenience and cost have largely guided test decisions in the past, the introduction of newer tests is being held to a higher standard which compares patient outcomes. Multicenter randomized comparative effectiveness trials with outcome measures are required

Data for: First Clinical Evidence Characterizing Safety and Efficacy of the New CoCr Biolimus-A9 Eluting Stent: The Biomatrix Alpha™ Registry

Data for Kalpan-Meier curves in figure 1

Improving the ECG classification of inferior and lateral myocardial infarction by inversion of lead aVR

OBJECTIVE—To assess whether the use of inverted lead aVR (−aVR) would improve the classification of acute inferior or lateral myocardial infarction presenting with ST elevation.
DESIGN—Observational study. The presence of ⩾ 1 mm ST elevation in lead −aVR (derived by manual assessment of ST depression in conventional lead aVR) was determined by a single investigator, blinded to patient outcome.
PATIENTS—173 consecutive patients with chest pain for ⩽ 12 hours and ST elevation of ⩾ 1 mm in inferior leads (II, III, aVF) or lateral leads (I, aVL, V5, V6), excluding those with anterolateral ST elevation.
MAIN OUTCOME MEASURE—Incidence of ST elevation in lead −aVR in patients with inferior or lateral ST elevation, or both.
RESULTS—ST elevation in lead −aVR was present in 25 of 136 patients (18%) with inferior but no lateral ST elevation (indicating greater superior involvement) and in three of 11 patients (27%) with lateral but no inferior ST elevation (indicating greater inferior involvement). ST elevation in lead −aVR bridged the gap between inferior and lateral ST elevation in 15 of 25 (60%) patients with inferior and lateral chest lead (V5/V6) ST elevation, and in all patients with inferior and lateral limb lead (I/aVL) ST elevation. The presence of ST elevation in lead −aVR was associated with a larger infarct size as defined by median peak creatine kinase on serial sampling: 1780 v 987  mmol/l; p = 0.021.
CONCLUSIONS—Use of lead −aVR improves the ECG classification of acute inferior or lateral acute myocardial infarction and thus may be useful as part of the routine 12 lead ECG assessment of such patients.


Keywords: electrocardiography; acute myocardial infarctio

Data for: First Clinical Evidence Characterizing Safety and Efficacy of the New CoCr Biolimus-A9 Eluting Stent: The Biomatrix Alpha™ Registry

Data for Kalpan-Meier curves in figure 1.THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV