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American College of Cardiology's 64th Annual Scientific Session PM tip sheet for March 14, 2015

American College of Cardiology

The studies below will be presented at the American College of Cardiology's 64th Annual Scientific Session the afternoon of Saturday, March 14.

1. Energy Drink Shown to Raise Resting Blood Pressure

Medical reports have linked energy drink consumption to adverse cardiac events such as changes in heart rhythm, heart attacks and even deaths in otherwise healthy people. To investigate how energy drinks affect the heart, researchers alternately gave a can of commercially available energy drink or a placebo drink to 25 healthy young adults (age 19-40 years) and assessed changes in heart rate and blood pressure. Participants experienced a marked rise in blood pressure after consuming the energy drink as compared to the placebo. The effect was most dramatic in people who did not typically consume much caffeine.

The results suggest consumers should use caution when using energy drinks because they may increase the risk of cardiovascular problems, even among young people, said Anna Svatikova, M.D., Ph.D., a cardiovascular diseases fellow at Mayo Clinic and the study's lead author.

She added that the risk could be greater among people who already have heart problems.

Svatikova will present the study, "Potentiated Blood Pressure Responses to Energy Drink Intake in Caffeine Naïve Healthy Adults. A Double Blind Randomized Controlled Study," on Saturday, March 14 at 1:30 p.m. PT/4:30 p.m. ET/8:30 p.m. UTC in Poster Hall B1.

2. Smoking May be to Blame for Broken Stents in Limb Arteries

Patients who smoke appear to be three times more likely than patients who do not to fracture stents placed in their limb arteries to open blockages. This association may be due to a loss of elasticity and increased rigidity of the vessels due to accumulation of calcium within the arterial wall of smokers, according to the authors, though further study is needed.

Stent fractures are a relatively common and significant issue in superficial femoral artery stenting, which is mostly used to treat severe blockages resulting in leg pain and ulcers. Cumulative incidence of femoropopliteal stent fracture varies from two percent to 65 percent depending on the type of stents used, length of the treated segment, number of overlapping stents, and how physically active the patient is (more activity after stenting is associated with higher risk of stent fracture). Previous studies have associated stents breaking with re-development of blockages within the stent, which can result in decreased blood supply to the affected limb.

Pawan Hari, M.D., M.P.H., of NYU Langone Medical Center, and the study's lead author, said smoking appears to be associated with increased frequency of break in stent continuity, putting patients at higher risk for developing blockages within previously placed stents in the limb arteries. His study of 97 consecutive patients with angiographically confirmed stent fracture was designed to assess the factors associated with fracture of Nitinol self-expanding stents placed in the femoral artery over a mean follow-up of 15.5 months. Approximately 10 million people in the United States suffer from peripheral arterial disease, a reduction of blood flow to the limbs due to narrowed arteries.

Being male and having larger stent width were also associated with a broken stent; however, only smoking remained significantly associated with fracture after controlling for other risk factors, including age, diabetes, high blood pressure, stent length and the number of stents placed.

Hari will present the study, "Smoking Is Strongly Associated with fracture of Nitinol Self Expanding Stents Implanted in the Superficial Femoral Artery," on Saturday, March 14 at 1:30 p.m. PT/4:30 p.m. ET/8:30 p.m. UTC in Poster Hall B1.

3. Social Habits of Inner-City Younger Adults May Impact Recovery from Early-Onset Heart Attacks

Younger adults from low-income, urban areas who are recovering from a heart attack (specifically, ST-elevation myocardial infarction or STEMI) are more likely to be male and of a non-white race-ethnicity as compared with their middle-aged and older counterparts and are much more prone to poor lifestyle habits and related disorders, including obesity, smoking, cocaine use and HIV infection.

Although these young adults, characterized as younger than 45-years-old, were less likely to die during follow-up, hospital readmission rates were more comparable to middle-aged heart attack patients who also have more cardiovascular risk factors.

"This study highlights the contributions of behavioral risk factors to the premature onset of heart attack in a low-income urban community of predominantly black or Hispanic race-ethnicity and the health burden associated with these factors in young survivors of a heart attack in terms of repeat hospitalization," said Muhammad Shahid, M.D., of Montefiore Medical Center, Bronx, New York, and the study's lead author.

These findings underscore the need for targeted community-level interventions to promote diet and physical activity and reduce smoking, drug use and other high-risk behaviors in socioeconomically disadvantaged urban settings, Shahid said.

Researchers analyzed a prospective registry of 771 patients with acute STEMI evaluated for primary coronary intervention at Montefiore Medical Center, a health system serving a predominantly socioeconomically disadvantaged community, from 2008 to 2012. STEMI affected a similar proportion of younger adults in this population, as is seen in national registries.

Shahid will present the study, "Characterization of ST-Elevation Myocardial Infarction Across the Age Spectrum in a Low-Income Urban Community: Clinical Features, Acute Care, and Long-Term Outcomes on Saturday, March 14 at 1:30 p.m. PT/4:30 p.m. ET/8:30 p.m. UTC in Poster Hall B1.

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