Volume 1, Number 1, April 2008

POPULAR
TOPICEDITORIALRiding the tide
Professor Michael Kirby

ORIGINAL RESEARCHElectrocardiography as a prognostic tool for identifying the development of heart failure in patients with β-thalassaemia: a retrospective cohort study
Mohammed Nabil Quraishi, Sarah Lawson, Paramjit S Gill

Objective: To determine the clinical utility of electrocardiographic (ECG) indices in the development of heart failure in patients with β-thalassaemia.
Design: A retrospective cohort study based in the Dubai Thalassaemia Centre, United Arab Emirates.
Participants: 114 patients aged over 12 years with β-thalassaemia – 16 with heart failure and 98 without heart failure.
Method: ECGs recorded at least six months before the date of the patients’ assessment or date of diagnosis of heart failure were examined.
Results: Sinus tachycardia (p<0.001), broad QRS complexes (p<0.05) and T wave inversions (p<0.01) were significantly increased in patients who developed heart failure. These three abnormalities significantly increased in frequency of occurrence with increasing ferritin levels. Sinus tachycardia and broad QRS complexes also inversely correlated with decreasing left ventricular ejection fraction (LVEF). Age was not related to increased occurrence of any of these abnormalities.
Conclusions: ECG is an inexpensive, non-invasive test that has potential in the cardiac assessment of patients with β-thalassaemia, particularly in resource-poor countries.

POPULAR
TOPICJOURNAL REVIEWJournal Review

POPULAR
TOPICTOPICAL REVIEWRosiglitazone: how should we be using this oral hypoglycaemic drug after studies indicating increased MI risk have resulted in changes in recommendations?
Brian Karet

POPULAR
TOPICTOPICAL REVIEWWhere are we now with rosiglitazone? A comment from GlaxoSmithKline
Phil Ambery

POPULAR
TOPICEVIDENCE REVIEWCardiovascular risk management series: 1 The epidemiology of cardiovascular disease
FD Richard Hobbs, Arno W Hoes, Elinor Washbrook, Martin R Cowie

CASE REVIEWA typical case of end-stage heart failure
Ahmet Fuat

This series of reflective case studies presents the history, examination and test results for ‘real life’ primary care patients, followed by assessment of the evidence indicating what constitutes best practice.

PRACTICE REVIEWMonitoring kidney function with eGFR
Donal O’Donoghue

We now know that around 8% of the adult population in England have chronic kidney disease (CKD) and that it is a major cardiovascular risk factor. Detection is the first step in improving outcome, followed by structured management. This has the potential to reduce the risk and improve the lives of millions of patients. Around 2.9 million people in the UK have moderate-to-severe kidney disease. Estimated glomerular filtration rate (eGFR) can help to identify patients at high risk of cardiovascular disease (CVD) and improve the prevention and management of CKD. Primary care plays a key role in detecting CKD and in reducing risk in patients found to have impaired kidney function.

PRACTICE REVIEWOptimising follow-up of myocardial infarction in primary care
Michael Kirby

Primary care has a central role in the provision of follow-up and ongoing care to patients who have suffered a myocardial infarction (MI). Optimising the process starts with obtaining accurate and detailed information on hospital discharge, followed by early review by the practice and regular follow-up visits with the aim of achieving targets recommended in post-MI management guidelines.

DRUG REVIEWStatin therapy for secondary prevention of coronary heart disease: an update
Kausik K Ray, Lesley A Everett

This is the first in a series of narrative reviews that comprehensively assess recent advances from randomised controlled trials of statin therapy in patients with coronary heart disease (CHD).

TRIAL REVIEWA new study suggests olmesartan may achieve regression of atherosclerosis
Manuel Taboada, Gill Jenkins

DEBATEGPs can, and should, manage obesity as part of reducing the risk of cardiovascular disease

No-one would argue that obesity is not a major public health problem. The question is: should GPs play a role in managing the problem, particularly in relation to cardiovascular risk? Two GPs debated the issue at a recent meeting at the Royal College of Surgeons, London. Susan Mayor reports.

NEWSNews in this issue...