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Awareness weeks

Health Awareness Week

 

Heart research month

February 2023

Heart disease is Australia’s leading cause of death affecting families and communities around the country. Heart Research Month raises awareness on the importance of life-saving heart research, including preventing, diagnosing and treating heart disease.  Heart research Australia

UpToDate

Children and infants

Heart disease in pregnancy

Heart disease in special populations

Research

Screening and evaluation

Articles

Journals

E-books

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Articles

Consensus statement on the current pharmacological prevention and management of heart failure
Introduction: This consensus statement of Australian clinicians provides new recommendations for the pharmacological management of heart failure based on studies reported since the publication of the 2018 Australian heart failure guidelines.
Main recommendations:

  • Use of sodium–glucose cotransporter 2 (SGLT2) inhibitors to prevent hospitalisation for heart failure in type 2 diabetes mellitus can be extended to patients with multiple cardiovascular risk factors, albuminuric chronic kidney disease, or atherosclerotic cardiovascular disease.
  • New evidence supports the use of a mineralocorticoid receptor antagonist (finerenone) to prevent heart failure in type 2 diabetes mellitus associated with albuminuric chronic kidney disease.
  • In addition to renin angiotensin system inhibitors (angiotensin receptor neprilysin inhibitor preferred), beta blockers and mineralocorticoid receptor antagonists, an SGLT2 inhibitor (dapagliflozin or empagliflozin) is recommended in all patients with heart failure with reduced left ventricular ejection fraction (LVEF ≤ 40%) (HFrEF). Lower quality evidence supports these therapies in patients with heart failure with mildly reduced LVEF (41-49%) (HFmrEF).
  • A soluble guanylate cyclase stimulator (vericiguat), selective cardiac myosin activator (omecamtiv mecarbil) and, if iron deficient, intravenous iron (ferric carboxymaltose) provide additional benefits in persistent HFrEF.
  • An SGLT2 inhibitor (empagliflozin) should be considered in patients with heart failure with preserved LVEF (≥ 50%) (HFpEF).

Key changes in management from this statement: This document broadens the scope of angiotensin receptor neprilysin inhibitor use in patients with HFrEF and HFmrEF. SGLT2 inhibitor use expands to become a cornerstone therapy in HFrEF, with increasing evidence to support its use in HFmrEF and HFpEF.  MJA 1 August 2022

The influence of ambulance offload time on 30‐day risks of death and re‐presentation for patients with chest pain
Longer ambulance offload times are associated with greater 30‐day risks of death and ambulance re‐attendance for people presenting to EDs with chest pain. Improving the speed of ambulance‐to‐ED transfers is urgently required. MJA 4 July 2022

The impact of cross-jurisdictional patient flows on ascertainment of hospitalisations and cardiac procedures for ST-segment-elevation myocardial infarction in an Australian population.
Cross-jurisdictional linked hospital data is essential to understand patient journeys of NSW residents who live in border areas and to evaluate adherence to treatment guidelines for STEMI. MBS data are useful where hospital data are not available and for procedures that may be conducted in out-patient settings. International journal of population data science 8 February 2023

Achieving lipid targets within 12 months of an acute coronary syndrome: an observational analysis
Almost half the patients did not achieve target lipid levels within 12 months of an admission to hospital with ACS. These people are at elevated risk of recurrent cardiovascular disease, and therapy could be optimised (eg, dose escalation, drug combinations, novel therapies) to improve outcomes. MJA 28 March 2022

Sex differences in the management and outcomes of non‐ST‐elevation acute coronary syndromes
The women with non‐ST‐elevation acute coronary syndrome (NSTEACS) in our study received less evidence‐based treatment, consistent with previous reports. The larger proportion of women with non‐obstructive coronary artery disease (NOCAD) may partly explain the difference. However, NOCAD is not a benign condition, and patients can benefit from secondary prevention therapies. In Australia, adherence to guideline‐based therapy for people with NSTEACS could be improved, especially for women in hospital and for both sexes at discharge. MJA 20 September 2021

The incidence of cardiac complications in patients hospitalised with COVID‐19 in Australia: the AUS‐COVID study
While clinicians should remain vigilant, the incidence of clinical cardiac complications during index hospitalisations was reassuringly low in this multicentre study of more than 600 consecutive patients admitted to Australian hospitals with COVID‐19. MJA 6 September 2021

Long term survival after acute myocardial infarction in Australia and New Zealand, 2009‒2015: a population cohort study
AMI care in Australia and New Zealand is associated with high rates of long term survival; 7‐year rates exceed 80% for patients under 65 years of age and for those who undergo revascularisation. Efforts to further improve survival should target patients with NSTEMI, who are often older and have several comorbid conditions, for whom revascularisation rates are low and survival after AMI poor. MJA 7 June 2021

National Heart Foundation of Australia: position statement on coronary artery calcium scoring for the primary prevention of cardiovascular disease in Australia
Introduction: This position statement considers the evolving evidence on the use of coronary artery calcium scoring (CAC) for defining cardiovascular risk in the context of Australian practice and provides advice to health professionals regarding the use of CAC scoring in primary prevention of cardiovascular disease in Australia.
Main recommendations:

  • CAC scoring could be considered for selected people with moderate absolute cardiovascular risk, as assessed by the National Vascular Disease Prevention Alliance (NVDPA) absolute cardiovascular risk algorithm, and for whom the findings are likely to influence the intensity of risk management. (GRADE evidence certainty: Low. GRADE recommendation strength: Conditional.)
  • CAC scoring could be considered for selected people with low absolute cardiovascular risk, as assessed by the NVDPA absolute cardiovascular risk algorithm, and who have additional risk-enhancing factors that may result in the underestimation of risk. (GRADE evidence certainty: Low. GRADE recommendation strength: Conditional.)
  • If CAC scoring is undertaken, a CAC score of 0 AU could reclassify a person to a low absolute cardiovascular risk status, with subsequent management to be informed by patient–clinician discussion and follow contemporary recommendations for low absolute cardiovascular risk. (GRADE evidence certainty: Very low. GRADE recommendation strength: Conditional.)
  • If CAC scoring is undertaken, a CAC score > 99 AU or ≥ 75th percentile for age and sex could reclassify a person to a high absolute cardiovascular risk status, with subsequent management to be informed by patient–clinician discussion and follow contemporary recommendations for high absolute cardiovascular risk. (GRADE evidence certainty: Very low. GRADE recommendation strength: Conditional.)

Changes in management as a result of this statement: CAC scoring can have a role in reclassification of absolute cardiovascular risk for selected patients in Australia, in conjunction with traditional absolute risk assessment and as part of a shared decision‐making approach that considers the preferences and values of individual patients.

MJA 17 May 2021

Absolute risk assessment for guiding cardiovascular risk management in a chest pain clinic
An absolute cardiovascular risk‐guided, pro‐active risk factor management strategy employed opportunistically in a chest pain clinic significantly improved 5‐year absolute cardiovascular risk scores. MJA 8 March 2021

The 2020 Australian guideline for prevention, diagnosis and management of acute rheumatic fever and rheumatic heart disease
The 2020 Australian guideline details best practice care for people with or at risk of ARF and RHD. It provides up‐to‐date guidance on primordial, primary and secondary prevention, diagnosis and management, preconception and perinatal management of women with RHD, culturally safe practice, provision of a trained and supported Aboriginal and Torres Strait Islander workforce, disease burden, RHD screening, control programs and new technologies. MJA 16 November 2020

Adverse pregnancy outcomes and long term risk of ischemic heart disease in mothers: national cohort and co-sibling study
In this large national cohort, women who experienced any of five major adverse pregnancy outcomes showed an increased risk for ischemic heart disease up to 46 years after delivery. Women with adverse pregnancy outcomes should be considered for early preventive evaluation and long term risk reduction to help prevent the development of ischemic heart disease. BMJ 1 February 2023

Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis
These findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease. European heart journal 6 February 2023

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Journals

This is just a sample of the journals the library subscribes to – you will need your library login

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E-books

This is just a sample of the e-books the library subscribes to – you will need your library login

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Previous Awareness Weeks


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