Latest news with #MACE
Medscape
3 days ago
- Health
- Medscape
Meeting Target Serum Urate Level Cuts CV Risk in Gout
BARCELONA, Spain — A 'treat-to-target' approach for gout was associated with a modest but significant reduction in the risk for major cardiovascular (CV) events (MACEs) when compared to a 'fire-and-forget' approach, according to findings reported at the European Alliance of Associations for Rheumatology (EULAR) 2025 Annual Meeting. Patients who achieved a target serum urate level of < 360 μmol/L (6 mg/dL) within the first 12 months of starting urate-lowering therapy (ULT) had a 6%-12% lower risk for MACE within 5 years compared with those who did not achieve that target level. The definition of MACE included nonfatal myocardial infarction, nonfatal stroke, or CV death. 'Gout is associated with an increased risk of cardiovascular events,' said Edoardo Cipolletta, MD, a rheumatology consultant at Azienda Ospedaliero Universitaria delle Marche, Torrette, Italy, and a research associate at the University of Nottingham, Nottingham, England. Although 'a temporal association between gout flares and subsequent cardiovascular events' had been described previously, it was not known whether using ULT to achieve a target serum urate level of at least < 360 μmol/L (6 mg/dL) would reduce the risk of CV events, Cipolletta added. Two Emulated Target Trials To learn whether ULT might reduce the risk for future MACE, Cipolletta and associates performed two emulated target trials using data from two large-scale primary care databases — the Clinical Practice Research Datalink (CPRD) Aurum in England and the Western Swedish Health Care Register (VEGA) in Sweden. Both databases are representative of the general population because they are linked to both hospital admission and mortality data, Cipolletta explained. Two study groups were created: those who had been 'exposed' or 'unexposed' to a treat-to-target strategy and had achieved a serum urate level of < 360 μmol/L within 12 months of their first ULT prescription. Those in the unexposed group had to have serum urate levels of 360 μmol/L or serum urate levels that had not been measured. A total of 116,518 patients were included in the analysis; 109,504 from CPRD and 7014 from VEGA. Cipolletta acknowledged that there were some key differences in baseline characteristics before cloning, censoring, and weighting had been performed to make the populations 'more homogenous,' but that afterward, the populations were well balanced. For instance, before the statistical methods were applied, 27.3% of patients from CPRD and 22.1% from VEGA achieved the target serum urate level. The mean age in each group was 62.9 years and 70.0 years, respectively, and 77.8% and 71.7% were men. The mean duration of gout before diagnosis was 2.5 years and 1.1 years, respectively. Before adjustments, 'the use of gout flare prophylaxis was much more diffuse' in the CPRD dataset than in VEGA, Cipolletta said. Conversely, there were more individuals in the VEGA dataset than in CPRD with a history of MACE (12.7% vs 2.5%). Key Findings Over a mean follow-up of 2.5-3.5 years, depending on which dataset was used, there was a 1.3%-1.4% difference between the groups in the weighted 5-year MACE-free survival, favoring the treat-to-target approach. Specifically, the 5-year weighted survival rates in those exposed and not exposed to a treat-to-target approach were 89.43% and 88.03%, respectively, in the CPRD dataset and 76.82% and 75.50%, respectively, in the VEGA dataset. The findings were consistent regardless of whether there was a history of prior CV events or whether the individual MACE components were considered, Cipolletta said. 'We observed comparable results for key secondary outcomes in sensitivity analysis, and we observed significantly lower incidence rates of flare in the treat-to-target ULT arm,' he added. Data Queried Ronan Mullan, consultant rheumatologist at Tallaght University Hospital and clinical associate professor at Trinity College Dublin, Dublin, Ireland, questioned the clarity of the baseline urate level comparisons. He told Medscape Medical News that data had been provided on two separate groups, but baseline data on those who had and had not achieved target urate levels had not been presented. 'There could have been all sorts of confounders,' Mullan said. 'I thought that was a bit odd. People with very high urate levels at baseline are also more likely to have cardiovascular comorbidities. I don't think it was transparent.' Cipolletta had also been asked by another delegate about the types of ULT that had been used to help people reach the target level because febuxostat had been linked to a risk for CV events vs allopurinol. He responded that 'more than 99% of first ULT prescriptions are allopurinol' in the UK and Sweden. 'We included the ULT starting dose and the molecule in the analysis as covariates, but we didn't stratify for them because there was no power to detect any reliably significant difference.' The work was funded by a research grant from the FOREUM Foundation for Research in Rheumatology. Cipolletta disclosed receiving speaking fees from Novartis and Institut Biochimique SA, and consulting fees from Horizon Therapeutics. Mullan reported no conflicts of interest.
Yahoo
6 days ago
- Health
- Yahoo
Cannabis Linked to 2x Risk of Heart Disease Death, Scientists Discover
New research suggests that cannabis use is linked to twice the risk of death from cardiovascular disease, and is also associated with increased risk of other major adverse cardiovascular events (MACE). Cannabis is being legalized in more and more places worldwide, increasing medicinal and recreational use – but it may warrant closer monitoring by health professionals. The researchers here, led by a team from the University of Toulouse in France, wanted to look more closely at potential health risks that had previously been flagged. They looked at 24 previous studies published between 2016 and 2023, involving around 200 million people. Overall, the increased risk linked to cannabis use was 29 percent for acute coronary syndrome (reduced blood flow to the heart), 20 percent for strokes, and 100 percent for cardiovascular disease mortality. "The findings reveal positive associations between cannabis use and MACE," write the researchers in their published paper. "These findings should encourage investigating cannabis use in all patients presenting with serious cardiovascular disorders." There are some limitations worth bearing in mind here. The studies included in the research differed in terms of how they defined cannabis use, relied on self-reporting, and didn't measure use of the drug over time. That makes them less statistically robust. The research also notes a high risk of bias in the majority of studies investigated, due to the way they were structured. And it's important to say the research doesn't show direct cause and effect, only an association. It's possible that other factors not considered here are driving both cannabis use and heart health issues in certain groups of people. Nevertheless, the large number of people surveyed on their real-world use of cannabis counts in the study's favor. It also has more recent data than many other studies, and we know that cannabis use and composition is changing over time. That's enough to warrant deeper investigation into the possible health risks. "Legalizing the drug and expanding its medical use worldwide have likely contributed to profound changes in the general perception of cannabis and to the overall rise in cannabis consumption," write the researchers. "Consequently, users' profiles and consumption habits profoundly differ from those in the 2010s, especially as cannabis products show an increasing trend in potency, with rising concentrations of delta-9-tetrahydrocannabinol (THC)." Further research is absolutely needed here, not least to determine whether the chemicals and compounds in cannabis – of which there are hundreds – could be leading to these health risks, and how taking cannabis in different forms, such as inhalables or edibles, might have an influence. Previous studies have already shown how the drug can increase the risk of cancer, and significantly alter our DNA, for example. Cannabis could also trigger psychosis through the impact it has on the brain. The new study is accompanied by an editorial written by epidemiologists Stanton Glanz and Lynn Silver, from the University of California San Francisco. In it, Glanz and Silver argue that as cannabis use rises, more should be done to educate people about the risks – as has been done with cigarettes. "Specifically, cannabis should be treated like tobacco: not criminalized but discouraged, with protection of bystanders from secondhand exposure," they write. The research has been published in the journal Heart. 5 Daily Habits Could Be Causing Your Liver Serious Harm FDA-Approved Sleeping Pill Slows Alzheimer's Tangles in Pre-Clinical Trial Risk of Sleep Breathing Disorder Set to Rise 45% by End of Century
Fox News
19-06-2025
- Health
- Fox News
Cannabis use raises risk of heart attack and stroke more than cocaine, other drugs, major review suggests
The potential risk of cannabis use has been in the spotlight following recent research pointing toward negative health effects. This includes a new meta-analysis by French researchers, published in the journal Heart, which reviewed multiple studies to assess the link between cannabis and major adverse cardiovascular events (MACE). The researchers analyzed data from more than 400 million patients involved in 24 previous cross-sectional studies (capturing data at a single point in time) and cohort studies (following patients over time). One study focused on medical cannabis. The overall results noted a significant increase in risk of major cardiovascular events, including a 29% higher likelihood of heart attack, 20% higher risk of stroke and twice the chances of cardiovascular death. The danger was also elevated in people who used cannabis at least once a week. Several studies found higher odds of acute myocardial infarction, commonly known as a heart attack. One study pinpointed the risk among younger populations aged 15 to 22, while another observed it in patients who used cannabis more than once a week. One study from the primary French administrative database for hospitals found that, compared to other illicit drugs like cocaine and opioids, cannabis was a larger predictor of heart attack. Another study analyzed the association between cannabis and acute coronary syndrome (reduced blood flow to the heart) in nearly 15,000 patients ranging from 18 to 54 years old. The analysis found no significant association in the overall sample, but signaled a higher risk in a subgroup of patients aged 18 to 36. Cannabis use significantly increased all-cause mortality and cardiovascular mortality in a cohort of patients who experienced a heart attack before age 50. A UK Biobank analysis pointed out that women have a "significantly higher" risk of cardiovascular mortality than men. The larger review concluded that these findings reveal "positive associations" between cannabis use and MACE, and should "encourage investigating cannabis use in all patients presenting with serious cardiovascular disorders." Although medical marijuana can provide relief for people with conditions like arthritis, multiple sclerosis, cancer and other illnesses, overuse has been linked to potential health risks, especially for seniors. The authors of the French review acknowledged that there were some limitations to the findings – primarily that there is a lower prevalence of cocaine and opioids compared to cannabis use. "Cannabis exposure was poorly reported in the included studies, which prevented our meta-analysis from assessing it," they wrote. There was also a potential for some degree of bias in some of the studies due to lack of information or missing data. "Studies that relied on patient surveys faced substantial bias regarding exposure and outcome misclassification when patients assessed these data themselves," the researchers noted. Other potential limitations included overlapping data and limited timeframes. During an appearance on "America's Newsroom" in early June, Fox News senior medical analyst Dr. Marc Siegel commented on a recent study that found more seniors are using cannabis than ever before, despite the potential health risks. Siegel noted that regular use of cannabis can be dangerous if not tracked. "We definitely jumped the gun by not anticipating all the medical risks here." "You might use a gummy to go to bed, and then the next thing, you're using two gummies, or three gummies, and it could increase anxiety, it can increase discombobulation, you're not thinking clearly, ER visits are on the increase," he cautioned. "We know about problems with the lungs," Siegel added. "It can accelerate dementia and can affect behavior." The doctor likened the use of marijuana to the effects of smoking cigarettes in terms of damage to the heart and lungs. "It is absolutely an active chemical we need to watch out for, and I'm very disturbed that the elderly are using it," he said. "We've completely jumped the gun [on legalization] because people are going to the ER with psychosis. They're going there with vomiting disorders. They're having car accidents as a result," he went on. For more Health articles, visit "We are studying Colorado ever since it was legalized there, and the results are not pretty. We definitely jumped the gun by not anticipating all the medical risks here." Fox News Digital reached out to the study authors for comment.
Hindustan Times
18-06-2025
- Politics
- Hindustan Times
Sitharaman visits project site for infra-red observatory in Ladakh
Union finance minister Nirmala Sitharaman, on Tuesday, visited the project site for national large solar telescope (NLST) near strategic Pangong Lake in Meral area of Ladakh. The finance minister also took to X and related the information. 'Smt @nsitharaman visits the project site for National Large Solar Telescope (NLST), located near the Pangong lake in Merak, Ladakh at an altitude of around 4200m', she wrote on X. NLST is a proposed ground based 2-m class optical and near infra-red (IR) observational facility and the site provides significant periods of coronagraphic skies (high transparency), it read further Dr Annapurni Subramaniam, Director of Indian Institute of Astrophysics (IIA) was also present. On Sunday, Sitharaman had laid the foundation stone for a mini planetarium and Astro Globe at the Hanle Dark Sky Reserve in the Changthang region of the strategic region. The initiative, sanctioned under the special development package comes at an estimated cost of ₹276.65 lakh and aims to promote scientific education, astro-tourism, stargazing, night sky programs, and generate local employment, said an official spokesperson. At the Bhabha Atomic Research Centre's Major Atmospheric Cherenkov Experiment (MACE) Telescope facility in Hanle, Prof Annapurni Subramaniam, Director of the Indian Institute of Astrophysics (IIA), and Dr K.K. Yadav from the Astrophysical Sciences Division, BARC presented the telescope's current achievements and future plans. Applauding the efforts of IIA and the local community, Sitharaman remarked, 'This project symbolizes a collaborative spirit between the scientific and public community, a true matter of national pride.' She urged the development of programs tailored for the common public to spark interest in astrophysics through hands-on learning and proactively putting out content generated through these scientific centres. During her visit to Hanle, Sitharaman engaged with delegations of anganwadi workers, contractor associations, and BJP members from Nyoma, attentively listening to their concerns. At Rongo, she visited an animal husbandry site where she met with mostly female pashmina goat and yak herders. She distributed goat-shearing machines to support their livelihood. As part of the Dharti Aaba Janbhagidari Abhiyan, Sitharaman interacted with campaign beneficiaries. She also presented a ₹50 lakh cheque to Nyoma nomads under SBI's Corporate Social Responsibility initiative. The departments of sheep and animal husbandry hosted a live demonstration of the nomadic lifestyle. The department of social and tribal welfare showcased a mobile Anganwadi centre for nomadic children and displayed millet-based dishes prepared within the centre.
The Star
17-06-2025
- Sport
- The Star
Educating athletes in an a-MACE-ing way to solve disputes
PETALING JAYA: Wiser athletes will handle disputes in a better way. And that is why the Sports Dispute Committee are looking into educating athletes to know what they need do if they have issues under Malaysian Athlete Career And Education (MACE). Billed as RM9.73 for the 1st month then RM13.90 thereafters. RM12.33/month RM8.63/month Billed as RM103.60 for the 1st year then RM148 thereafters. Free Trial For new subscribers only
