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  1. Iqbal Malik, Editor

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Ischaemic heart disease

Angiographically complex plaques have more inflammation ▸

Previous work has shown that complex plaques are found in acute coronary syndromes (ACS) more often than in stable angina, and that inflammation plays a role in ACS. This study links the two findings. A total of 79 patients with unstable (n = 46) or stable angina (n = 33) underwent directional coronary atherectomy for culprit lesions. The mean (SD) percentage of macrophages in atherectomy specimens from patients with unstable angina was greater than in specimens from patients with stable angina (21 (14)% v 13 (10)%, p = 0.01); similar results were seen when complex coronary lesions were compared with simple lesions (23 (13)% v 9 (8)%, p < 0.001).

Exercise for pleasure is better than exercise at work ▸

Does having a strenuous job provide any protection from cardiovascular risk? Leisure activity showed a clear inverse association with risk of coronary heart disease (CHD). A case–control study of 312 patients with known coronary artery disease (CAD) and 479 controls was performed. Compared with subjects who reported no summer leisure activities, the odds ratio for CHD was 0.85 (95% confidence interval (CI) 0.47 to 1.53) in the category < 1 hour/week; 0.60 (95% CI 0.38 to 0.95) in the category 1–2 hours/week; and 0.39 (95% CI 0.26 to 0.59) in the category > 2 hours/week, after full adjustment for covariates. Similar results were obtained for winter activities. By contrast, there was a strong positive association between work related activity and risk of CHD. Furthermore, levels of inflammatory markers such as C reactive protein, serum amyloid A, interleukin 6, and intercellular adhesion molecule 1 were inversely and independently associated with leisure time activities, but not with work.

Women are most at risk of ACS during and after menses ▸

ACS in pre-menopausal women is …

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