Heart Attack Archive

In the journals

If you have suffered a heart attack and plan to undergo prostate cancer treatment, you may want to weigh the risks and benefits of androgen deprivation therapy (ADT). ADT decreases the amount of androgens in the body, which prostate cancer needs to grow and survive. It is also often used along with radiation therapy, and the combination has been shown to prolong survival in men with unfavorable-risk prostate cancer—defined as cancer with two or more high-risk factors, like a PSA level between 10 and 40 ng/mL, a Gleason score of 7 or higher, or biopsies with 50% or higher cancerous cells.

But a study in The Journal of the American Medical Association suggests that men who had a prior heart attack can increase their risk of a fatal one if they undergo both radiation therapy and ADT. Researchers compared overall survival and death from prostate cancer, fatal heart attack, and other causes in a group of 206 men with unfavorable-risk prostate cancer. The men received either radiation alone, or radiation and six months of ADT. The researchers also categorized the men into subgroups based on other health conditions, including heart disease.

Ask the doctor

Q I have a relative who had a total cholesterol value of 155, yet he still had a heart attack with 90% blockage in one artery. How could that happen?

A I understand your confusion, considering how doctors have long focused on the importance of having an optimal total cholesterol level (less than 200 milligrams per deciliter or mg/dL) as a way to lower the chance of having a heart attack. It's actually the harmful LDL cholesterol value that's most important in terms of this risk. However, a person with a total cholesterol level of 155 mg/dL probably has an LDL level under 100 mg/dL, which is currently considered a reasonable target for avoiding heart disease.

To use the online heart age calculator, the only numbers you need are your height, weight, and blood pressure reading.

Most Americans are not as young at heart as they might like to believe. More than three in four adults have a "heart age" that's greater than their chronological age, according to federal health officials.

Image: Thinkstock

Research we're watching

Women who have heart attacks before age 60 may be less likely to receive a lifesaving procedure to restore blood flow to the heart (an angioplasty plus a stent) than men in that age group, according to a study in the Oct. 26, 2015, Journal of the American College of Cardiology. (Stents are tiny mesh tubes that help keep arteries open.)

Data for the study came from a nationwide sample of more than 630,000 people ages 18 to 59 who had heart attacks. Younger women also were more likely to die in the hospital compared with younger men (4.5% versus 3%, respectively). However, men may be more likely to die before reaching the hospital than women, which may partly explain that difference, the researchers say.

Image: Thinkstock

Squeezing chest pain isn't always from a blocked artery.

Classic heart attack symptoms—severe pressure, heaviness, or pain in the chest—most often arise from a blockage in a coronary artery that prevents blood from reaching the heart muscle. But a lesser-known condition, called takotsubo cardiomyopathy, can produce the same sudden heart symptoms even when the coronary arteries are clear.

Research we're watchting

Many people with heart disease worry if sexual activity is safe for their hearts. But sex is rarely the cause of a heart attack, and sex after a heart attack is safe for most people, according to a research letter in the September Journal of the American College of Cardiology.

Researchers asked 536 people ages 30 to 70 who were undergoing cardiac rehabilitation after a heart attack to fill out questionnaires about their sexual activity in the 12 months before their heart attack. Over the 10-year follow-up, there were 100 adverse heart-related events among the participants, including heart attacks, strokes, and deaths from cardio-vascular disease.

Ask the doctor

Q. I've read news reports that the heartburn drug I take may cause heart attacks. Should I worry about this?

A. Several studies have reported an association between proton-pump inhibitors (PPIs) and heart attacks. PPIs are medications for heartburn, such as omeprazole (Prilosec) and pantoprazole (Protonix). Overall, however, the evidence suggests these medications are not risky for your heart.

Image: Bigstock

In the journals

The influential U.S. Preventive Services Task Force (USPSTF) has endorsed low-dose daily aspirin to prevent cardiovascular disease in people ages 50 to 59 who have a 10% or greater chance of heart attack or stroke in the next 10 years. Unless a person already has cardiovascular disease, the actual number of heart attacks and strokes prevented with daily aspirin is relatively small. This draft recommendation did not recommend aspirin for those younger than 50 or 60 or older, citing insufficient evidence to make a recommendation.

The USPSTF statement is at odds with a statement in 2014 by the FDA that evidence does not support general use of aspirin to prevent a first heart attack or stroke in otherwise healthy adults. However, daily aspirin is often recommended for those with a history of cardiovascular disease, since the potential benefit (preventing heart attacks and strokes) outweighs the risk of bleeding that comes with regular aspirin use.

Participation in a cardiac rehabilitation program following a heart attack helps people live longer and better.

In emergency departments, doctors routinely test blood levels of a protein called troponin to diagnose people with suspected heart attacks. That's because damaged heart muscle releases troponin into the bloodstream. Now, new research suggests that a high-sensitivity troponin test may help identify people with heart disease who face a high risk of fatal heart events.

For the study, published in the August 13 issue of The New England Journal of Medicine, researchers measured troponin levels with the high-sensitivity test in nearly 2,300 people with type 2 diabetes and stable heart disease (meaning they had narrowed heart arteries and chest pain but not a heart attack). Within five years, nearly one in three people with elevated troponin levels had a heart-related problem or died from one.