New Consumer Research Explores How the Zika Virus, Marijuana, Erectile Dysfunction Drugs and Ceramide Levels Impact CV Events

New consumer research exploring Zika-related cardiovascular complications, marijuana’s influence on stroke and heart failure (HF), erectile dysfunction drugs’ impact on myocardial infarction (MI) survivors, and the predictive qualities of ceramides in the blood were presented as abstracts throughout ACC.17.

Zika-Related Cardiovascular Complications

Results from a study led by Karina Auristela Gonzalez Carta, MD, suggest that the Zika virus may be linked to potentially harmful effects on the heart. Carta and colleagues enrolled nine patients who reported symptoms and were treated at the Institute of Tropical Medicine in Caracas, Venezuela. Their mean age was 47 years and six were women. Only one patient reported previously well-controlled high blood pressure.

From July 2016, follow-up was conducted every six months. Eight of the nine patients with an active Zika infection had arrhythmias and six had HF (one with preserved ejection fraction). Since contracting the infection, the patients have yet to report resolved issues.

The study highlights the need to raise awareness about Zika’s possible link to cardiovascular complications, especially because the data show an initial average lag time of 10 days. “It’s likely that many more people are affected,” Carta said. “We need larger, systematic studies to understand the actual risk of Zika-related cardiac problems and what makes one patient more prone to develop them.”

Marijuana Use and Stroke, HF

Medical and recreational marijuana use may be legal in more than half of U.S. states, but results from a recent study investigating cardiovascular outcomes found that it raises the risk of stroke and HF, even after accounting for demographic and additional lifestyle risk factors.

Study investigators found that use was not only associated with a 26 percent increase in the risk of stroke and 10 percent increase in developing HF, it also was linked to obesity, high blood pressure, and smoking and alcohol use. Of the 20 million health records of young and middle-aged patients analyzed, marijuana use was diagnosed in 1.5 percent.

“More research will be needed to understand the pathophysiology behind this effect,” said Aditi Kalla, MD, the study’s lead author.

Erectile Dysfunction Drugs After MI

Men 80 years and younger prescribed erectile dysfunction drugs following a myocardial infarction were 33 percent less likely to die and 40 percent less likely to be hospitalized for HF than men who were not.

Study investigators analyzed the records of 43,000 patients from 2007 to 2013 using a Swedish national database. Of the 7 percent of men prescribed an erectile dysfunction drug, 92 filled prescriptions for phosphodiesterase-5 (PDE-5) inhibitors, while 8 percent filled prescriptions for alprostadil.

The results came as a surprise for the study’s lead author, Daniel Peter Andersson, MD, PhD, becasue of their previous associations with increased risk of cardiovascular disease in otherwise healthy men. “From the perspective of a doctor, if a patient asks about erectile dysfunction drugs after a [MI] and has no contraindications for PDE-5 inhibitors, based on these results you can feel safe about prescribing it,” Andersson concluded.

Ceramide Level in Blood

While low levels of low-density lipoproteins have played an important part in predicting cardiovascular events, a new study, led by Jeffrey W. Meeusen, PhD, found measuring ceramides in the blood to be a better marker. Of the 499 patients studied, 46 percent were found to have evidence of a blockage, despite similarities in age, blood pressure, smoking status and high-density lipoproteins.

Study investigators found that those with the highest levels of ceramides were four times more likely to experience a cardiovascular event than those with the lowest levels (7.2 vs. 2.2 percent). With each one-point increase in a patient’s ceramide risk score, risk rose by 9 percent. Additionally, men were less likely to have high levels of ceramides.

A new test, released in August 2016, will help cardiologists at Mayo Clinic further stratify patients who remain at high risk but might not receive treatment. “Knowing their ceramide score can improve therapeutic compliance and patient motivation, particularly since the numbers improve within a few weeks,” Meeusen added.

Clinical Topics: Arrhythmias and Clinical EP, Dyslipidemia, Heart Failure and Cardiomyopathies, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Lipid Metabolism, Statins, Acute Heart Failure, Hypertension, Smoking

Keywords: Alcohols, Alprostadil, Arrhythmias, Cardiac, Blood Pressure, Cannabis, Ceramides, Cyclic Nucleotide Phosphodiesterases, Type 5, Demography, Erectile Dysfunction, Follow-Up Studies, Heart Failure, Hypertension, Life Style, Lipoproteins, HDL, Lipoproteins, LDL, Marijuana Smoking, Middle Aged, Motivation, Myocardial Infarction, Obesity, Phosphodiesterase 5 Inhibitors, Risk Factors, Smoking, Stroke, Survivors, Sweden, Tropical Medicine, Venezuela, Washington, ACC Annual Scientific Session, ACC17, ACC Scientific Session Newspaper

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