Researchers have identified two biomarkers that could help in the diagnosis of a heart condition that raises the risk of stroke.
Atrial fibrillation (AF) is the most common heart rhythm disturbance, affecting around 1.6m people in the UK.
But it is often only detected after someone has had a stroke.
The British Heart Foundation said the study could pave the way towards better detection of people with AF and targeted treatment.
At the moment, an electrocardiogram (ECG) which measures the electrical activity of your heart, is usually used to screen patients for atrial fibrillation.
This study, by researchers at the University of Birmingham, found that three clinical risk factors and two biomarkers had a strong connection with AF.
Those most at risk of the condition were older, male and had a high BMI.
The researchers looked at 638 hospital patients who were recruited between 2014 and 2016 for acute illnesses.
They took blood samples and looked for 40 cardiovascular biomarkers and considered seven clinical risk factors – age, sex, hypertension, heart failure, history of stroke or transient ischaemic attack, kidney function and body mass index (BMI).
They were also all given an echocardiogram.
Two biomarkers stood out as a link to atrial fibrillation, the researchers found.
One is a hormone secreted by the heart called brain natriuretic peptide (BNP) and the other is a protein responsible for phosphate regulation called fibroblast growth factor-23 (FGF-23).
The researchers say these people could be screened for the condition by testing their blood to see if they have elevated levels of the two biomarkers.
Lead author Yanish Purmah said: "The biomarkers we have identified have the potential to be used in a blood test in community settings such as in GP practices to simplify patient selection for ECG screening."
Joint first author Dr Winnie Chua said: "People with atrial fibrillation are much more likely to develop blood clots and suffer from strokes. To avoid strokes it is important for them to take anticoagulant drugs to prevent blood clotting. However, atrial fibrillation is often only diagnosed after a patient has suffered a stroke.
"Therefore it is important that patients at risk are screened so that they can begin taking anticoagulants to prevent potentially life-threatening complications."
Atrial fibrillation symptoms
- Noticeable heart palpitations, when the heart feels like it is pounding, fluttering or beating irregularly
- Your heart may also beat very fast (often considerably higher than 100 beats per minute)
- You can work out your heart rate by checking the pulse in your neck or wrist.
- Other symptoms may include tiredness and being less able to exercise, breathlessness, feeling faint or lightheaded and chest pain
- The way the heart beats in atrial fibrillation reduces the heart's performance and efficiency
- This can lead to low blood pressure (hypotension) and heart failure
- You should see your GP immediately if you notice a sudden change in your heartbeat and experience chest pain
- Sometimes atrial fibrillation does not cause any symptoms and a person who has it is completely unaware that their heart rate is irregular.
Source: NHS England
Professor Metin Avkiran, associate medical director at the British Heart Foundation, welcomed the study.
"Atrial fibrillation increases the risk of stroke, a serious condition that causes over 36,000 deaths in the UK each year, but is often detected too late. This research has used sophisticated statistical and machine learning methods to analyse patient data and provides encouraging evidence that a combination of easy-to-measure indices may be used to predict atrial fibrillation.
"The study may pave the way towards better detection of people with AF and their targeted treatment with blood-thinning medicines for the prevention of stroke and its devastating consequences."
The research was carried out by scientists from the Institute of Cardiovascular Sciences and the Institute of Cancer and Genomic Sciences at the University of Birmingham's College of Medical and Dental Sciences and is published in the European Heart Journal.
NHS ‘should not prescribe acne drug’
The parents of young people who have killed themselves and patients unable to have sex are calling f..
The parents of young people who have killed themselves and patients unable to have sex are calling for the NHS to stop prescribing acne drug Roaccutane.
Ed Henthorn said it had caused him erectile dysfunction, psychosis and suicidal thoughts.
And one man who believes his son killed himself after taking the drug said the risks "are just too high".
Manufacturer Roche said "millions of patients worldwide have benefited from taking the drug".
The majority of those who take the drug have a positive experience.
"I used to think about girls… but my feelings, thoughts, just faded away," Ed Henthorn told the BBC's Victoria Derbyshire programme.
He was 19 when he took Roaccutane. He describes his acne as mild but bad enough to want to treat.
After three weeks he started to experience side-effects, including reduced energy and sex drive.
Then he experienced erectile dysfunction.
"That was why I decided to stop taking it," he said. (more…)
Spina bifida: Keyhole surgery repairs baby spine in womb
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In a UK first, doctors have used keyhole surgery to su..
In a UK first, doctors have used keyhole surgery to successfully repair the spine of a baby with spina bifida while it was still inside the womb.
Surgeons at King's College Hospital say the procedure is not a cure, but could be the difference between some children learning to walk or not.
Sherrie Sharp and her son Jaxson had the operation 27 weeks into the pregnancy.
Spina bifida was diagnosed after the routine 20-week pregnancy scans.
They showed Jaxson's spine and spinal cord were not forming correctly.
Gaps in the developing spine meant the cord was bulging out of his back and was left exposed to the amniotic fluid in the womb.
This damages the crucial nerves in the spinal cord and could lead to paralysis, a loss of sensation in the legs and problems controlling the bladder and bowels.
The longer the spinal cord is left exposed, the greater the damage.
Sherrie, 29, and from West Sussex, said the news was a shock, but an abortion was a "definite no". (more…)
Less chemotherapy better for older or frail patients with advanced stomach and oesophageal cancers
Less chemotherapy is as effective at controlling disease for elderly or frail patients with advanced..
Less chemotherapy is as effective at controlling disease for elderly or frail patients with advanced cancer of the stomach or oesophagus (food pipe), and leads to fewer side effects such as diarrhoea and lethargy. These are the results of a Cancer Research UK funded study, presented prior to the ASCO conference today (Wednesday).
“Increasingly were realising its not just age that affects how well someone can tolerate their treatment and we need to do more work to understand how other conditions or aspects of frailty might play a role.” – Dr Peter Hall, Cancer Research UK Edinburgh Centre[contfnewc]
Results from the GO2 trial could change the standard of care for patients who cant have full dose chemotherapy due to their age, frailty or medical fitness.
The study, which ran at hospitals all over the UK, coordinated from the University of Leeds, involved 514 people with stomach or oesophageal cancer. Their average age was 76 and the oldest was 96 years old. All were either frail, elderly or medically unfit, and for those reasons would be unlikely to tolerate full-strength treatment, which involves three chemotherapy drugs.
Patients went through a careful medical assessment, then went onto chemotherapy with just two drugs* and were allocated at random to receive them at either full-strength, medium-dose or low-dose. They were then carefully monitored to see how well the cancer was controlled, whether they had symptoms and side-effects, whether they felt their treatment was worthwhile, and what overall effect it had on their quality of life.
The researchers reported that the medium and lower doses of chemotherapy were as effective as the full-strength dose for controlling the cancer. But when the researchers looked at the overall effect of treatment, including quality of life, they reported that it was the lowest dose treatment that came out best.**
Around 15,800 people in the UK are diagnosed with stomach and oesophageal cancers every year***. Almost half (45%) of these people are 75 and over****. By 2035, this proportion is projected to rise to 55%*****, because of the UKs ageing population. This study, is one of few phase III trials in the country that seek to address how to best care for and treat this increasing population of elderly or frail cancer patients.
These findings also open up the possibility of more older and frail patients being able to take part in clinical trials.
Professor Charles Swanton, Cancer Research UKs chief clinician, said: “These valuable results reduce fears that giving a lower dose chemotherapy regimen is inferior and could make a huge difference for patients with stomach or oesophageal cancer who cant tolerate intensive courses of treatment.
“Older or frail patients are often not considered for new drug trials or standard of care therapy as theyre less able to tolerate combination chemotherapy. These trials are critical to provide much needed evidence on the effectiveness of new therapies and combination approaches, helping us develop new treatments for this growing group of patients.”
The researchers also assessed whether there were differences for the patients in the study who were under 75, or less frail, who might be expected to benefit from stronger treatment; but will be reporting that the lowest dose treatment gave the best results for them as well. (more…)
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