Scientists identify a rise in life-threatening heart infection

Scientists at the University of Sheffield have identified a significant rise in the number of people diagnosed with a serious heart infection alongside a large fall in the prescribing of antibiotic prophylaxis to dental patients.

The pioneering study is the largest and most comprehensive to be conducted with regards to the National Institute for Health and Care Excellence (NICE) guidelines, which recommended dentists should no longer give antibiotics before invasive treatments to people considered at risk of the life threatening heart infection, Infective Endocarditis (IE), which in 40 per cent of cases is caused by bacteria from the mouth.

The team of international researchers, led by Professor Martin Thornhill at the University of Sheffield’s School of Clinical Dentistry, discovered that since the NICE guidelines were introduced in March 2008, there has been an increase in cases of Infective Endocarditis above the expected trend. By March 2013 this accounted for an extra 35 cases per month.

They also identified that the prescribing of antibiotic prophylaxis fell by 89 per cent from 10,900 prescriptions a month, before the 2008 guidelines, to 1,235 a month by March 2008.

Martin Thornhill, Professor of Translational Research in Dentistry at the University of Sheffield, said: “Infective Endocarditis is a rare but serious infection of the heart lining. We hope that our data will provide the information that guideline committees need to re-evaluate the benefits, or not, of giving antibiotic prophylaxis.

Professor Thornhill stressed that healthcare professionals and patients should wait for the guideline committees to evaluate the evidence and give their advice before changing their current practice.

He added: “In the meantime, healthcare professionals and patients should focus on maintaining high standards of oral hygiene. This will reduce the number of bacteria in the mouth which have the potential to cause Infective Endocarditis and reduce the need for invasive dental procedures to be performed.”

The data analysed by an international collaboration of experts from the University of Sheffield, Oxford University Hospitals NHS Trust, Taunton and Somerset NHS Trust, and the University of Surrey in the UK, as well as from the Mayo Clinic and the Carolinas HealthCare System’s Carolinas Medical Center in the USA, is published in The Lancet and will be presented to more than 19,000 delegates from across the world at the American Heart Association annual meeting in Chicago.

The research was funded by a grant from national heart charity Heart Research UK, healthcare provider Simplyhealth and the National Institute for Dental and Craniofacial Research (NIDCR).

Barbara Harpham, National Director of Heart Research UK, said: “The findings play an important part in the ongoing exploration of the link between dental and heart health.

“Projects such as this one are vital to the ongoing collation of evidence to support our understanding of how oral health can impact upon the heart and other conditions within the body. We are committed to furthering medical research in the UK and welcome these new findings.”

http://www.medicalnewstoday.com/releases/285754.php

 

 

Heightened risk of anxiety, depression among women after heart attack

A new study by researchers from Lithuania claims women are more likely to experience anxiety and depression following a heart attack than men. Furthermore, patients with depression may be at much higher risk of death in the 6 months after a heart attack than those without depression.

 

Study author Prof. Pranas Serpytis and colleagues presented their findings at the annual meeting of the Acute Cardiovascular Care Association – a part of the European Society of Cardiology – in Geneva, Switzerland.

To reach their findings, the team analyzed 160 patients who were admitted to the Vilnius University Hospital Santariskiu Clinics in Vilnius, Lithuania, with a heart attack.

The researchers interviewed patients around 1 month after their heart attack to gather demographic information, such as age, sex education and marital status, and to determine whether they had a history of mental illness.

The team also collected clinical information from the patients – such as whether they had experienced a heart attack before and whether they had a history of high blood pressure or diabetes – and determined if they had any other risk factors for cardiovascular disease, including smoking and lack of physical activity.

The Hospital Anxiety and Depression Scale (HADS) was used to assess patients. Those who had a score of 0-7 had nodepression or anxiety, a score of 8-10 indicated possible depression and anxiety, while a score of 11 or more suggested mild to moderate levels of depression and anxiety.

The risks of anxiety, depression and death after heart attack

Almost 25% of patients were depressed, the researchers say, and 28.2% of these had used antidepressants.

The team found, however, that women were more likely to be depressed and anxious than men after a heart attack. Men had an average depression score of 6.87, while women’s average score was 8.66. For anxiety, men had an average HADS score of 7.18 and women had an average score of 8.20.

The researchers say that further studies are needed to determine why women appear to be at higher risk of anxiety and depression following a heart attack than men.

Commenting on this finding, Prof. Serpytis says:

“Women are misrepresented in many clinical studies on myocardial infarction (heart attack) even though they often have worse outcomes. Our study shows that women are more likely to develop anxiety and depression after myocardial infarction than men but until now this issue has been largely unnoticed.

Clinicians should assess myocardial infarction patients, particularly women, for anxiety and depression so that timely treatment can be started.”

Earlier this year, Medical News Today reported on a study suggesting the reverse effect – that depressed women are at higher risk of heart attack.

The researchers of this latest study also found that patients with depression following a heart attack were almost six times more likely to die in the 6 months after a heart attack, compared with patients who were not depressed.

“Major depression follows myocardial infarction in approximately 18% of cases and is an important predictor of disability and poor quality of life in the year post-myocardial infarction,” notes Prof. Serpytis.

“The increased risk of death in patients with depression persists up to 18 months after the myocardial infarction. But despite the fact that post-myocardial infarction depression is common and burdensome, the condition remains under-recognised and undertreated.”

Smoking increases anxiety risk, while lack of physical activity linked to depression

Furthermore, the team found an increased risk of anxiety among patients who smoked; the average HADS score for anxiety among smoking patients was 10.16, compared with an average score of 7.3 for patients who had never smoked and 4.55 for patients who stopped smoking more than 2 years before.

No link was found between smoking and depression after a heart attack, the researchers say.

However, a small link was found between lack of physical activity and depression. The 64% of patients who were physically inactive had an average HADS depression score of 8.96.

Commenting on the team’s overall findings, Prof. Serpytis says:

“Our study suggests that encouraging patients to quit smoking and increase their physical activity levels should reduce their risks of anxiety and depression after myocardial infarction. More research is needed on the links between myocardial infarction and mental health problems.”

MNT recently reported on a study by researchers from Duke University Medical Center in Durham, NC, claiming theeffects of mental stress on the heart differ between men and women.

Written by Honor Whiteman

http://www.medicalnewstoday.com/articles/284082.php

 

 

 

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