Category Archives: Coronary Heart Disease

CT Versus Invasive Angiography in Stable Chest Pain

Heart attacks and chest pains are linked to blocked arteries in the heart

We’re all gonna die of something, right?

The #1 cause of death in the U.S. is coronary artery disease (CAD), which causes heart attacks and sudden cardiac death. Blockage in the heart arteries typically develops over years and many people are walking around not knowing it’s there. The lucky ones develop warning signs like chest pain or shortness of breath on exertion. After consulting a physician, the next step may be a “stress test” or some sort imaging of the arteries of the heart.

Angiography refers to imaging of arteries or veins. Angiography of the heart arteries is helpful in diagnosing blockage of arteries that may cause heart attacks or sudden cardiac death in the future.

CT stands for computerized tomography: x-rays obtain images that are then manipulated by computer technology to provide more information than plain x-ray technology alone. CT angiography of the heart arteries is done with iodinated contrast injected into the low-pressure venous system of circulation. In contrast, standard arterial angiography involves introduction of a needle (and catheter) into the high-pressure arterial system, usually the femoral artery in the groin or the smaller radial artery in the wrist. Standard arterial angiography is associated with a higher risk of complications such as leakage of blood from the artery. Another potential complication is embolization of arterial plaque or clots downstream from the arterial puncture. Because of the higher complication rate in the arterial system, standard angiography is considered “invasive.”

The study at hand asks which is a better way to image heart arteries in a patient with stable chest pain: CT versus standard arterial angiography. The article abstract doesn’t define “stable” chest pain. I assume the researchers did not include acute myocardial infarctions (heart attacks) and unstable angina.

European researchers concluded that:

Among patients referred for invasive coronary angiography (ICA) because of stable chest pain and intermediate pretest probability of coronary artery disease, the risk of major adverse cardiovascular events was similar in the CT group and the ICA group. The frequency of major procedure-related complications was lower with an initial CT strategy. 

I bet the non-invasive CT is also less expensive that standard arterial angiography.

Steve Parker, M.D.

Ultra-Processed Foods ——> Higher Coronary Artery Disease Risk

Heart attacks and chest pains are linked to blocked arteries in the heart (coronary artery disease)

What are ultra-processed foods? I’m not paying $35 for the scientific article to find out. If you can grab the definition from your copy, please share in the Comments section. The 2020 profit from my publishing company was only $937.08, so I’m watching my expenses.

Here’s the free abstract:

ABSTRACT

Background

Higher ultra-processed food intake has been linked with several cardiometabolic and cardiovascular diseases. However, prospective evidence from US populations remains scarce.

Objectives

To test the hypothesis that higher intake of ultra-processed foods is associated with higher risk of coronary artery disease.

Ultra-processed versus processed?

Methods

A total of 13,548 adults aged 45–65 y from the Atherosclerosis Risk in Communities study were included in the analytic sample. Dietary intake data were collected through a 66-item FFQ. Ultra-processed foods were defined using the NOVA classification, and the level of intake (servings/d) was calculated for each participant and divided into quartiles. We used Cox proportional hazards models and restricted cubic splines to assess the association between quartiles of ultra-processed food intake and incident coronary artery disease.

Results

There were 2006 incident coronary artery disease cases documented over a median follow-up of 27 y. Incidence rates were higher in the highest quartile of ultra-processed food intake (70.8 per 10,000 person-y; 95% CI: 65.1, 77.1) compared with the lowest quartile (59.3 per 10,000 person-y; 95% CI: 54.1, 65.0). Participants in the highest compared with lowest quartile of ultra-processed food intake had a 19% higher risk of coronary artery disease (HR: 1.19; 95% CI: 1.05, 1.35) after adjusting for sociodemographic factors and health behaviors. An approximately linear relation was observed between ultra-processed food intake and risk of coronary artery disease.Conclusions

Higher ultra-processed food intake was associated with a higher risk of coronary artery disease among middle-aged US adults. Further prospective studies are needed to confirm these findings and to investigate the mechanisms by which ultra-processed foods may affect health.

Article

I admit I must eat some ultra-processed foods, but try to limit them.

Heart disease is the #1 killer in the developed world, even more lethal the COVID19! If you’ve abandoned your New Years’ weight-loss diet, consider one low in ultra-processed foods, like the Mediterranean diet.

Greek salad with canned salmon. Salmon is rich in heart-healthy omega-3 fatty acids.

Steve Parker, M.D.

Yet Another Study Supports the Life-Preserving Effect of the Mediterranean Diet

Cardiovascular diseases include heart attacks and strokes. Those are major killers. So it’s good to know about dietary habits that counteract the threat.

Mozzarella cheese, roasted garlic cloves, olives, salami, spinach, tomato, and roasted peppers

Article

ABSTRACT

Background

Examining a variety of diet quality methodologies will inform best practice use of diet quality indices for assessing all-cause and CVD [cardiovascular disease] mortality.

Objective

To examine the association between three diet quality indices (Australian Dietary Guideline Index, DGI; Dietary Inflammatory Index, DII; Mediterranean-DASH Intervention for Neurodegenerative Delay, MIND) and risk of all-cause mortality, CVD mortality and non-fatal CVD events up to 19 years later.Design

Data on 10,009 adults (51.8 years; 52% female) from the Australian Diabetes, Obesity and Lifestyle study were used. A food frequency questionnaire was used to calculate DGI, DII and MIND at baseline. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95% CI of all-cause mortality, CVD mortality and non-fatal CVD events (stroke; myocardial infarction) according to 1 SD increase in diet quality, adjusted for age, sex, education, smoking, physical activity, energy intake, history of stroke or heart attack, and diabetes and hypertension status.Results

Deaths due to all-cause (n = 1,955) and CVD (n = 520), and non-fatal CVD events (n = 264) were identified during mean follow-ups of 17.7, 17.4 and 9.6 years, respectively. For all-cause mortality, HRs associated with higher DGI, DII and MIND were 0.94 (95% CI: 0.89, 0.99), 1.08 (95% CI: 1.02, 1.15) and 0.93 (95% CI: 0.89, 0.98), respectively. For CVD mortality, HRs associated with higher DGI, DII and MIND were 0.93 (95% CI: 0.85, 0.99), 1.10 (95% CI: 1.00, 1.24) and 0.90 (95% CI: 0.82, 0.98), respectively. There was limited evidence of associations between diet quality and non-fatal CVD events.Conclusions

Better quality diet predicted lower risk of all-cause and CVD mortality in Australian adults, while a more inflammatory diet predicted higher mortality risk. These findings highlight the applicability of following Australian dietary guidelines, a Mediterranean style diet and a low-inflammatory diet for the reduction of all-cause and CVD mortality risk.


Steve Parker, M.D.

COVID-19 Link Dump: Vax Making People Worse?, Omicron Surge at Cornell U in Vax’d Students, Hospitals Dropping Vax Requirement for Workers, More Vax—>More Cases, Kroger Penalizes UnVax’d Employees, Gates Foundation Suppresses Ivermectin Effectiveness?

face mask, elderly, worried
You should be worried

Dr. Fauci opens up the possibility that the COVID-19 vaccine could be making people more likely to be infected by the virus.

Fraudci:

“This would not be the first time, if it happened, that a vaccine that looked good in initial safety actually made people worse.”


Cornell University reports more than 900 Covid-19 cases this week. Many are Omicron variant cases in fully vaccinated students

From CNN:

Cornell University reported 903 cases of Covid-19 among students between December 7-13, and a “very high percentage” of them are Omicron variant cases in fully vaccinated individuals, according to university officials.

The school’s Covid-19 dashboard was updated late Tuesday afternoon, accounting for the jump in case numbers reported.”Virtually every case of the Omicron variant to date has been found in fully vaccinated students, a portion of whom had also received a booster shot,” said Vice President for University Relations Joel Malina in a statement.

As of result, the school has decided to shut down its Ithaca, New York, campus, where it has about 25,600 students. 

“While I want to provide reassurance that, to date, we have not seen severe illness in any of our infected students, we do have a role to play in reducing the spread of the disease in the broader community,” Pollack said.

Ninety-seven percent of people on campus are fully vaccinated, the university says on its website.

Those vaccines are really great, aren’t they?!


hospital emergency room
New York Governor Cuomo sent COVID-19 patients to nursing homes from the hospital, to help spread the infection, I guess.

Some hospitals drop COVID-19 vaccine mandate for employees

From MSN.com:

As U.S. hospitals continue to grapple with a surge of COVID-19 patients and ongoing staffing shortages, the vaccine mandate debate is heating up once again.

Now, some of the largest U.S. hospital systems have dropped their vaccine mandate for employees.

Tenet Healthcare and Cleveland Clinic are among the companies dropping the mandates, according to information reported by The Wall Street Journal.Caption: Some of the largest U.S. hospital systems have dropped their vaccine mandate for employees, reports Lexi Nahl. (WPEC)

This comes as several hospitals deal with ongoing labor shortages due to burnout and increasing labor costs.

Cleveland Clinic and AdventHealth have also abandoned their vax mandates.

Photo by Cedric Fauntleroy on Pexels.com

I hear that healthcare systems with a staffing crisis bring in “traveling nurses” to help fill the gap at a salary three times greater than the “healthcare heroes” that that have been there since the beginning. How would that make you feel if you were that loyal nurse who has been there for the long haul, but no change in salary and forced to take the vax?

Some hospitals will pay a “finder’s fee” of $2,000 or more if you refer a frontline healthcare worker that they hire.


The more we vaccinate, the higher the number of cases

From Steve Kirsch:
This comes as no surprise to those of us who have been paying attention.

Next time you talk to your county health official, ask them why. The officials will then explain that they just follow orders. They don’t make public policy.

They are simply never going to figure this stuff out that their interventions are making things worse. It’s too embarrassing to admit. So they don’t talk about it and hope you don’t notice.


Supermarket giant strips unvaccinated workers of their benefits

From WND.com:

Supermarket chain Kroger announced Tuesday it will eliminate paid emergency leave for unvaccinated employees who contract COVID-19 in addition to requiring some of them to pay a monthly $50 health insurance surcharge starting in 2022, according to a company memo.

The country’s largest supermarket chain, which employs roughly 465,000 workers….


Researcher Andrew Hill’s conflict: A $40 million Gates Foundation grant vs a half million human lives

From World Tribune:

In a stunning admission, virologist Dr. Andrew Hill acknowledged in a zoom call that publication of his study could lead to the deaths of at least a half million people.

In defending his reversal on the effectiveness of ivermectin as a treatment for COVID-19, he discussed his “difficult situation” and said, “I’ve got this role where I’m supposed to produce this paper and we’re in a very difficult, delicate balance.”

Andrew Hill, PhD, is a senior visiting Research Fellow in Pharmacology at Liverpool University. He is also an advisor for the Bill and Melinda Gates Foundation and the Clinton Foundation. As a researcher for the WHO evaluating ivermectin, Hill wielded enormous influence over international guidance for the drug’s use.

Hill had previously authored a analysis of ivermectin as a treatment for COVID-19 that found the drug overwhelmingly effective.

On Jan. 6 of 2021, Hill testified enthusiastically before the NIH COVID-19 Treatment Guidlelines (sic) Panel in support of ivermectin’s use. Within a month, however, Hill found himself in what he describes as a “tricky situation.” Under pressure from his funding sponsors, Hill then published an unfavorable study. Ironically, he used the same sources as in the original study. Only the conclusions had changed.


Steve Parker, M.D.

Mediterranean Diet Prevents Progression of Coronary Artery Disease

Heart attacks and chest pains are linked to blocked arteries in the heart

Most patients with a heart attack have underlying atherosclerosis (“hardening of the arteries”) in the heart, called coronary artery disease. Around the time of a heart attack (if not before), doctors and patients should focus on mitigating risk factors for future heart attacks and other cardiac events. This is called “secondary prevention.” Risk factor modification might include smoking cessation, regular exercise, stress reduction, and diet modification. For years, I’ve been recommending the Mediterranean diet. Many others recommend a low-fat diet instead. A recent study supports my diet recommendation.

One way to assess risk of progressive atherosclerosis is to measure the thickness of the the carotid artery wall by ultrasound. Increasing thickness of the artery wall is linked to higher risk of atherosclerotic complications like heart attack and stroke. To drill down deeper, it’s the thickness of the innermost two layers of the artery wall, called the intima-media, that matters. The study at hand showed a reduction in carotid artery intima-media thickness over five years on a Mediterranean diet compared to a low-fat diet. Here’s the abstract:

Background and Purpose:

Lifestyle and diet affect cardiovascular risk, although there is currently no consensus about the best dietary model for the secondary prevention of cardiovascular disease. The CORDIOPREV study (Coronary Diet Intervention With Olive Oil and Cardiovascular Prevention) is an ongoing prospective, randomized, single-blind, controlled trial in 1002 coronary heart disease patients, whose primary objective is to compare the effect of 2 healthy dietary patterns (low-fat rich in complex carbohydrates versus Mediterranean diet rich in extra virgin olive oil) on the incidence of cardiovascular events. Here, we report the results of one secondary outcome of the CORDIOPREV study. Thus, to evaluate the efficacy of these diets in reducing cardiovascular disease risk. Intima-media thickness of both common carotid arteries (IMT-CC) was ultrasonically assessed bilaterally. IMT-CC is a validated surrogate for the status and future cardiovascular disease risk.

Methods:

From the total participants, 939 completed IMT-CC evaluation at baseline and were randomized to follow a Mediterranean diet (35% fat, 22% monounsaturated fatty acids, <50% carbohydrates) or a low-fat diet (28% fat, 12% monounsaturated fatty acids, >55% carbohydrates) with IMT-CC measurements at 5 and 7 years. We also analyzed the carotid plaque number and height.

Results:

The Mediterranean diet decreased IMT-CC at 5 years (−0.027±0.008 mm; P<0.001), maintained at 7 years (−0.031±0.008 mm; P<0.001), compared to baseline. The low-fat diet did not modify IMT-CC. IMT-CC and carotid plaquemax height were higher decreased after the Mediterranean diet, compared to the low-fat diet, throughout follow-up. Baseline IMT-CC had the strongest association with the changes in IMT-CC after the dietary intervention.

Conclusions:

Long-term consumption of a Mediterranean diet rich in extravirgin olive oil, if compared to a low-fat diet, was associated with decreased atherosclerosis progression, as shown by reduced IMT-CC and carotid plaque height. These findings reinforce the clinical benefits of the Mediterranean diet in the context of secondary cardiovascular prevention.

Reference

Parker here again. Undoubtedly, it would be more helpful if the investigators reported the actual rates of heart attack, stroke, and death in the two diet groups over five years. I suspect that will be in a future report.

An article in Clinical Cardiology states the serious nature of coronary artery disease (CAD) in those with diabetes (DM): “CAD is the main cause of death in both type 1 and type 2 DM, and DM is associated with a 2 to 4-fold increased mortality risk from heart disease. Over 70% of people >65 years of age with DM will die from some form of heart disease or stroke. Furthermore, in patients with DM there is an increased mortality after MI [myocardial infarction], and worse overall long-term prognosis with CAD.”

Steve Parker, M.D.

“Doc, I Have a Positive COVID-19 Test But Feel Fine. Am I Infectious?”

artist's rendition of coronavirus
Artist’s rendition of Coronavirus SARS-CoV-2

One of the arguments for forcing everybody to take a COVID-19 vaccine is that you could have the virus infecting you, but not know it because you have no symptoms. I.e., you’re an asymptomatic “case.” Then you engage with others, coughing and sneezing and spitting on their food, resulting in transmission of your infection to others. Your germs in the wrong person – e.g., old and sickly – could kill them.

I haven’t done a formal search of the medical literature yet, but did run across one article addressing transmission of SARS-CoV-2 infection by asymptomatic individuals. This article says it doesn’t happen

Abstract

Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423–0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.

https://www.nature.com/articles/s41467-020-19802-w

Go ahead and analyze the article and tell me why it’s invalid. It was generated in China, and some will say we can’t trust any of the pandemic info originating there.

Asymptomatic infection with various germs is a real thing. Off the top of my head, I can’t think of any respiratory infection for which we would isolate an asymptomatic patient. Because they’re not a significant infectious risk to others.

It appears that a person with symptomatic COVID-19 can shed potentially infectious particles for some period of time even after they’re feeling back to normal. We’ve shortened that period of viral shedding as we’ve learned more about this virus (is it about a week now?).

Fauci told us earlier this year that vaccinated folks are getting symptomatic COVID-19 infections and they’re just as infectious as the un-vaccinated symptomatic patients.

The most common arguments against mandated COVID-19 vaccinations are:

  • The vaccinations haven’t been proven to be adequately safe, so I’ll take my chances with catching the virus. I’ll reconsider after we have 3-5 years of good clinical data on effectiveness and adverse events.
  • I’ve already had COVID-19 so I’m immune and present no infectious risk to anybody else.
  • I feel fine but if I develop COVID-19 symptoms I’ll get tested right away and self-isolate until I’m not a risk to anyone else.
  • The religious exemption: God gave me this life and body so I need to be a good steward and protect it. The vaccine may kill me or permanently injure me, whereas as I might never catch the virus. And if I did, I have a great chance of recovering fully. OR: I’ll depend on God to protect me. If I get sick, it’s God’s will and I accept it. OR: click for extensive documentation from Orthodox Christianity.
  • My body, my choice.

Steve Parker, M.D.

Sweden Suspends Moderna COVID-19 Vaccination for Those Under 30

…because of the risk of myocarditis (heart inflammation). Daily Mail reports.

U.S. Deaths Attributable to COVID-19 Vaccines

elderly man, face mask
If he’s age 85 and has obesity, diabetes, COPD, and CHF, odds of death over next six months are relatively high, regardless of COVID-19 vaccination

A computer programmer and healthcare data analyst alleges that deaths potentially attributable to COVID-19 vaccines as of July 2021 are 45,000. Not the 9,000 in the Vaccine Adverse Event Reporting System (VAERS) database. Here’s part of the sworn statement of a whistleblower:

On July 9, 2021, there were 9,048 deaths reported in VAERS. I verified these numbers by collating all of the data from VAERS myself, not relying on a third party to report them. In tandem, I queried data from CMS medical claims with regard to vaccines and patient deaths, and have assessed that the deaths occurring within 3 days of vaccination are higher than those reported in VAERS by a factor of at least 5. This would indicate the true number of vaccine-related deaths was at least 45,000. Put in perspective, the swine flu vaccine was taken off the market which only resulted in 53 deaths.

https://renz-law.com/45k-whistleblower-suit

Even the figure of 9,048 deaths attributable to the vaccine is highly debatable. Could be lower, could be higher. I’m not sure anybody anybody knows the true number. But I bet it’s higher than Fauci and most public health authorities claim.

In the U.S., 162,000,000 have been fully vaccinated thus far. If 9,048 actually died from the vaccination, the odds of death for an individual are 0.0056%. If the true number is five times higher, the odds are 0.028%. In more understandable terms, the risk of death is 1 in 18,900 versus 1 in 89,000. If my math is correct.

If the whistleblower’s figure is correct, a one in 18,900 chance of death doesn’t sound too bad. But what if the age-adjusted rates are more like one in a million for 20-year olds compared to one in 1,000 for 60-year-olds? Would that affect your vaccination decision if you’re a healthy 60-years-old?

Astute reader will note my ignoring the other potential adverse effects of the experimental vaccines, including blood clots, strokes, heart attacks, myocarditis, and miscarriages. And effects that may take several years to manifest. Remember, these are the first ever gene therapy vaccines tried in humans.

I’ve never seen the consent form for a COVID-19 vaccine. If it doesn’t at least mention the possiblity of death, it’s not informed consent. It’s fraud.

Steve Parker, M.D.

Olive Oil Lowers Cardiovascular Disease Risk

Steve Parker MD, low-carb diet, diabetic diet
Olives, olive oil, and vinegar: classic Mediterranean foods

A new analysis of the Nurses Health Study confirms the headline above. Olive oil, of course, is a primary component of the healthy Mediterranean diet. From the American College of Cardiology:

Higher olive oil intake was associated with a lower risk of CHD [coronary heart disease] and total CVD [cardiovascular disease] in two large prospective cohorts of US men and women. The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil could lead to lower risk of CHD.

***

This study of well-educated health professionals is the first in the United States to show the relative value of higher intake of olive oil for preventing CHD and CVD. It was conducted in the era that margarine was primarily trans fatty acids and would not apply to the present soft and liquid margarines. The benefit attributed to olive oil is not simply the substitution for saturated fatty acid. The modest benefit of olive oil in the United States occurred at relatively low olive oil intake (average 12 g/day). In contrast, the Mediterranean diet generally has over 25 g/day. In European studies, a healthy cohort had a 7% reduction in CHD risk for each 10 g/d increase in olive oil; extra virgin olive oil reduced cerebrovascular events by 31% in a high-risk group, and regular olive oil was associated with a 44% lower risk of CHD after about 7.8 years in Italian women survivors of an MI. Amongst the benefits of olive oil include positive effects on inflammation, endothelial function, hypertension, insulin sensitivity, and diabetes.

Source: Olive Oil Consumption and Cardiovascular Risk – American College of Cardiology

Steve Parker, M.D.

Is Body Weight Linked to Survival of Heart Patients with #COVID19? #Coronavirus

This can’t be a good prognostic sign

Maybe…

We have very little data thus far relating body mass index and survival of COVID-19 in any population.

I ran across a small study out of Wuhan, China. Researchers compared 16 heart patients admitted to the ICU with 96 admitted elsewhere in the hospital. Of the non-survivors, nearly all had BMI over 25. Of the survivors, only one in five had BMI over 25.

Conclusion: COVID-19 patients combined with cardiovascular disease are associated with a higher risk of mortality. Critical patients are characterized with lower lymphocyte counts. Higher BMI are more often seen in critical patients and non-survivor. ACE inhibitor/Angiotensin receptor blocker drug use does not affect the morbidity and mortality of COVID-19 combined with cardiovascular disease. Aggravating causes of death include fulminant inflammation, lactic acid accumulation and thrombotic events.

Remember, in non-Asians, BMI between 25 and 30 is simply overweight. BMI over 30 qualifies as obesity in most cases. In the U.S., about a third of adults are overweight, and a third are obese.

Adverse effects of obesity occurs at lower BMIs in Chinese and other populations. So obesity in Chinese adults is a BMI over 28. The obesity rate among both men and women in China is 14%.

Source: [Clinical Characteristics and Outcomes of 112 Cardiovascular Disease Patients Infected by 2019-nCoV] – PubMed

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

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