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For some cardiac patients with stents, long-term aspirin treatments might be on the way out - WLWT Cincinnati

For some cardiac patients with stents, long-term aspirin treatments might be on the way out

This is be well, helping you live life better on today's show, *** heart scare for lebron James. Son is shining *** spotlight on the health of young athletes, the life saving information that could help protect your child plus the best backpacks for back to school from the hottest trends to budget buys. We've got you covered and his wild weather ruining your yard. The tips from HGTV S John getting to keep it looking healthy with whatever mother nature throws our way and workouts for your abs to get you more challenged every week. They're gonna get harder. This is be well, lately we've heard about young athletes suffering cardiac arrest while playing sports and in many cases, these young athletes have had no prior heart conditions. Earlier this year, we watched as Buffalo Bill safety demar Hamlin suffered *** cardiac arrest and most recently lebron James 18 year old son, Ronnie suffered one during basketball practice. So here to shed some light on this topic and share some life saving information is the Associate professor of pediatric cardiology at Columbia University, Doctor Warren Zuckerman. So thanks so much for joining us because I feel as though *** lot of people have questions because you would, you know, let's just take Brown, for instance, I mean, young man seems to be very healthy, very fit and why would something like this happen? So, uh in *** lot of cases, there is an underlying issue that uh is *** risk factor for this to happen, but we just don't know it at the time that this happens. Um Some of those things include having an underlying cardiomyopathy, underlying congenital heart disease. People who are born with abnormal formation of the heart, notably an abnormality of the coronary arteries, except it doesn't manifest in any way until this event actually happens. So help people understand the difference between *** cardiac arrest and *** heart attack. So *** heart attack is when there's an almost always when there's an acute blockage of the coronary arteries, usually by uh uh *** clot or *** plaque of cholesterol. This usually happens in older people and it causes an acute blockage of the blood flow to feed the the heart muscle itself. Uh with acute injury to that, to that heart muscle, uh it starts to, to basically die and not function. Well, *** cardiac arrest occurs when there is *** sudden abrupt arrhythmia that causes the heart to effectively stop pumping. Um It happens immediately and there's *** loss of consciousness uh at the time and complete incapacitation of the patient. So now if you have *** young athlete and they go for *** regular physical at the doctor's office. Would I even know that any of these issues, you know, are there, uh, in some cases, yes, some forms of cardiomyopathy, especially uh hypertrophic cardiomyopathy, which is the number one reason why this happens in young athletes, uh, may come with *** heart murmur to uh the thickness of the heart muscle causing obstruction to blood flow. Unfortunately, in *** lot of cases there would be nothing And, and in, in most of these cases, it's not like the pediatricians or internists miss something. So there are no signs that really look out for or what about tests to even try to figure out if they have um some signs. Uh uh the, the cardiac arrest is from an arrhythmia. Some patients may have um brief arrhythmias when they're playing sports where they feel palpitations if, if *** young athlete is feeling that they probably should be checked out by *** cardiologist. Um in some cases, uh you will see that, but in *** lot of the cases again, you, you won't. Um it is controversial whether there should be screening programs in place for young athletes. Uh there would be so many false positives, so much anxiety from, from doing that and probably to be honest, *** lot of people who would be excluded from athletics that that really shouldn't be. Now, when you look at DEMAR Hamlin or even, you know, someone who's playing like lacrosse when you get hit and it just hits you at the wrong moment in time. You don't need to have an underlying condition for something like that. Right. Correct. That that occurs almost always with no underlying condition and it is extremely rare. Um, it has, it, it, it happens at exactly the right time in the electrical cycle of the heartbeat and it has to happen with the right speed and in the right position in the chest. So how important is CPR immediately after someone experiences one of these issues? So I would say that is the most important thing uh take home from these events. Uh these very public events is knowing good CPR and having people in place at athletic competitions who know CPR and also having uh automatic defibrillators or AES on the premises and people knowing where they are, the people in little leagues and in youth sports who are coaching should be trained in CPR and know where these are at the time of the sport. Thank you so much, Doctor Zuckerman. We appreciate it. Well, from extreme heat to downpours and flooding. So many of us have been dealing with the string of extreme weather. But what does it all mean for your landscaping? Well, I caught up with HGTV S John Gidding for some helpful tips on how to care for your yard. No matter what's happening outside John, there are *** lot of different extreme weather conditions going on right now in the world So what do people do to really preserve their landscape? Still make it look pretty after going through *** drought like we have here on the east coast. It literally just stopped raining. You know, it's funny everywhere around the country, people are wondering what to do with their landscapes because it's becoming less and less predictable. Is it gonna be drought season? Is it gonna be downpours? What I'm saying is what you need to do is embrace native landscaping. Native plants basically are *** way of stepping past all of these problems is because the plants that you'll end up introducing into your landscape will be perfectly happy with any kind of precipitation that naturally occurs in your area. So flowers like this, they look like they're enjoying the weather right now. They're blooming and going bright, things like that is *** good example of something that can really thrive in this type of weather condition. Well, what I also love about this is how volumetric it is. We don't necessarily have to think about our lawns as these tight to the ground carpets. Basically, let's play with some volume, let's play with some energy. And that way the native plants that we bring in can actually have our houses nestled into nature rather than just sitting on top of it. Ok. But what about those people that are in really dry locations? I don't like to think of like *** cacti that can survive those dry climates and things like that and those aren't always the prettiest boost your landscape. No, it's *** really good point. Actually, you don't necessarily have to go, uh, cactuses just because you want to stay water positive. I've created five green prints with Scott's Miracle Grow. And if you go to think water positive dot com, these green prints become available for free and basically, it's *** way for homeowners to get inspiration and *** list of plants that are gonna do really well in their area. If you don't really know where to start, these green prints are *** great place to go because they'll give you *** sense of which kinds of plants will do well for you even better. I like the fact that you can help design *** for us. We'll just follow your blue. I will. Exactly right. August is National Wellness Month and we want to show you that being healthy doesn't have to be hard. And that is the mission of health coach Coy Rodriguez. Today. He's showing us how to keep our fruits and veggies fresh for today's wellness. In one minute, we want to talk about how we store our fruits and vegetables and there's really *** do and don't to this Corey. Yeah, you want your fruits and vegetables separate for the most part when they're in the fridge. Ok. So we have this CRISPR draw and for some people there's like *** little slider on there and that's actually pretty important. Yeah. You want it open for the fruit so the humidity gets out and you want it closed for the vegetables to lock the humidity in. Ok. So, if you do have that slider, pay attention to where you put it. And one of the other things too is they can interact with each other. I know I've put avocados underneath my bananas that weren't ripened and then all of *** sudden they start to ripen. Yeah, that's the ethylene gas that's produced by one ripening the other. That's why in the crisper jars are where they're supposed to go. But separately and there are some things we want to keep on the counter such as tomatoes, tomatoes will have *** change in both taste and texture by going in the fridge as opposed to sitting on the counter. All right. So on the counter they go and of course, all this month we're gonna have those 62nd tips. All so you can live life better. New research is looking into how many times *** week you need to work out to make it worth your while. Researchers in Australia found 3 may be the magic number and doing small regular exercises multiple times *** week is more effective than one or two large session. Researchers got one group to work their biceps three times *** week, another did the same exercise but only twice *** week. After *** month, the twice *** week group, they saw no significant changes. But the three day *** week group saw increases in bicep strength, good tips there. All right. Our own Kristen ser spoke with Luke Lloyd, wealth advisor and investment strategist as strategic wealth partners about what the fed's decision to raise interest rates means to you and your home mortgage. This is the most unaffordable and most expensive way or time to stretch your dollar. If you're below 50 years old, if you're above 50 years old, you got to witness this kind of crazy expensive times. But if you're below 50 it's harder now than ever. So what are people to do? How do they navigate this? One of the biggest keys? I think you can really take advantage of maybe buy building your forever home. Right. So like right now there's *** very minimal amount of inventory right. Right now, um out there in the marketplace which making everything expensive, everyone that *** mortgage rate below 3% doesn't want to get rid of their homes, right. So if you want to build your forever home, the cost of lumber came down *** little bit. This might be the time to do it, ok? But you're still going to pay *** hefty mortgage, right? If you have to finance it. So this is the kind of time if you have some extra cash on the sidelines, you don't want to pay these hefty valuations, you might want to actually look to lay down some of the capital you have on the sidelines to build your forever. Sure. At the front, right at the very front. But the key is refinancing down the road, right. You can always refinance down the road. That that's why I think it's an opportunity to maybe build that forever home refinance at lower rates. Because eventually, if we see any kind of economic downturn in the economy, the Federal Reserve is gonna lower rates and you can always go and refinance it, which means go back to the bank, get rid of that 7% mortgage rate or 7% interest rate and go back down to maybe three or four when they get down there. Well, they definitely *** couple years, *** lot of money on the line, right? If you want to buy *** home in this market, you know, inventory is an issue. Prices are still high and you're right, *** mortgage is going to make it less affordable. So, is it just that easy to refinance what you need to know, to prepare for something like that? So it is pretty easy to refinance. Um, but that being said, the difficult part is it comes with *** cost, right? You can't just go to the bank and say, hey, I'm gonna refinance this loan for seven from 7% to 4% and not pay anything. So usually it could range from *** couple of $1000 up to 10 to $15,000 depending on where you're refinancing. But that being said on the life of *** loan, if you're getting *** 30 year mortgage, you know, refinancing *** couple percent could save you hundreds of thousands of dollars down the road. Well, some good tips there. Well, coming up *** new school year means new gear after the break. Backpacks with cool features and even cooler price tags. More be. Well, is next.

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For some cardiac patients with stents, long-term aspirin treatments might be on the way out

For some high-risk cardiovascular patients with stents, the often-recommended practice of prolonged taking of aspirin might be ineffective, and in some cases, even harmful, a new study found.Related video above: Understanding cardiac arrest and heart healthThe report, published in the scientific journal Circulation, looked at more than 7,500 patients with acute coronary syndrome: a term that describes a variety of heart conditions — including heart attacks — caused by a sudden drop in blood flow to the heart.To treat the condition, each of the patients underwent a common procedure called percutaneous coronary intervention, in which doctors thread a small balloon into the body to open the blocked artery. They also insert a metallic mesh tube called a stent into the coronary artery, which props up the blood vessel and keeps blood flowing. To prevent blood clots from forming after putting in the stent, most doctors recommend taking a combination of an antiplatelet medication and aspirin for about a year.However, the study found that getting rid of aspirin from the regimen after three months was just as effective in avoiding clotting complications — while significantly reducing the risk of severe bleeding that aspirin can cause."You often think to yourself, 'What's aspirin really doing being next to a very, very potent agent already? ' " said Dr. Roxana Mehran, the study's principal investigator and a cardiologist at the Icahn School of Medicine at Mount Sinai. "What is it doing except to profoundly increase the bleeding risk?"Potential for new standard of careCardiovascular diseases are the leading cause of death worldwide, responsible for nearly 18 million deaths each year, according to the World Health Organization.For years, medical professionals widely recommended regular aspirin to prevent heart problems, since aspirin can reduce blood clotting to prevent complications like heart attacks or strokes.However, the medication could also increase the risk of severe bleeding, particularly as people get older.As a result, in 2019, the American College of Cardiology and the American Heart Association shifted course and no longer recommended daily aspirin as a preventative for older adults who don't have a high risk or existing heart disease. In 2022, the United States Preventive Services Task Force recommended daily aspirin for people over 60. For healthy, younger adults with an increased risk of heart attack or stroke, daily aspirin could have a modest benefit, though experts still recommend weighing it against the risk of bleeding.Still, many health care professionals consider aspirin to be beneficial for many patients who have heart problems or have a stent. The new study's results, however, might challenge that assumption.Using pooled patient data from two large clinical trials — one that Mehran helped conduct in the United States and a separate trial from collaborators in South Korea — the researchers looked at patients with acute coronary syndrome who were receiving ongoing therapy to prevent clotting after getting stents.Normally, patients take a combination of aspirin and a potent anti-clotting medication called ticagrelor for up to a year after getting the stent. However, the report found that patients who stopped taking aspirin after three months fared just as well as those on the aspirin-ticagrelor combination therapy: rates of death, heart attacks, and strokes were the same in both groups.Dropping aspirin also reduced the risk of severe bleeding by nearly 50% compared with patients on the combination therapy, said Mehran — without increasing the risk of cardiac complications.It's a finding that experts believe could lead to a new standard of care for high-risk cardiac patients. Given the results of her clinical trial and a growing amount of evidence suggesting that long-term aspirin may not be beneficial for acute coronary syndrome, Mehran prescribes a treatment plan without long-term aspirin for her patients.She also believes that aspirin can be removed from the regimen even earlier — potentially after a month. That shortened time frame, she added, is being investigated by several ongoing studies."If we have good evidence that aspirin is not doing much of anything except to increase bleeding in that vulnerable period, why not withdraw aspirin after a certain amount of time?" Mehran said.Aspirin remains 'an essential therapy'However, experts agree that aspirin remains a beneficial medication for heart conditions."The public should know that aspirin remains an important treatment for a heart attack, and in these studies, it was an essential therapy in the 3 months after receiving the stent," Dr. Harlan Krumholz, a cardiologist and professor at the Yale School of Medicine, wrote in an email to CNN.For one, the results do not apply to patients who have other heart problems, such as atrial fibrillation, a condition that requires blood thinners to treat."We are not saying that aspirin is terrible and should be stopped in all patients; that is not at all the message," Mehran added.The report focused on a select group of high-risk patients recovering from acute coronary syndrome and stent placement, and eliminating aspirin from their treatment plans is contingent on the patients taking ticagrelor twice a day for at least a year.Patients in the study also needed to make it through the first three months of combination therapy without any complications before aspirin was removed from their regimen.Krumholz believes that further research that looks to simplify medication plans could also improve patients' health."We need more studies like these where we are testing the value of withdrawing medications people are on — instead of just assuming that we need to continue them," he wrote. "This study helps us understand how we can safely simplify the drug regimen for these patients, and by subtracting a drug, we can actually improve outcomes."

For some high-risk cardiovascular patients with stents, the often-recommended practice of prolonged taking of aspirin might be ineffective, and in some cases, even harmful, a new study found.

Related video above: Understanding cardiac arrest and heart health

The report, published in the scientific journal Circulation, looked at more than 7,500 patients with acute coronary syndrome: a term that describes a variety of heart conditions — including heart attacks — caused by a sudden drop in blood flow to the heart.

To treat the condition, each of the patients underwent a common procedure called percutaneous coronary intervention, in which doctors thread a small balloon into the body to open the blocked artery. They also insert a metallic mesh tube called a stent into the coronary artery, which props up the blood vessel and keeps blood flowing. To prevent blood clots from forming after putting in the stent, most doctors recommend taking a combination of an antiplatelet medication and aspirin for about a year.

However, the study found that getting rid of aspirin from the regimen after three months was just as effective in avoiding clotting complications — while significantly reducing the risk of severe bleeding that aspirin can cause.

"You often think to yourself, 'What's aspirin really doing being next to a very, very potent agent already? ' " said Dr. Roxana Mehran, the study's principal investigator and a cardiologist at the Icahn School of Medicine at Mount Sinai. "What is it doing except to profoundly increase the bleeding risk?"

Potential for new standard of care

Cardiovascular diseases are the leading cause of death worldwide, responsible for nearly 18 million deaths each year, according to the World Health Organization.

For years, medical professionals widely recommended regular aspirin to prevent heart problems, since aspirin can reduce blood clotting to prevent complications like heart attacks or strokes.

However, the medication could also increase the risk of severe bleeding, particularly as people get older.

As a result, in 2019, the American College of Cardiology and the American Heart Association shifted course and no longer recommended daily aspirin as a preventative for older adults who don't have a high risk or existing heart disease. In 2022, the United States Preventive Services Task Force recommended daily aspirin for people over 60.

For healthy, younger adults with an increased risk of heart attack or stroke, daily aspirin could have a modest benefit, though experts still recommend weighing it against the risk of bleeding.

Still, many health care professionals consider aspirin to be beneficial for many patients who have heart problems or have a stent. The new study's results, however, might challenge that assumption.

Using pooled patient data from two large clinical trials — one that Mehran helped conduct in the United States and a separate trial from collaborators in South Korea — the researchers looked at patients with acute coronary syndrome who were receiving ongoing therapy to prevent clotting after getting stents.

Normally, patients take a combination of aspirin and a potent anti-clotting medication called ticagrelor for up to a year after getting the stent. However, the report found that patients who stopped taking aspirin after three months fared just as well as those on the aspirin-ticagrelor combination therapy: rates of death, heart attacks, and strokes were the same in both groups.

Dropping aspirin also reduced the risk of severe bleeding by nearly 50% compared with patients on the combination therapy, said Mehran — without increasing the risk of cardiac complications.

It's a finding that experts believe could lead to a new standard of care for high-risk cardiac patients. Given the results of her clinical trial and a growing amount of evidence suggesting that long-term aspirin may not be beneficial for acute coronary syndrome, Mehran prescribes a treatment plan without long-term aspirin for her patients.

She also believes that aspirin can be removed from the regimen even earlier — potentially after a month. That shortened time frame, she added, is being investigated by several ongoing studies.

"If we have good evidence that aspirin is not doing much of anything except to increase bleeding in that vulnerable period, why not withdraw aspirin after a certain amount of time?" Mehran said.

Aspirin remains 'an essential therapy'

However, experts agree that aspirin remains a beneficial medication for heart conditions.

"The public should know that aspirin remains an important treatment for a heart attack, and in these studies, it was an essential therapy in the 3 months after receiving the stent," Dr. Harlan Krumholz, a cardiologist and professor at the Yale School of Medicine, wrote in an email to CNN.

For one, the results do not apply to patients who have other heart problems, such as atrial fibrillation, a condition that requires blood thinners to treat.

"We are not saying that aspirin is terrible and should be stopped in all patients; that is not at all the message," Mehran added.

The report focused on a select group of high-risk patients recovering from acute coronary syndrome and stent placement, and eliminating aspirin from their treatment plans is contingent on the patients taking ticagrelor twice a day for at least a year.

Patients in the study also needed to make it through the first three months of combination therapy without any complications before aspirin was removed from their regimen.

Krumholz believes that further research that looks to simplify medication plans could also improve patients' health.

"We need more studies like these where we are testing the value of withdrawing medications people are on — instead of just assuming that we need to continue them," he wrote. "This study helps us understand how we can safely simplify the drug regimen for these patients, and by subtracting a drug, we can actually improve outcomes."

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