CLINICAL
NEWS JACC in a FLASH
Focus On: Population Health
availability when determining AED
placement, as well as advocating for
government legislation mandating that
all AEDs be registered with emergency
medical services dispatch centers and
accessible to the public 24/7.
In an accompanying editorial
comment, Robert J. Myerburg, MD,
applauds the study and writes that its
findings should be taken into account
as part of planning strategies for AED
locations. However, he also notes that
society would benefit from a “parallel effort to develop a roadmap for
improving prediction and prevention
of out-of-hospital cardiac arrest.”
JACC Special Issue Dedicated to Cardiovascular
Health Promotion
JACC recently published a special issue focused solely on cardiovascular health promotion. Studies
addressed topics ranging from smoking cessation to the prevention of cardiovascular disease and other
related conditions. Check out the full issue at onlinejacc.org. Some study highlights are listed here:
Longer Living Parents, Longer Living
Children
The risks of cardiovascular conditions may be progressively lower the
longer a person’s parents lived past
69 years old, according to a study out
of the U.K. Researchers examined
186,151 non-adopted participants
aged 55-73 years with deceased
parents who participated in U.K.
Biobank, a voluntary health research
database. Follow-up data was collected over 8 years from hospital admissions records and death records.
Results showed an inverse
relationship between age of parent’s death and the mortality rate
of offspring. When the mother and
father survived past age 69, allcause mortality of offspring declined
16% and 17%, respectively, per additional decade of the parents’ lives.
Coronary heart disease mortality
declined by 20% and 21% per additional decade of the parents’ lives.
Participants with parents who lived
longer also showed lower incidence
of peripheral vascular disease,
heart failure, stroke, hypertension,
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CardioSource WorldNews
anemia, hypercholesterolemia, and
atrial fibrillation.
“It’s been unclear why some older
people develop heart conditions in their
sixties while others only develop these
conditions in their nineties or even
older,” says David Melzer, MBBCh,
PhD, senior author of the study. “Avoiding the well-known risk factors such
as smoking is very important, but our
research shows there are also factors
inherited from parents that influence
heart health. As we understand these
parental factors better, we should be
able to help more people to age well.”
Where’s the AED?
There’s only a one in five chance that
a potentially life-saving automated
external defibrillator (AED) will be
nearby when someone experiences
cardiac arrest, and a 20% to 30%
chance that the nearby device will
be inaccessible because it is inside a
building that’s closed, according to a
study out of Toronto.
Researchers, led by Timothy C.Y.
Chan, PhD, examined all public outof-hospital cardiac arrests occurring
between January 2006 and August
2014 in Toronto. Public locations
included public buildings, places of
recreation, industrial facilities and
outdoor public spaces, but not hospitals or nursing homes. Researchers
compared that to a list of registered
AEDs in Toronto as of March 2015.
Results showed that Toronto had
2,440 cases of out-of-hospital cardiac
arrest during the study period and 767
AED locations. Of the AED locations,
542 (73%) were not open 24 hours
a day and 211 (28.6%) were closed
on weekends. Of the total number of
out-of-hospital cardiac arrests, 451
were located near an AED but only
354 were located near an AED when
the AED was accessible, resulting
in a coverage loss of 21.5%. When
researchers looked at cardiac arrests in
the evening/overnight hours (between
4 p.m. and 8 p.m.) and over weekends,
coverage loss increased to 31.6%.
Study authors suggest using a model that accounts for both location and
Pay to Quit Smoking
Cessation Model?
A Swiss study that randomized 805
low-income smokers to an incentive
group that received incremental monetary rewards (up to $1,500) for confirmed smoking abstinence or a control
group that wasn’t paid, found that those
in the incentive group had a higher rate
of confirmed abstinence at 3 months, 6
months and 18 months.
Results showed that at 3 months,
44.4% of the smokers in the incentive
group reported they had been abstinent
continuously versus 6.4% of the control
group. At 6 months, 35.9% of the
incentive group and 5.7% of the control
group reported continuous abstinence.
At 18 months, which was 1 year after
incentive payments ended, 9.5% of the
incentive group and 3.7% of the control
were confirmed abstinent.
The authors conclude that while a
large group relapsed after payments
ended, abstinence rates a full year
after the last incentive were almost six
percentage points higher among smokers who received financial incentives
compared with those who did not.
In an accompanying editorial comment, Joseph A. Ladapo, MD, PhD,
and Judith J. Prochaska, PhD, MPH,
write that incentives may prove useful
for engaging unmotivated smokers
in quitting. “Future work should aim
to bridge critical knowledge gaps
concerning incentive design and
delivery, and ultimately, inform the
comparative effectiveness of financial
incentives relative to other clinical
and behavioral approaches to treating
nicotine addiction,” they said. ■
September 2016