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NIHR Signal Routine engagement in end of life planning can improve health outcomes for people with heart failure
Interventions that encourage healthcare professionals to engage in advance care planning with heart failure patients can work more effectively than stand-alone training activities in improving health outcomes. Approaches that involve patients to change clinicians’ professional practice behaviours, the use of reminder systems and educational meetings may offer the best potential. There is no cure for heart failure, and palliative care is known to help this patient group. Advance care plann...
NIHR Signal Warfarin and newer anticoagulants equally effective for long-term treatment of blood clots
Warfarin and newer anticoagulants work equally well to prevent blood clots in extended treatment after venous thromboembolism. One clot is prevented for every 15 people receiving either anticoagulant. Aspirin is ineffective. Following venous thromboembolism – a blood clot in the deep leg veins (deep vein thrombosis) or lungs (pulmonary embolism) – anticoagulant treatment is given for three months, as standard. Prolonged treatment may be given for patients at high risk of recurrence....
NIHR Signal Older people with acute coronary syndromes may benefit from routine invasive therapy
Routine invasive therapy for people aged over 75 with non-ST-elevation acute coronary syndromes reduced the risk of dying, having a heart attack or stroke, and need for further intervention. However, there was a higher risk of major bleeding compared to treating people with medication. This is the largest review to date to gather the evidence on treatments for older people with smaller heart attacks or severe angina (chest pain). NICE recommend treating these “non-ST-elevation acute coron...
NIHR Signal Telehealth may help some people be more active after a heart attack
A variety of “telehealth” approaches may be worth considering for encouraging physical activity after a heart attack or heart surgery, suggests a review of published research. Cardiac rehabilitation and exercise programmes are well known to be effective in improving survival following a heart attack. Typical cardiac rehabilitation programmes offer exercise classes, education about heart disease and healthier lifestyle, and approaches to reduce stress. Although rehabilitation is usua...
NIHR Signal No benefit from therapeutic cooling after a major heart attack
There is no evidence at present that therapeutic cooling after a major heart attack could prevent death or future heart attacks. Therapeutic cooling, also called therapeutic hypothermia, or targeted temperature management, involves artificially reducing the body temperature by a few degrees, here to under 35˚C. This approach is recommended in NICE guidance to help protect brain function after cardiac arrest, but not for heart attack. Recent treatments involving stents or clot busting drugs have...
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