A tweet from Jonathan Reiner, MD.

Cardiovascular Disease

Heating Up: Two Heart Medications May Increase Risk

Antiplatelet medications and beta blockers can improve survival and quality of life for people with cardiovascular disease. But those protections may come with added risk on hot summer days.

A study published in Science found that a disproportionate number of people who suffer non-fatal heart attacks during hot weather are taking antiplatelet or beta blocker medications. 

Researchers analyzed 2.5k cases in which a non-fatal heart attack occurred during hot weather. Heat-associated MI events were more common among those taking the heart drugs:

• Antiplatelet medication users had a 63% increased risk.
  
• Beta-blocker users had a 65% increased risk.
  
• People taking both drugs had a 75% higher risk.
  
• Non-users were not more likely to have a heart attack on hot days. 

Importantly, the authors do not claim that these medications cause heart attacks, noting that patients who take these prescriptions are likely doing so because they are more susceptible to cardiac events.  

Even so, a clue indicates that the heart drugs may indeed be partly to blame. Younger patients (25 to 59 years) had lower rates of coronary heart disease than older participants (60 to 74 years), yet younger patients taking beta-blockers and antiplatelet medications were still more susceptible to heat-related heart attacks.

The authors speculate that the medications may make it harder for people to regulate their body temperature, but future research will be necessary to investigate this. 

The Takeaway

Two groups of heart medications – beta blockers and antiplatelets – could potentially place patients at a higher risk of heat-related heart attacks. As temperatures continue to creep up globally, the risk associated with these medications may become even more pronounced. 

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The Wire

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• GE Canada’s Cardiac AI Acceleration: GE Healthcare’s Canadian Edison Accelerator program launch announcement revealed a notable focus on cardiology AI startups, naming  Us2.ai (echo AI), CardioWise (cardiac CT AI), and Corelinesoft (CT CAC scoring, plus other non-cardiac AI applications) to the program’s six-startup cohort. GE will provide the startups with guidance and technical support with the goals of accelerating their integration into the Edison Platform and their path towards commercialization.

• CTs Before LAAO: New research from Henry Ford Hospital found that using CT scans to plan left atrial appendage occlusion procedures is superior to relying solely on transesophageal echocardiogram imaging guidance. The researchers reviewed 485 Watchman implantation procedures and found that clinicians who used CTs for additional preprocedural planning had a higher implantation success rate (98.5% vs. 94.9%), operated for a shorter amount of time (median of 45.5 mins vs. 51 mins), and were less likely to change Watchman device sizes (5.6% versus 12.1%). 

• Bodyport’s Cardiac Scale: Bodyport received FDA 510(k) clearance for its Cardiac Scale, which allows patients with heart failure to monitor their heart function and fluid status in the same step they take to measure their weight. The pandemic is driving increased demand for remote patient care options, and Bodyport’s rollout (planned for later this year) should help HF patients manage their condition remotely.

• Hypertension Barriers: A study in Mayo Clinic Proceedings found that social determinants of health have a significant impact on hypertension control. The study evaluated 3.3k patients on a one-year blood pressure control program, finding that hypertension control rates were higher for those without any SDOH barriers (73%) than for those with one barrier (60%) or two barriers (55%). Although the authors noted Black patients with poorly controlled hypertension had a higher prevalence of SDOH barriers, there were no racial differences in BP control when two or more SDOH barriers were present.

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