1.
Dietary saturated fat and heart disease: a narrative review.
Heileson, JL
Nutrition reviews. 2020;(6):474-485
Abstract
The American Heart Association (AHA) recently published a meta-analysis that confirmed their 60-year-old recommendation to limit saturated fat (SFA, saturated fatty acid) and replace it with polyunsaturated fat to reduce the risk of heart disease based on the strength of 4 Core Trials. To assess the evidence for this recommendation, meta-analyses on the effect of SFA consumption on heart disease outcomes were reviewed. Nineteen meta-analyses addressing this topic were identified: 9 observational studies and 10 randomized controlled trials. Meta-analyses of observational studies found no association between SFA intake and heart disease, while meta-analyses of randomized controlled trials were inconsistent but tended to show a lack of an association. The inconsistency seems to have been mediated by the differing clinical trials included. For example, the AHA meta-analysis only included 4 trials (the Core Trials), and those trials contained design and methodological flaws and did not meet all the predefined inclusion criteria. The AHA stance regarding the strength of the evidence for the recommendation to limit SFAs for heart disease prevention may be overstated and in need of reevaluation.
2.
The non-cardiac use and significance of cardiac troponins.
Mannu, GS
Scottish medical journal. 2014;(3):172-8
Abstract
Cardiac Troponins are blood markers of myocardial damage and are widely utilised across all acute medical departments. However, with a massive rise in requests for this test, the interpretation of raised serum levels in the absence of cardiac sounding clinical features can become a clinical conundrum. This is especially true if the numerous causes of positive test results are not fully appreciated. A thorough understanding of the strengths and weaknesses of this blood test in light of a patient population living longer, increasing in comorbidities and possible causes of false test results can provide invaluable support in establishing an accurate diagnosis and instigating effective management. This article will describe the history of cardiac markers along with a discussion of the various causes of elevated cardiac troponins outside acute coronary syndrome. It will elaborate on the applications and significance of this blood test and the potential uses of positive results with elevated serum Troponin levels.