News in brief: Poker-playing cardiologist featured on ABC; DOACs reduce dementia risk in AF; Milk consumption impacts mortality

Thursday, 24 Mar 2022

Poker-playing cardiologist featured on ABC

Paediatric cardiologist Dr Bo Remenyi has featured on the ABC’s Conversations radio program, recounting her journey from Communist Hungary to working in the Top End treating rheumatic heart disease in Indigenous communities.

In a wide ranging discussion, the Darwin-based clinician and NT Australian of the Year for 2018 revealed that she played high stakes poker for thousands of dollars a hand at Melbourne’s Crown Casino to help support herself while training in cardiology.

Dr Remenyi told Richard Fidler that she started playing poker to pass the time when she was immobolised for six weeks after dislocating her shoulder. She said one factor in her poker success was skill in mathematics and probabilities, while the ability to bluff and sheer luck accounted for about two thirds of outcomes.

The assessment of probability also applied in cardiology, she told the presenter.

“Even prescribing basic medications for example aspirin for people who have had a heart attack. Aspirin gives you the benefit of preventing clogging of the arteries but has a risk of gastric ulcers, so everything in medicine is a risk benefit. The difference in poker is that you see it play out three or four hundred times a night. In medicine you see the negatives and positives over maybe 20 years,” she said.

DOACs reduce dementia risk in AF

Use of direct‐acting oral anticoagulants instead of warfarin in patients with atrial fibrillation may halve the risk of dementia.

An analysis of Australian general practice data from 18,813 patients with newly diagnosed AF between 2010 and 2017 found that compared with exclusive warfarin users, exclusive DOAC users had a lower risk of dementia (HR, 0.46; 95% CI, 0.28–0.74; P=0.002).

“A possible explanation for the higher risk of dementia in patients receiving warfarin may be difficulty in managing the time in therapeutic range for the international normalised ratio,” the study said.

“Time outside the therapeutic range in these patients can lead to microemboli and microbleeds, which could cause chronic cerebral injury and finally lead to dementia.”

The researchers said the possibility of confounding by indication and a relatively short-term follow-up of 3.7 years were potential limitations of the study.

Read more in the Journal of the American Heart Association

Milk consumption impacts mortality

Australians with ischaemic heart disease (IHD) who consume reduced fat milk over the long term have a 31-41% reduced risk of mortality compared to those people who choose other milks.

Data from the 45 and Up Study compared whole milk, reduced fat milk, skim milk and soy milk intake in 7,236 participants with cardiovascular disease.

“Clear differences were found across different types of long-term milk consumption and survival for males and females (both p < 0.001), with whole milk having the lowest survival rates and skim milk (males) and reduced fat (females) with the highest survival rates.”

“With regards to a subgroup analysis in those with specific types of CVD, we found a specific benefit of long-term reduced fat milk in males with IHD.”

There was also some evidence that people who chose reduced fat milk also made healthier food choices overall.

Read more in Nutrients

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