Treatment with B vitamins did not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. A harmful effect from combined B vitamin treatment was suggested. Such treatment should therefore not be recommended. (ClinicalTrials.gov number, NCT00266487.).

Fiftythree patients with chronic atrial fibrillation participated in a randomized cross-over trial in order to compare the ability of two drug regimens to establish and maintain sinus rhythm. The patients were given orally either sustained release quinidine 0.4 g twice a day or verapamil 80 mg three times a day. Thirtyone patients tried both regimens. Quinidine was found to have a greater ability to induce conversion to sinus rhythm by drug alone (p <0.05) and also a greater ability to maintain sinus rhythm after conversion (after 3 months p < 0.05). There was, however, also a significantly larger proportion of patients on quinidine who were withdrawn from the study due to side effects and two patients on quinidine died outside hospital.The study indicate that quindine is somewhat superior to verapamil both in the establishing and preserving of sinus rhythm in subjects who are able to tolerate the drug.

Summary10 healthy male volunteers fasted for 72 hours. Their plasma concentration of free fatty acid increased more than two-fold, to 1.8 mmol/1. The number of reversible venous “in vivo” platelet aggregates increased significantly (p <0.01); this figure correlated with the concentration of long-chain saturated free fatty acid in plasma (p <0.02). The correlation with the amount of long-chain saturated free fatty acid plus oleic acid (18:1) was even better (p <0.01). Plasma PF-4 concentration increased, suggesting increased platelet release reaction. In spite of the plasma increase, total platelet FFA concentration was reduced and there was a change in the distribution of platelet free fatty acid which correlated with the degree of aggregation.

A decentralised prehospital thrombolytic therapy system based on ambulance personnel, telemetry and centralised 7/24 invasive diagnosis and treatment service, combined with system maturation over time, was associated with earlier reperfusion, improved clinical outcomes and better survival. Prehospital thrombolytic therapy is a feasible and safe intervention used in rural settings with long evacuation lines to percutaneous coronary intervention facilities.

ABSTRACT. Ten healthy male students in regular sinus rhythm fasted for 66 hours. Their overnight fasting plasma concentration of free fatty acids (FFA) was 455±104 μmol/l (mean ± S.E.M., n=7), the reference value of our laboratory, measured in another normal population of young men, being 344±28 μmol/l (n = 10). After 42 and 66 hours of fasting, the plasma concentration of FFA rose to 1198±181 (p>0.01, n=10) and 1471±89 μmol/l (p>0.001, n = 10), respectively. During the last 24 hours of fasting, the heart rhythm was monitored continuously by means of a Holter recorder and computer. No arrhythmias were observed, indicating that elevated plasma concentrations of FFA, exceeding those reported in patients with acute myocardial infarction, are well tolerated by the healthy human myocardium.