A daily dose of omega-3 fatty acids could help to reduce the risk of cardiovascular (CV) events in patients who already have chronic heart failure, Italian research suggests.

The first three commissioners have been appointed to the Shadow Care Quality Commission.

Treating depression in patients who have suffered a heart attack does not lower the risk of future cardiovascular (CV) events, according to Dutch research.

Taking the drug ivabradine can reduce the risk of heart attacks by 36 per cent in patients with stable coronary artery disease (CAD), UK research suggests.

Objective To determine the effects of low dose aspirin on cognitive function in middle aged to elderly men and women at moderately increased cardiovascular risk.

Design Randomised double blind placebo controlled trial.

Setting Central Scotland.

Participants 3350 men and women aged over 50 participating in the aspirin for asymptomatic atherosclerosis trial.

Intervention Low dose aspirin (100 mg daily) or placebo for five years.

Main outcome measures Tests of memory, executive function, non-verbal reasoning, mental flexibility, and information processing five years after randomisation, with scores used to create a summary cognitive score (general factor).

Results At baseline, mean vocabulary scores (an indicator of previous cognitive ability) were similar in the aspirin (30.9, SD 4.7) and placebo (31.1, SD 4.7) groups. In the primary intention to treat analysis, there was no significant difference at follow-up between the groups in the proportion achieving over the median general factor cognitive score (32.7% and 34.8% respectively, odds ratio 0.91, 95% confidence interval 0.79 to 1.05, P=0.20) or in mean scores on the individual cognitive tests. There were also no significant differences in change in cognitive ability over the five years in a subset of 504 who underwent detailed cognitive testing at baseline.

Conclusion Low dose aspirin does not affect cognitive function in middle aged to elderly people at increased cardiovascular risk.

Trial registration ISRCTN 66587262.

Two new genes have been identified that could increase the risk of developing inflammatory bowel disease (IBD) in childhood, say US researchers.

The NHS 'can at times be too bureaucratic', admitted health minister Ann Keen in a webchat with patients.

More practices do not think that practice-based commissioning (PBC) has improved patient care than do, according to DoH figures.

The Conservatives want to encourage competition to provide out-of-hours care with GPs at the heart of the plan.

The North West has been appointed the first SHA to lead on allergy services, the DoH has announced.

Objective To compare the effectiveness and safety of three types of stents (sirolimus eluting, paclitaxel eluting, and bare metal) in people with and without diabetes mellitus.

Design Collaborative network meta-analysis.

Data sources Electronic databases (Medline, Embase, the Cochrane Central Register of Controlled Trials), relevant websites, reference lists, conference abstracts, reviews, book chapters, and proceedings of advisory panels for the US Food and Drug Administration. Manufacturers and trialists provided additional data.

Review methods Network meta-analysis with a mixed treatment comparison method to combine direct within trial comparisons between stents with indirect evidence from other trials while maintaining randomisation. Overall mortality was the primary safety end point, target lesion revascularisation the effectiveness end point.

Results 35 trials in 3852 people with diabetes and 10 947 people without diabetes contributed to the analyses. Inconsistency of the network was substantial for overall mortality in people with diabetes and seemed to be related to the duration of dual antiplatelet therapy (P value for interaction 0.02). Restricting the analysis to trials with a duration of dual antiplatelet therapy of six months or more, inconsistency was reduced considerably and hazard ratios for overall mortality were near one for all comparisons in people with diabetes: sirolimus eluting stents compared with bare metal stents 0.88 (95% credibility interval 0.55 to 1.30), paclitaxel eluting stents compared with bare metal stents 0.91 (0.60 to 1.38), and sirolimus eluting stents compared with paclitaxel eluting stents 0.95 (0.63 to 1.43). In people without diabetes, hazard ratios were unaffected by the restriction. Both drug eluting stents were associated with a decrease in revascularisation rates compared with bare metal stents in people both with and without diabetes.

Conclusion In trials that specified a duration of dual antiplatelet therapy of six months or more after stent implantation, drug eluting stents seemed safe and effective in people both with and without diabetes.