UPDATED // One of the authors on a new registry analysis says the findings are persuasive: possibly enough to persuade guideline-writing groups to reconsider the class 3 recommendation against performing elective PCI without surgical backup.
Washington, DC - One of the largest, "most comprehensive" studies to show no differences in outcomes between PCI facilities with and without on-site surgical backup has now been published in the June 30, 2009 issue of the Journal of the American College of Cardiology [1]. Moreover, say the authors, no differences were seen when they looked just at primary PCI or elective PCI procedures.
Results of the study were first presented at the ACC 2008 meeting, as reported by heartwireat the time.Read full article »
Inside: Acute Coronary Syndromes
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HORIZONS-AMI has influenced US practice; after TRITON-TIMI 38, the potential role of prasugrel is a hot topic. How has Latin America responded to these data? Recorded at SOLACI 2009, Dr. Mahmud has an information exchange on contemporary antiplatelet management with two of Argentina's leading interventionalists, Drs. Grinfeld and Londero.
Early-ACS, HORIZONS-AMI, On-TIME 2... How do you use GP IIb/IIIa inhibitors in contemporary practice? Given the continued uncertainty regarding the optimal duration of dual antiplatelet therapy, what do you do for AF patients on warfarin who need stents? Answer our 3 short polling questions and learn your peers' responses.
Studies suggest that major bleeding is associated with a 5-fold increase in the risk for death among ACS patients. Join our expert panel: Profs. Hamm, Kristensen, and Spaulding as they discuss treatment options and strategies to reduce bleeding in STEMI patients.
iQandA, The Interactive Medical Intelligence Zone is a needs assessment-driven continuing medical education (CME) activity that utilizes international experts to provide evidence-based, guideline-consistent, and practice behavior-changing information focused on critical and challenging topics in clinical medicine.
As innovative research expands and unfolds, management of the patient with acute coronary syndrome continually takes on new dimensions. Join Dr. Eugene Braunwald and other experts as they delve into current and future pharmacotherapeutic strategies and issues surrounding the best practices for ACS patients.
Recently published data suggest that prior polyvascular disease increases the risk for inhospital adverse events in patients with ACS. Join Drs. Deepak Bhatt, Jean-Pierre Bassand, and José R. Gonzalez-Juanatey for a discussion of the current data on identification and management of patients with polyvascular disease.
AF can lead to stroke, congestive heart failure, and other serious complications. Successful management should include reducing these risks. Join our expert panel, Drs. Peter Rothwell, Donald Easton, and Mark Alberts, as they discuss new data and strategies for improving outcomes in patients with AF.
Despite modern therapy, the rates of death, MI, bleeding, and readmission remain high in patients with ACS. Join Drs. Jeffery Popma, Héctor Bueno, Freek Verheugt, and Sunil. Rao for a review of the latest data on antiplatelet therapy for patients with ACS.
How can we reduce the time taken to accurately diagnose ACS? ECGs and biomarkers may be nondiagnostic, even the presenting symptoms can vary or be absent. As every 30 minutes delay is associated with a 7.5% relative increase in mortality, time is indeed muscle. Join Drs. Gibson, Pride, Santini, and Krucoff as they present new insights into this complex field.
The rate of major adverse cardiac events was significantly lower among patients "reloaded" with atorvastatin 80 mg 12 hours prior to PCI and 40 mg just before the procedure than in those who did not receive the additional statin boost.
A new meta-analysis including some of the more contemporary statin trials has found that the agents significantly improve survival and reduce coronary and cardiovascular end points in primary-prevention populations, a benefit that extends to all subgroups. But the exact cost/benefit equation for each group remains to be determined.
Screening for contemporary biomarkers, such as CRP, will not add much to conventional cardiovascular risk factors in terms of helping to predict future events in the primary-prevention setting, say the authors of a new study.
White-coat hypertension and masked hypertension should not be regarded as benign, say the authors of a new 10-year study. The risk of developing sustained hypertension is higher in people with the above two conditions than in those who have normal blood pressure, they found.
Identifying these unstable coronary plaques could be used to aggressively treat patients who are at higher risk for future events, according to researchers. There are skeptics, however, and at present even researchers concede there are no different preventive measures available to treat those with high-risk lesions.
Experts suggest that early PCI is beneficial in STEMI patients already treated with fibrinolysis, as long as it is performed at least two hours after the lytic is given.
Investigators report that echogenicity, an ultrasound-based measure of plaque stability, was significantly improved among patients treated to very low LDL-cholesterol levels.
UPDATED // After a rocky ride in and out of the Texas legislature (twice) and most recently a perplexing pairing with bariatric surgery, the bill is now poised to become law September 1.
Patients hospitalized for CABG or MI were twice as likely to successfully quit smoking if they received intensive counseling in the hospital with follow-up support after discharge, in a recent study.
As well as being an independent risk factor for cardiovascular disease, psoriasis is also associated with an increased risk of cerebrovascular disease and peripheral arterial disease, a new case-control study has shown.
The role of lipids in women for primary prevention of cardiovascular disease is a challenging issue for all providers. Join Drs. Foody, Mora, and Welty as they discuss limitations to current risk stratification models, recent clinical trial data, and the changing paradigm in the management of lipids in women.
We know there are sex and biological differences in the manifestation of CVD. How do these pathophysiological differences affect the diagnosis and treatment of our female patients? Drs. Hayes, Johnson, Manson, and Piña provide their insight.
Despite increased awareness of CVD in women, contemporary studies demonstrate gender differences in outcomes. Differences in age and comorbidities account for some, but not all of these disparities. Join Dr. Foody as she discusses these issues with Drs. Mieres and Redberg.
Join Dr Robert Califf for a probing and personal interview with Dr Steven Nissen, about his activist days at the University of Michigan and the development of IVUS, to how he ended up at the Cleveland Clinic and what he thinks about the future of medicine in America.
Drs. Hayes and Foody and a committee of experts address the gaps and correct the misconception that CVD is more common in men than women.