theheart.org: Acute Coronary Syndromes (ACS) news and education

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Brain/Kidney/Peripheral

AAA: Aspirin not warranted in healthy subjects with low ABI, based on population screening

5 COMMENTS - Mar 2, 2010 16:00 EST

Authors of the study say their study does not rule out a role for ankle/brachial index screening in the clinic or for other CVD drugs to reduce risk in asymptomatic subjects. But for aspirin and for populationwide screening, the study raises some questions.

Edinburgh, UK - Results of the Aspirin for Asymptomatic Atherosclerosis (AAA) trial, showing no reduction in vascular events in asymptomatic subjects with a low ankle/brachial index (ABI) randomized to daily aspirin, have now been published in the March 3, 2010 issue of the Journal of the American Medical Association [1]. First presented at the ESC 2009 meeting and reported there by heartwire, the trial adds to mounting evidence that the risks of aspirin may outweigh its benefits in people without established cardiovascular disease. Read full article »

Inside: Acute Coronary Syndromes

Accredited educational programs, supported by industry, developed by theheart.org

Acute Coronary Syndromes

Focus on Antiplatelet Therapy at AHA 2009

Feb 12, 2010 14:07 EST

CHAMPION, PLATO, and OPTIMUS were among the trials featured at AHA. Read Dr. Prasad's review and watch presentations by Drs. Angiolillo, Gurbel, Harrington, and Storey.

Acute Coronary Syndromes

The Key to Their Hearts: The Indispensable Role of the Primary Care Clinician in the Management of Patients Post-MI

Feb 12, 2010 10:16 EST

Drs Toth and McPherson discuss the importance of collaboration between PCPs and cardiologists in managing patients with ACS to decrease adverse outcomes and mortality. They review the ACC/AHA guidelines for appropriate length of therapy, risk factor reduction, and medication use before and after interventions.

Acute Coronary Syndromes

Best Practices in STEMI Management: The Crossroads of Bleeding and Outcomes

Feb 3, 2010 10:49 EST

Dr. Gabriel Steg introduces a discussion between Drs. Anthony Gershlick and Martial Hamon on achieving a balance between favorable outcomes and reducing bleeding in STEMI patients.

Acute Coronary Syndromes

Improving Outcomes in STEMI: Management of Adjunctive Antithrombotic Therapy in ACS

Nov 26, 2009 11:27 EST

Our international panel of experts, Drs. Hamm, Verheugt, Dauerman, and Rao, give their insights into which antiplatelet and antithrombotic agents they prefer to use and when.

Acute Coronary Syndromes

Antiplatelet Therapy for Atherothrombotic Disease: Taking the Next Steps

1 COMMENT - Jan 4, 2010 14:37 EST

Examine current perspectives in antiplatelet therapy on emerging agents vs current therapy, and review data from recently completed clinical trials.

Acute Coronary Syndromes

Thrombosis: Describing the Clinical Link Between the Coagulation Cascade and Platelet Function

2 COMMENTS - Dec 14, 2009 17:21 EST

Join Drs. Alexander, Becker, and Weitz for a discussion on the coagulation cascade, its link to platelet function, and the risk/benefit and clinical utility of agents that target the coagulation cascade and platelet receptors.

Acute Coronary Syndromes

Translating Evidence From Trials With Antiplatelet Agents Into Clinical Practice

Dec 8, 2009 10:03 EST

Recently reported and new trials of antiplatelet therapy continue to redefine optimal management strategies for patients with atherothrombotic disease and patients with atrial fibrillation. Drs. Harrington, Angiolillo, Bhatt, Connolly, Mehta, and Simon discuss guidelines? recommendations for the use of antiplatelet therapies and the potential impact of emerging data regarding currently used and novel antiplatelet agents.

Acute Coronary Syndromes

The Role of Antiplatelet Therapy in the Management of Patients with NSTE ACS

1 COMMENT - Oct 28, 2009 10:46 EDT

In the US, each year over 1.4 million people will be hospitalized for unstable angina (UA) and non-ST-segment-elevation myocardial infarction (NSTEMI). Multiple antiplatelet agents have been developed to interfere with or inhibit the specific pathways of platelet activation and aggregation that lead to the development of UA and NSTEMI. Join Drs Newby, Popma, and Wiviot as they discuss.

NonMenu Sponsored Content

What Happened at ESC 2009? The Perspective From DUKE Heart Center and DUKE Clinical Research Institute

Sep 17, 2009 15:13 EDT

What Happened at ESC 2009? The Perspective From DUKE Heart Center and DUKE Clinical Research Institute
Drs. Rao, Alexander, Newby, and O?Connor discuss RE-LY, PLATO, and MADIT-CRT.

Interventional/Surgery

PLATO CABG analysis confuses cardiologists

1 COMMENT - Mar 16, 2010 17:15 EDT

Cardiologists here at the ACC meeting were confused by a new analysis of PLATO, this time in ACS patients who subsequently underwent CABG surgery. Those in the ticagrelor group were 50% less likely to die, despite the fact that there was no difference in bleeding or MIs between these patients and those who got clopidogrel. The investigator admitted he didn't have the answers, and further analyses "are ongoing."

Interventional/Surgery

Is triple antiplatelet therapy after PCI the way forward?

Mar 16, 2010 11:00 EDT

Adding cilostazol to clopidogrel and aspirin did not significantly reduce event rates, but it did improve posttreatment platelet reactivity in the CILON-T trial, and the study was underpowered for hard clinical events.

Hypertension

Is BP variability a stronger determinant of CV outcomes than mean pressure?

Mar 16, 2010 09:45 EDT

A host of new analyses published in the Lancet journals, some of which were also reported at the ACC meeting, suggest that variability in blood pressure is a much stronger determinant of both stroke and coronary disease outcome than average blood pressure. And calcium-channel blockers have the strongest effect of all antihypertensives on reducing BP variability, say the researchers.

Interventional/Surgery

Cardiologists voice concern on FDA clopidogrel warning

3 COMMENTS - Mar 16, 2010 09:00 EDT

Several experts have questioned why the FDA has issued a warning about poor metabolizers of clopidogrel when there are no firm data about what to do for these patients.

Thrombosis

Optimal dual antiplatelet duration in REAL-LATE, ZEST-LATE: Too little, too soon

3 COMMENTS - Mar 15, 2010 10:30 EDT

UPDATED // Cardiologists of every stripe are eager for any new information on just how long their patients should be taking dual antiplatelet therapy after receiving a drug-eluting stent. But the REAL-LATE/ZEST-LATE analysis seems to provide more questions than answers. The question everyone now seems to be asking now is, so what?

Acute Coronary Syndromes

"Lenient" as good as "strict" ventricular rate control in permanent AF: RACE-2 trial

Mar 15, 2010 08:00 EDT

UPDATED // The standard heart-rate target of <80 bpm doesn't lead to better clinical outcomes and is harder to achieve than a target of <110 bpm, a prospective randomized trial found.

Acute Coronary Syndromes

New meta-analysis: Routine invasive strategy betters selective care for non-ST-elevation ACS

Mar 14, 2010 18:45 EDT

A more aggressive routine invasive strategy is clearly better than a conservative selective invasive strategy for all patients with non-ST-elevation acute coronary syndromes, a new meta-analysis shows. And the highest-risk patients had the most to gain, indicating that risk stratification is crucial, says the lead researcher.

Hypertension

ACCORD BP: Intensive BP lowering futile in diabetics

5 COMMENTS - Mar 14, 2010 08:00 EDT

The ACCORD BP study shows that there is no benefit to be gained from intensively lowering systolic blood pressure to less than 120 mm Hg in type 2 diabetics; for now, a goal of <140 mm Hg seems reasonable in this population, say the authors.

Clinical cardiology

Fitness more important than fatness for thrombotic risk in firefighters

Mar 13, 2010 16:45 EST

Despite looking fit and healthy, a third of firefighters examined in a new study were at high risk of a thrombotic event, and improving their fitness is more likely to reduce this risk than tackling excess body weight, say the researchers.

Medscape Medical News

Clopidogrel receives boxed warning for reduced benefit in poor metabolizers

8 COMMENTS - Mar 12, 2010 17:42 EST

The warning will inform clinicians that tests are available to predict whether a patient will convert the drug to its active form based on the genetic profile of a key liver enzyme.

Interventional/Surgery

ISAR-DESIRE 2: No advantage, no downside to switching stents for DES in-stent restenosis

Mar 11, 2010 14:00 EST

Either a sirolimus-eluting stent or a paclitaxel-eluting stent are suitable choices for treating in-stent restenosis of a sirolimus-eluting stent. Whether plain old or drug-eluting-balloon angioplasty might also work remains an open question.

The Heart of a Woman

Primary and Secondary Prevention of CVD and Stroke in Women

Racial/Ethnic Disparities: CVD in African American Women

Feb 24, 2010 10:29 EST

Drs. Hayes and Ofili discuss disparities in the care of African American women with CVD, followed by Dr. Mitchell's presentation on heart failure.
Primary and Secondary Prevention of CVD and Stroke in Women

Primary Prevention in Women: The Role of Lipids

4 COMMENTS - Jul 2, 2009 00:00 EDT

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.
Primary and Secondary Prevention of CVD and Stroke in Women

All About Eve: The Unique Aspects of CVD in Women

3 COMMENTS - May 29, 2009 00:00 EDT

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.

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Editorial Programs

Editorial series

Informed consent, clinical research, and patient care

1 COMMENT - Mar 11, 2010 14:20 EST

Does informed consent protect patients or shield researchers? Join the debate with Dr Bob Harrington and his guests Drs Deepak Bhatt and Harvey White.

Editorial series

Women in cardiology: Is gender an issue?

4 COMMENTS - Mar 4, 2010 10:15 EST

Do gender perceptions affect the way female physicians are treated in cardiology? Drs Melissa Walton-Shirley, Judith Hochman, Suzanne Oparil, and Lynne Warner Stevenson tackle this important question.

Editorial series

Public smoking bans and cardiovascular health

15 COMMENTS - Feb 25, 2010 15:25 EST

Studies suggest public smoking bans reduce the incidence of acute MI. So why is America not smoke-free? Dr Melissa Walton-Shirley discusses this important issue with the AHA's Nancy Brown and Dr Clyde Yancy.