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

Acute Coronary Syndromes

Latest European and US STEMI guidelines compared and contrasted

Nov 6, 2009 17:15 EST

The latest recommendations for the treatment of ST-elevation MI issued by American cardiology associations and the European Society of Cardiology are compared and contrasted in a new paper.

Interventional/Surgery

VELETI in print: Plaque sealing of SVGs a strategy "ahead of its time"?

Nov 4, 2009 15:30 EST

The imaging study was the first to show that stenting a non-flow-limiting stenosis of an SVG may help slow or halt the accelerated atherosclerosis that takes place in these vessels. An accompanying editorial cautions that the study does little more than "infer a trend toward anatomic benefit."

Imaging

CAC scoring plus SPECT provide long and short view of cardiac risk

6 COMMENTS - Nov 3, 2009 17:00 EST

UPDATED // An 1126-patient trial shows that SPECT and CAC scoring imaging tests are independent and complementary predictors of short- and long-term cardiac risk, respectively.

Interventional/Surgery

US updates advice on perioperative beta-blocker use in noncardiac surgery

5 COMMENTS - Nov 3, 2009 14:30 EST

A US update on the perioperative use of beta blockers for noncardiac surgery is, says the lead author, "similar" to recent European guidance on this issue.

Imaging

Imaging study shows plaque regression with niacin vs placebo

15 COMMENTS - Oct 30, 2009 16:00 EDT

Just weeks before ARBITER-HALTS 6 results come out at AHA 2009, an MRI study suggests that niacin is better than placebo in statin-treated patients with low HDL, at least for reducing carotid wall area. Experts say they'd also like to see insights into niacin effects on lipid-rich plaque volumes—the more commonly seen end point with MRI.

Acute Coronary Syndromes

First trial of viral-derived protein agent shows promise as anti-inflammatory ACS therapy

Oct 29, 2009 11:45 EDT

Inflammatory responses contribute to coronary plaque rupture, thrombosis, and vascular occlusion. Some viruses have proteins that interfere with these inflammatory responses. Researchers have identified a viral-derived protein that may eventually be an anti-inflammatory treatment for coronary syndromes.

Acute Coronary Syndromes

Sex differences in changing MI prevalence, mortality challenge conventional wisdom

Oct 29, 2009 10:30 EDT

Two well-known observational registries highlight such changes in women and men over a decade or more: Do women younger than 55 still have an advantage over men in the same age group?

Acute Coronary Syndromes

Bariatric surgery fails to reduce risk of MI long term

1 COMMENT - Oct 28, 2009 14:30 EDT

After a median follow-up of 12 years, MI rates were essentially the same among those treated with surgery and those who received conventional care for weight loss.

Acute Coronary Syndromes

Contrary to common belief, women feel same heart-attack symptoms as men

4 COMMENTS - Oct 27, 2009 14:30 EDT

Women and men have the same rates of chest pain and other classic symptoms during ACS, although women are more likely to experience some other symptoms such as jaw and neck pain.

Interventional/Surgery

NRMI data raise more questions about PCI in nonsurgery centers

4 COMMENTS - Oct 26, 2009 13:00 EDT

A new analysis of national registry data suggests that the superior outcomes of NSTEMI patients in hospitals with open-heart-surgery capabilities vs those without it are due to their size, procedure volume, and adherence to medication guidelines.

Lipid/Metabolic

New MESA data: Pericardial fat a better predictor of CHD than BMI

9 COMMENTS - Oct 23, 2009 17:00 EDT

Pericardial fat, which is found around the heart, predicts future CHD events and may even be a better predictor of these than conventional obesity measures, such as BMI and waist circumference, a new study of MESA participants shows.

Brain/Kidney/Peripheral

Iloprost prevents contrast-induced nephropathy in high-risk patients undergoing coronary intervention

Oct 21, 2009 13:00 EDT

Intravenously administered iloprost, a prostacyclin analog, may help prevent contrast-induced nephropathy in patients with renal dysfunction undergoing coronary procedures, a new pilot study suggests.

Clinical cardiology

ACE inhibitors of benefit in ischemic heart disease patients with preserved LV function

8 COMMENTS - Oct 19, 2009 17:00 EDT

Patients with ischemic heart disease and preserved LV function on standard therapy will gain additional benefit from taking ACE inhibitors, a new review concludes. The same cannot be said for ARBs, a drug class for which the evidence is much weaker, but these are a good substitute in those who cannot tolerate ACE inhibitors, the authors say.

Thrombosis Risk

TYCOON: One year of dual-antiplatelet therapy with DES isn't enough

3 COMMENTS - Oct 19, 2009 12:45 EDT

New results from an Italian registry reopen the question of how long drug-eluting stent recipients should stay on a dual antiplatelet regimen to prevent late thrombosis.

Heart failure

Transfusion in acute HF: No extra mortality risk

Oct 19, 2009 11:00 EDT

Blood transfusions for anemia in acute decompensated heart failure don't exacerbate outcomes, as may happen in some ACS cases, suggests a one-year experience of hospitals in Israel. On the contrary . . .

Prevention

Smoking bans reduce the risk of acute coronary events: IOM report

4 COMMENTS - Oct 16, 2009 16:00 EDT

IOM report confirms the cardiovascular benefit of implementing a ban on smoking in public places. The reduction in acute MI, anywhere from 6% to 47%, typically occurs quickly, often within 12 months of the ban.

Imaging

Zero CAC score not 100% reassuring in those presenting to ER with chest pain

14 COMMENTS - Oct 16, 2009 12:45 EDT

In those presenting to the ER with chest pain, a prior zero calcium score cannot completely rule out a coronary obstruction, a new analysis of the MESA study has shown. This is likely due to the presence of soft plaques not detected by calcium screening, the researchers say.

Acute Coronary Syndromes

Racial background woefully underreported in CV trials

1 COMMENT - Oct 15, 2009 13:15 EDT

Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.

Interventional/Surgery

Scripps starts routine genetic testing for clopidogrel responsiveness

5 COMMENTS - Oct 14, 2009 11:00 EDT

Scripps Health has announced that it is now offering patients undergoing elective stenting a test for the gene variants associated with an inability to convert clopidogrel to its active metabolite so that antiplatelet therapy can be individualized.

Thrombosis Risk

Hopes build for natriuretic-peptide risk stratification before noncardiac surgery

Oct 13, 2009 10:00 EDT

Could a preoperative blood assay take the place of imaging studies or other more costly assessments of cardiovascular risk? A meta-analysis suggests yes. A massive randomized trial is looking into it now.

Features

Target HbA_1c levels still the subject of much debate, but tailored therapy should be the aim

35 COMMENTS - Oct 9, 2009 16:45 EDT

Diabetologists are trying to tease out the best message to convey when it comes to target HbA_1c levels for primary-care physicians and other nonspecialists who might be treating patients with type 2 diabetes.

heartbriefs

EULAR: CV risk management in inflammatory arthritis

Oct 9, 2009 11:45 EDT

The European League Against Rheumatism has issued 10 recommendations for cardiovascular risk management in patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.

Thrombosis Risk

Coronary thrombosis—the culprit is not just plaque rupture

3 COMMENTS - Oct 8, 2009 17:45 EDT

Clots derived from a different source—erosions of the arterial wall—may be an important cause of MI and sudden death, particularly in younger women, who may need a different approach to treatment, new research suggests.

Prevention

New review confirms homocysteine lowering does not prevent CVD events

Oct 8, 2009 15:30 EDT

The latest review to look at the effects of homocysteine lowering with vitamin-B supplementation has come to much the same conclusions as most other studies and analyses in this field.

Arrhythmia/EP

IRIS confirms: No survival gains from early post-MI primary-prevention ICDs

1 COMMENT - Oct 7, 2009 17:00 EDT

Defibrillators implanted within a month of acute MI may prevent sudden cardiac deaths, but they don't reduce overall mortality, according to a trial that supports current guidelines based primarily on the smaller 2004 trial DINAMIT.

	Yes, at greater than or equal to 100 mg/day
	Yes, at less than 100 mg/day
	No