theheart.org: Brain, kidney and peripheral medical news

Hypertension

INVEST: Mortality hazard with lowest blood pressures in diabetics with CAD?

1 COMMENT - Mar 14, 2010 18:00 EDT

Diabetic patients whose systolic blood pressure was lowered to 130 to 140 mm Hg had a better outcome than those with systolic pressures over 140. But reductions below 130 did not appear to offer any additional benefit and had a higher mortality rate in this retrospective analysis.

Atlanta, GA - Intensive blood-pressure control in patients with diabetes and cardiovascular disease was associated with a higher mortality rate than usual control, in a new retrospective analysis of the International Verapamil SR-Trandolapril (INVEST) trial.

The analysis, presented today at the American College of Cardiology (ACC) 2010 Scientific Sessions, found that patients whose systolic blood pressure was lowered to 130 to 140 mm Hg had a better outcome than those with systolic pressures over 140 mm Hg. But those whose systolic blood pressure was reduced to below 130 mm Hg did not appear to receive any additional benefit and had a higher mortality rate. Read full article »

Brain/Kidney/Peripheral

Abnormal ABI an indicator of cardiovascular events in low-risk elderly

2 COMMENTS - Mar 19, 2010 15:00 EDT

An abnormal ankle-brachial index can predict an increased risk for future cardiovascular events in elderly people with low to intermediate Framingham risk scores, according to results from a new study.

Hypertension

ACE inhibitor/ARBs still used in pregnancy despite teratogenicity

1 COMMENT - Mar 19, 2010 14:15 EDT

New research from the UK has found that doctors are still prescribing ACE inhibitors and angiotensin-receptor blockers in women of child-bearing age, despite evidence that they are teratogenic. Reasons include a lack of awareness of the issue among GPs and obstetricians and ambiguity in hypertension guidelines, says the researcher.

Arrhythmia/EP

Watchman delayed: FDA wants more data on the LAA-closure device before approving

Mar 19, 2010 11:15 EDT

Atritech, the maker of the Watchman device, announced that the FDA requested another study to provide more safety and effectiveness data before it will approve the LAA-closure device.

Heart failure

Broaden CRT indications to include mild heart failure, recommends FDA advisory panel

1 COMMENT - Mar 19, 2010 09:00 EDT

The panel unanimously recommended that cardiac resynchronization therapy indications be extended to include patients in NYHA functional class 1 or 2, with a few added twists aimed at excluding subgroups that are least likely to benefit from the device therapy.

Hypertension

Mar 18, 2010 16:00 EDT

A new BP-lowering drug that acts in a similar way to omapatrilat—an agent that never quite made it to the market—has shown promise in a preliminary trial. Crucially, this dual inhibiting agent, named LCZ696, blocks angiotensin II rather than angiotensin-converting enzyme; there was no indication of angioedema in the study.

Heart failure

How to diurese in acute HF: Dosing strategies get an evidence base

Mar 17, 2010 11:00 EDT

Is it safe to start patients with acute decompensated heart failure on loop diuretics at higher-than-standard doses? And is it more effective to administer them in a continuous infusion or intermittent boluses? Until the DOSE trial asked those questions, IV diuretic strategies in ADHF had never or rarely been put to a randomized, controlled test.

Interventional/Surgery

PLATO CABG analysis confuses cardiologists

6 COMMENTS - 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."

Thrombosis

Warfarin genotyping reduces hospitalizations

Mar 16, 2010 16:00 EDT

Although there was a suggestion that some of the effect could have simply been due to more attention being paid to the patients, most agree that any intervention that helps warfarin control is worthwhile.

Hypertension

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

1 COMMENT - 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.

Arrhythmia/EP

New factor Xa inhibitor betrixaban safe in phase 2 AF trial

Mar 15, 2010 14:45 EDT

A novel oral factor Xa inhibitor, betrixaban, was safe and well tolerated when compared with warfarin in a phase 2 trial in patients with AF. Along with other new anticoagulants, this could represent an advance on warfarin, but betrixaban first needs to be evaluated in a much larger phase 3 trial, said the lead researcher.

Arrhythmia/EP

Safely switch from amiodarone to dronedarone in two days, suggests analysis

Mar 15, 2010 08:30 EDT

Most patients, at least, who are in sinus rhythm after cardioversion from atrial fibrillation and for whom a transition from the old drug to the new one is planned can switch in two days. The post hoc analysis points to two signals that waiting longer might be safer, according to researchers.

View all »

Editorial Programs

The Cardiology Show

ACC 2010 Review from Atlanta: INVEST, ACCORD, EVEREST II, and NAVIGATOR

Mar 17, 2010 16:25 EDT

Dr Valentin Fuster sits down with Drs Peter Berger, Anne Curtis, Tim Gardner, Tony Gershlick, Harlan Krumholz, Darren McGuire, Ileana Piña, and Rita Redberg to discuss the lessons learned at the ACC 2010 Scientific Sessions, including why lower may not be better for blood pressure, why preventing diabetes does not necessarily reduce cardiovascular risk, and the future of the mitral-valve clip.

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?

5 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.