Brain/Kidney/Peripheral

Thrombosis Risk

Ultrasound-based strategies comparable for DVT diagnosis, treatment guidance

Oct 7, 2008 17:30 EDT

A randomized trial found that two ultrasound-based strategies were similarly effective at determining the need for anticoagulation in symptomatic patients with suspected deep-vein thrombosis; both have strengths and weaknesses. (Bernardi E et al. JAMA 2008; 300:1653-1659.)

Chicago, IL - Two ultrasound-based evaluations, both with their advantages and disadvantages, are about equally effective at guiding the management of patients with suspected lower-extremity deep-vein thrombosis (DVT), conclude the authors of a randomized trial reported in the October 8, 2008 issue of Journal of the American Medical Association [1]. But the writer of an accompanying editorial [2] gives the edge to one of the techniques, the one that's been around longer and is simpler and probably more widely available, and notes that a clinical prediction rule not evaluated in the study can also play a role in the initial evaluation of DVT. Read full article »

(Bernardi E et al. JAMA 2008;300:1653-1659.)

Inside: Brain/Kidney/Peripheral

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

Interventional/Surgery

Challenging cases: Lower limb intervention

Mar 27, 2008 11:13 EDT

Dr Alan Lumsden walks us through a lower limb percutaneous revascularization procedure, pointing out technical tips and common pitfalls along the way.

MediaPulse

Cheney's AF recurs, electrical defibrillation scheduled

1 COMMENT - Oct 15, 2008 13:00 EDT

Arrhythmia/EP

Continuous amiodarone for sinus-rhythm maintenance upheld in randomized AF trial

1 COMMENT - Oct 15, 2008 10:30 EDT

An "episodic" amiodarone regimen was less safe and effective and didn't reduce complications from the drug's toxicity. (Ahmed S et al. JAMA 2008; 300:1784-1792.)

Clinical cardiology

New rofecoxib data will help inform treatment decisions with other coxibs, NSAIDs

Oct 13, 2008 18:30 EDT

New results from the extended follow-up of the APPROVE trial provide a more complete assessment of the cardiovascular toxicity of the COX-2 inhibitor rofecoxib than previously reported. The findings are still very relevant, because this is a class effect, say the researchers and editorialists. (Baron JA et al. Lancet; published online before print October 13, 2008.)

Hypertension

Good and bad news on hypertension in US

Oct 13, 2008 16:00 EDT

A new report shows that more US adults have hypertension than ever before, and the increase is primarily due to the rising rates of obesity in recent times, say the NHLBI researchers. However, awareness, treatment, and control of blood pressure have also improved. Nevertheless, much work remains, specifically with certain subgroups, they say. (Cutler JA et al. Hypertension; published online October 13, 2008.)

Arrhythmia/EP

Warfarin warning: Shortfalls in anticoagulation for AF up risks of ICH and embolic stroke

9 COMMENTS - Oct 10, 2008 12:45 EDT

Documentation of the care of patients in a nationwide health plan suggests that less than half of patients with atrial fibrillation are prescribed an anticoagulant. (Walker AM, Bennett D. Heart Rhythm 2008; 5:1365-1372.)

Brain/Kidney/Peripheral

NOMAS: Just a 2% overlap for PFO and migraine; St Jude shuts down ESCAPE trial

Oct 9, 2008 14:30 EDT

While both migraine and PFO occurred in roughly 15% of the NOMAS participants, the two were rarely found together. Experts agree: hopes are dimming that PFO closure may help migraineurs. Indeed, only one company is still testing this hypothesis in randomized trials. (Rundek T et al. Circulation 2008; 118:1419-1424.)

Prevention

Societies confront GI risks of antiplatelets, NSAIDs in consensus document

1 COMMENT - Oct 7, 2008 10:00 EDT

It addresses a common clinical problem for which there is little clinical-trial-quality data for guidance and gives a starring role to proton-pump inhibitors in treating GI ulcers and bleeding and, in high-risk groups, in their prevention. (Bhatt DL et al. J Am Coll Cardiol; Circulation; published online before print October 3, 2008.)

Brain/Kidney/Peripheral

Endovascular AAA repair cost-effective in high-risk patients

Oct 6, 2008 14:30 EDT

The average one-year costs for EVAR and open surgery were nearly identical, despite the significantly more expensive endovascular procedural costs. Patients undergoing endovascular repair spent less time in the hospital, and this reduced morbidity translated into lower nonprocedural costs. (Tarride JE et al. J Vasc Surg 2008; 48:779-787.)

Acute Coronary Syndrome

New study finds type of HRT is key with regard to MI risk

Oct 1, 2008 13:45 EDT

Important new information on HRT and the risk of MI has emerged from a Danish observational study, which finds that the type of HRT used could be key when it comes to the likelihood of a heart attack. (Lokkegaard E et al. Eur Heart J; published online before print September 30, 2008.)

Brain/Kidney/Peripheral

"Consider" candesartan for diabetic retinopathy

Sep 26, 2008 10:45 EDT

Despite meeting none of the primary end points in the three DIRECT studies in diabetic retinopathy, the angiotensin receptor blocker candesartan could still be considered a treatment option in certain patients with this condition, say the trial authors and accompanying editorialists. (Chaturvedi N et al. Sjølie AK et al. Lancet; published online before print September 25, 2008.)

Brain/Kidney/Peripheral

Inhaled anticholinergics for COPD raise CV-event risk in meta-analysis

7 COMMENTS - Sep 23, 2008 16:00 EDT

Chronic use of inhaled ipratropium or tiotropium bromide independently increased the risk of CV death by 80%; patients who took them for at least six months appeared the most vulnerable. A forthcoming randomized trial may provide more authoritative guidance on the issue. (Singh S et al. JAMA 2008; 300:1439-1450.)

Heart failure

Severe subclinical hypothyroidism ups risk of HF

Sep 22, 2008 17:00 EDT

A new study has found that older adults with severe subclinical hypothyroidism had almost double the risk of developing heart failure compared with those with normal thyroid function. The findings are important to inform the debate on whether to screen and treat subclinical hypothyroidism, say the researchers. (Rodondi N et al. J Am Coll Cardiol 2008; 52:1152-1159.)

Brain/Kidney/Peripheral

Passive smoking ups risk of PAD by 50%

Sep 22, 2008 16:00 EDT

Chinese researchers have reported, for the first time, a link between exposure to passive smoke and peripheral arterial disease in a cohort of women who have never smoked. They call for urgent public-health measures to protect individuals from secondhand smoke. (He Y et al. Circulation: published online before print September 22, 2008.)

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