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heartbriefs

Sen Grassley questions top medical schools about ghostwriting

Nov 20, 2009 13:15 EST

As part of his mission to see more financial transparency in medicine, Sen Grassley has asked eight top US medical schools about their policies on ghostwriting.

Medscape Medical News

Stroke incidence related to PCI steady over 15 years

2 COMMENTS - Nov 20, 2009 13:00 EST

Mayo Clinic researchers report that their stroke rate related to PCI has stayed steady for the last 15 years, something they interpret as good news, given that substantially older, sicker patients with more complex anatomy are now undergoing PCI.

News

EFFECT: Public reporting of hospital performance improves quality of care?

Nov 19, 2009 10:00 EST

Publicly released report cards based on hospital performance did not result in a measurably greater systemwide improvement in two composite AMI or CHF process-of-care indicators in a Canadian study. But they did appear to stimulate some important changes in delivery of care that could have led to some better outcomes.

Acute Coronary Syndromes

ACC/AHA focused update of guidelines for STEMI, PCI

9 COMMENTS - Nov 18, 2009 09:00 EST

The latest evidence for the treatment of STEMI and PCI has been incorporated into a fast-track update of US guidelines. But questions remain about the quality of some of the evidence informing the guidelines and about the composition of the writing committees.

Medscape Medical News

RE-LY: Post hoc analysis confirms benefit of dabigatran relative to warfarin at all INR levels

Nov 17, 2009 16:30 EST

A new analysis confirms that regardless of INR control achieved across participating centers, dabigatran remained noninferior at the lower dose and superior at the higher dose to warfarin for prevention of stroke and systemic embolism.

Heart failure

HEAAL: High-dose trumps low-dose ARB for heart failure in the ACE-inhibitor intolerant

1 COMMENT - Nov 17, 2009 08:15 EST

UPDATED WITH COMMENTARY // The randomized trial, which compared losartan dosages of 150 mg/day and 50 mg/day, "makes a strong case for the value of incremental inhibition of the renin-angiotensin system," its authors say.

Heart failure

FAIR-HF: Symptom improvement, functional gains follow correction of iron deficiency in heart failure

3 COMMENTS - Nov 17, 2009 08:00 EST

UPDATED WITH COMMENTARY // The randomized, placebo-controlled study's intriguing wrinkle: the benefits after 24 weeks of treatment with an injectable form of iron were independent of whether the patients were anemic.

Brain/Kidney/Peripheral

Bypassing the blues: How simple collaborative care can help tackle depression after CABG surgery

Nov 16, 2009 18:45 EST

Depression after coronary artery bypass surgery is often overlooked by physicians but is associated with worse outcomes. A new US study illustrates a simple telephone-based approach to tackle this, with nurses encouraging patients to seek help from their primary-care doctors and providing ongoing feedback and review.

Interventional/Surgery

Postop anemia in high-CV-risk patients: No CV gains from fixed hemoglobin target in trial

Nov 16, 2009 17:45 EST

A randomized trial found no protection from in-hospital cardiovascular events with a strategy of blood transfusions to maintain hemoglobin above 10 g/dL, compared with a more conservative approach to transfusion therapy, in patients with CV disease or risk factors who underwent hip surgery.

Medscape Medical News

SGR repair bill failure could cool physician support for healthcare reform

Nov 12, 2009 15:00 EST

Now that the US House of Representatives has passed a healthcare reform bill, organized medicine anticipates another vote—possibly next week—on a second bill that would rewrite Medicare's controversial sustainable-growth-rate formula for physician reimbursement.

Interventional/Surgery

ASTRAL finds no benefit of revascularization over medical therapy alone for renal-artery stenosis

9 COMMENTS - Nov 11, 2009 17:00 EST

Percutaneous revascularization of atherosclerotic renal arteries improves patency, but its benefits on renal function have been evaluated only in small studies. The 806-patient ASTRAL trial found no evidence of benefit from revascularization.

News

What's going to be hot at AHA 2009?

2 COMMENTS - Nov 11, 2009 09:00 EST

Anticipation is building for full trial results from ARBITER 6-HALTS, plus a better understanding of what went wrong with cangrelor in the CHAMPION trials. Also in the lineup are updates from PLATO, RE-LY, ALLHAT, BARI 2D, STICH, CASCADE, POPULAR, HEARTMATE II, and many more. Indeed, this year's "late-breaking" sessions include more than 30 trials over five days.

Clinical cardiology

Walking speed predicts CV mortality in older people

4 COMMENTS - Nov 10, 2009 19:01 EST

Fast walkers should find themselves less likely to succumb to cardiovascular death, according to a new French study in older adults. Measuring general fitness in this way could easily be incorporated into a general global assessment of cardiovascular risk, say the researchers.

Prevention

No benefits of aspirin for primary prevention in diabetics, meta-analysis suggests

6 COMMENTS - Nov 10, 2009 17:15 EST

Most guideline documents recommend aspirin for primary prevention in people with diabetes, but a new meta-analysis has found no benefit of the widely used drug across a range of different cardiovascular end points. The results speak to the need for dedicated randomized trials, investigators say.

Medscape Medical News

Echocardiographic evidence of PAH often doesn't trigger referral to a specialist

Nov 10, 2009 11:00 EST

Only one in four patients with echocardiographic evidence of pulmonary arterial hypertension is being referred for further evaluation.

Hypertension

Ambrisentan effective long-term for pulmonary arterial hypertension

1 COMMENT - Nov 9, 2009 17:00 EST

New data from the extension phase of two pivotal trials of the endothelin-receptor antagonist ambrisentan support its use as part of a long-term strategy for the treatment of pulmonary arterial hypertension.

Arrhythmia/EP

Obesity may top hypertension as risk factor for LA enlargement

Nov 9, 2009 17:00 EST

Obesity and hypertension were major independent risk factors for left atrial enlargement (itself a risk factor for atrial fibrillation) in an observational, population-based study, but obesity was the strongest predictor.

Acute Coronary Syndromes

Latest European and US STEMI guidelines compared and contrasted

7 COMMENTS - 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.

Arrhythmia/EP

Enrollment halts in randomized trial of CPR for out-of-hospital arrest

Nov 6, 2009 16:00 EST

No survival differences after out-of-hospital cardiac arrest were seen at a preliminary DSMB review in the ROC PRIMED trial, which compared early vs delayed post-CPR assessment for defibrillation and tested the effectiveness of a device for optimizing intrathoracic pressure during CPR.

heartbriefs

Serum phosphorous, kidney function predict CAC

Nov 5, 2009 17:00 EST

The Spokane Heart Study finds a connection between kidney function, serum phosphorus, and the risk of coronary artery calcification.

Medscape Medical News

Prehospital triage "immediately successful" in boosting rates of thrombolytic therapy for stroke

Nov 5, 2009 11:00 EST

Toronto researchers report that a citywide prehospital protocol raised their rates of thrombolytic treatment to among the highest in North America, underlining, they say, the critical importance of organized stroke care.

Interventional/Surgery

Off-pump CABG shows no benefit over on-pump approach: ROOBY study

10 COMMENTS - Nov 4, 2009 17:00 EST

A 2203-patient randomized trial of off-pump vs on-pump CABG surgery found no differences in neuropsychological outcomes and worse overall outcomes for the off-pump group at one-year follow-up.

Hypertension

Adding fuel to the J-curve fire; debate is reignited

2 COMMENTS - Nov 4, 2009 14:30 EST

More discussion about the J-curve in hypertension is published this week; one expert believes the undue attention being paid to this subject might discourage doctors from treating high blood pressure aggressively.

heartbriefs

No CV risk reduction with B vitamins posttransplant

Nov 4, 2009 13:15 EST

In keeping with all the other evidence showing no effects of homocysteine-lowering with B vitamins, the FAVORIT study now confirms that this lack of benefit is also seen in renal-transplant recipients.

Interventional/Surgery

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

6 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.

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