Clinical cardiology

Interventional/Surgery

Lower stroke and death rates with carotid endarterectomy vs carotid stenting

Dec 2, 2008 19:00 EST

With conflicting data in the literature about stenting vs endarterectomy, a couple of highly anticipated randomized studies will be important in determining the future applicability of carotid artery stenting in patients with carotid artery stenosis, say investigators. (McPhee JT et al. J Vasc Surg; published online before print September 30, 2008.)

Arrhythmia/EP

Female heavy drinkers have increased risk of AF

Dec 2, 2008 16:00 EST

Beware that extra glass of wine—women consuming more than two alcoholic drinks per day are at increased risk of developing atrial fibrillation compared with their nondrinking counterparts, a new US study has found. (Conen D et al. JAMA 2008; 300:2489-2496.)

Clinical cardiology

Generic drugs in CVD: Just as effective as brand-name pills

5 COMMENTS - Dec 2, 2008 16:00 EST

Twenty years of research show that generic CVD drugs across nine classes are just as good as brand-name agents, yet editorials often boost superiority of brand-name agents. (Kesselheim AS et al. JAMA 2008; 300:2514-2526.)

Prevention

Rapid-response teams may not reduce hospital codes or mortality rate

1 COMMENT - Dec 2, 2008 16:00 EST

Specialized teams trained to recognize and respond to early signs of cardiopulmonary arrest, thereby preventing "code blues" before they happen, are popping up at hospitals around the US, but a new study suggests there may be no evidence to support their use. (Chan PS et al. JAMA 2008; 300:2506-2513.)

Lipid/Metabolic

New research reveals how binge drinking could drive atherosclerosis

Dec 2, 2008 13:30 EST

It's not just the amount of alcohol is drunk, but the way that it is drunk that is important when it comes to cardiovascular health. New research suggests a precise mechanism by which binge drinking might contribute to atherosclerosis. (Redmond EM et al. Atherosclerosis; published online before print October 18, 2008.)

Interventional/Surgery

"Striking" difference in quality of CABG across US hospitals

Nov 27, 2008 14:30 EST

Sex differences in risk-adjusted death rates for CABG surgery in the US vary between the best- and worst-performing hospitals, a new study shows. And those of either sex treated in the worst hospitals were four times more likely to die than those treated in the top hospitals, illustrating a "striking" quality difference. (Culler et al. Arch Intern Med 208; 168:2317-2322.)

Clinical cardiology

CORE 64 published as debate over trial progress, technology proliferation continues

1 COMMENT - Nov 26, 2008 17:00 EST

Investigators say CORE 64 shows that CT angiography can accurately identify the presence and severity of obstructive CAD in symptomatic patients but that it is not yet at the point where it can replace invasive coronary angiography. Others focus on the widespread use of CT tests, despite no randomized clinical-trial data supporting its use. (Miller JM et al. Redberg R and Walsh J. N Engl J Med 2008; 359:2324-2336, 2309-2310.)

Arrhythmia/EP

GASP! Agonal breathing common, predicts survival after out-of-hospital cardiac arrest

Nov 26, 2008 16:30 EST

It tripled the patient's chances for surviving to hospital discharge in a retrospective study; discharge was five times more likely if there was also bystander cardiopulmonary resuscitation. (Bobrow BJ et al. Circulation; published online before print November 24, 2008.)

Clinical cardiology

Periodontal disease associated with elevated levels of Lp-PLA₂

Nov 25, 2008 18:30 EST

The independent association between oral health and inflammation suggests that inflammation may be a factor in the relation between oral health and cardiovascular disease, report investigators. (Mochari H et al. Am J Cardiol 2008; 102:1509-1513.)

Lipid/Metabolic

Diabetics with poor glycemic control and 9p21 variant at high risk of CAD

Nov 25, 2008 17:00 EST

New research has found that type 2 diabetics who carry two copies of the variant 9p21 allele are at higher risk of coronary artery disease and that this risk is amplified if they also have poor glycemic control. The findings may have prognostic implications for such patients, say the researchers. (Doria A et al. JAMA 2008; 300:2389-2397.)

Clinical cardiology

Lack of exercise, other bad behaviors explain link between depression and CVD, study suggests

Nov 25, 2008 16:00 EST

Physical inactivity, smoking, and poor adherence to medication probably explain why people with depression are at higher risk of CV events, and not "fancy physiological mediators," investigators for the Heart and Soul Study say. (Whooley MA et al. JAMA 2008; 300:2379-2388.)

Heart failure

Older patients face higher mortality, CHF hospitalizations with rosiglitazone over pioglitazone

14 COMMENTS - Nov 24, 2008 18:00 EST

A retrospective analysis of Medicare beneficiaries found all-cause mortality to be increased by 15% in patients taking rosiglitazone, while congestive heart failure hospitalizations were 13% higher. Stroke and MI, however, were no different between the treatment groups. (Winkelmayer WC et al. Arch Intern Med 2008; 168:2368-2375.)

Heart failure

An emerging picture of heart failure in Africa

Nov 24, 2008 16:00 EST

One of the largest and most comprehensive studies of heart failure to date in Africa has shown that the disease is a big problem and that although the traditional causes of HF—which differ from those seen in Western nations—still predominate, there are signs that the range of etiologies is broadening (Stewart S et al. Circulation 2008; published online before print November 24, 2008.)

Acute Coronary Syndrome

Lower-than-expected bleeding in CABG patients taking clopidogrel within five days preop

2 COMMENTS - Nov 24, 2008 11:30 EST

People who took clopidogrel within five days of their procedure were more likely to require red blood cell transfusions but no more likely to require reoperation for bleeding than people who had taken it more than five days beforehand, the study showed. One surgeon cautions this is not a "carte blanche" for clopidogrel. (Kim JHJ et al. Am Heart J 2008; 886-892.)

Arrhythmia/EP

Remote ICD monitoring safely cuts clinic visits in large randomized trial

Nov 24, 2008 10:30 EST

There had previously been few prospective data to support the increasingly common strategy for following patients with the devices. (American Heart Association 2008 Scientific Sessions.)

Arrhythmia/EP

FDA panel unanimously recommends approval of first AF ablation catheter

Nov 21, 2008 17:30 EST

UPDATED // The new device, known as the NaviStar ThermoCool radiofrequency ablation catheter, would be the first approved for the treatment of atrial fibrillation.

Clinical cardiology

Change in heart rate over time predicts mortality

Nov 21, 2008 13:00 EST

The first study to ever assess the prognostic value of a change in heart rate over a number of years has found that increasing HR over time can increase mortality, by around 20%. Conversely, a decline in HR was accompanied by reduced rate of death over the five-year study period. (Jouven et al. Am J Cardiol; published online before print November 7, 2008.)

Hypertension

LVEF data refine ALLHAT message to favor diuretic as HTN monotherapy

3 COMMENTS - Nov 21, 2008 10:15 EST

Chlorthalidone and lisinopril as initial antihypertensive agents were about equally effective at reducing the risk of new systolic heart failure, an analysis suggests; the thiazide was superior at preventing heart failure with preserved EF. (Davis BR et al. Circulation; published online before print November 10, 2008.)

Thrombosis Risk

Bevacizumab significantly increases venous thromboembolism

Nov 18, 2008 16:00 EST

The risk of venous thromboembolism was increased by 33%, compared with controls, concludes a new meta-analysis of 15 cancer trials. (Nalluri SR et al. JAMA 2008; 300:277-2285.)

Acute Coronary Syndrome

ACC/AHA publishes new performance measures for STEMI patients

1 COMMENT - Nov 18, 2008 13:30 EST

Differing from guidelines, the new performance measures identify aspects of care with evidence so strong, such as prescribing a statin upon discharge or delivering reperfusion in a timely manner, that every patient should be receiving the same treatment. In other words, "If you're not doing things a certain way, then you're not providing the best care," says one expert. (Masoudi FA et al. Krumholz HM et al. J Am Coll Cardiol, Circulation; published online before print November 10, 2008.)

Clinical cardiology

ECGs add little when it comes to prognosis in those with chest pain

7 COMMENTS - Nov 18, 2008 12:45 EST

ECGs or exercise ECGs have little incremental value over and above clinical assessment for prognosis in patients with suspected angina, a new study has found. Hence, such tests should not be used to rule out future events in these patients, researchers say. (Sekhri N et al. BMJ; published online before print November 13, 2008.)

Heart failure

Negative thinking predicts depression in heart-failure patients

Nov 17, 2008 18:00 EST

Negative thinking may play a major role in the development of depression in patients with heart failure, new research suggests. (American Heart Association 2008 Scientific Sessions.)

Prevention

Cardiovascular effects of air pollution, even in the comfort of home

Nov 14, 2008 16:45 EST

Researchers who fitted study subjects with "air-pollution vests" to continuously monitor exposure to both indoor and outdoor air pollutants say that people are probably exposed to much higher levels of pollutants than community monitoring stations typically indicate and that this exposure affects both endothelial function and systolic blood pressure. (American Heart Association 2008 Scientific Sessions.)

Clinical cardiology

Music, like laughter, benefits heart health

1 COMMENT - Nov 14, 2008 09:15 EST

Listening to enjoyable music may be good for cardiovascular health in the same way that laughter is beneficial, new research suggests. (American Heart Association 2008 Scientific Sessions.)

Dr Richard W Nesto

Lipid/Metabolic

APPROACH: Rosiglitazone doesn't affect atherosclerosis progression in diabetics with CV disease

19 COMMENTS - Nov 13, 2008 15:00 EST

The thiazolidinedione, given for 18 months, didn't appear to reverse or slow disease progression compared with the same duration of treatment with a sulfonylurea, according to the IVUS-based study. Investigators point to hints that that rosiglitazone may have slowed atherosclerosis in such patients with longer-established diabetes. (American Heart Association 2008 Scientific Sessions.)

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