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Heart failure

CORONA analysis reopens door for statins in heart failure

Nov 3, 2009 10:45 EST

Statins for heart failure? After they failed to show much effect in two large randomized trials? Yes—maybe; at least in patients with ischemic heart failure who start the drugs early enough, suggests a post hoc analysis based on one of the trials.

Heart failure

Benefits of targeted lead placement with CRT devices supported by long-term mortality data

Oct 29, 2009 15:00 EDT

An additional year of data from the INCREMENTAL study showed that echo-targeted LV lead positioning increased the likelihood of a response to device therapy by about 40% over standard lead placement. But does that difference translate into better long-term outcomes for the patient?

Interventional/Surgery

Underutilization of ICDs in CABG patients is worst in women and elderly, Halifax study shows

1 COMMENT - Oct 28, 2009 16:45 EDT

Only 101 of 1169 post-bypass-surgery patients eligible for an ICD got one over a 13-year period in Nova Scotia.

Arrhythmia/EP

NT-proBNP "remarkable predictor" of incident atrial fibrillation

1 COMMENT - Oct 23, 2009 16:30 EDT

The fact that elevated baseline NT-proBNP levels predict a diagnosis of AF even 16 years later suggests that peptide elevations precede the onset of arrhythmia, according to the researchers.

Prevention

HCM transmitted by sperm donation: A case report

Oct 22, 2009 15:45 EDT

The donor, who was later shown to be affected by a novel beta-myosin heavy-chain mutation that causes HCM, is responsible for at least nine children known to be genetically affected with HCM.

Clinical cardiology

Cardiovascular disease increases risk of hip fracture

Oct 20, 2009 16:00 EDT

Swedish researchers have confirmed a link between stroke and subsequent hip fracture in older people and identified for the first time that a diagnosis of heart failure also increases the risk for this fracture. They also identify a large genetic component to this association, via their use of a twin registry.

Heart failure

Just one-third of heart-failure patients receive aldosterone antagonists

7 COMMENTS - Oct 20, 2009 16:00 EDT

Just one-third of hospitalized HF patients who meet the criteria for an aldosterone antagonist receive the drugs upon discharge. On the plus side, few patients with contraindications are prescribed the medication.

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 . . .

Heart failure

No link seen between heart failure and coffee intake

Oct 16, 2009 10:15 EDT

With few studies in the literature specifically looking at the issue, a prospective, population-based study in Sweden has found no significant rise or fall in risk of heart-failure hospitalization or death at increasing levels of coffee intake.

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.

Heart failure

A fish tale with merit: Omega-3 PUFAs underrated for heart failure

18 COMMENTS - Oct 14, 2009 12:30 EDT

Are the data not shouting loud enough, or is cardiology hard of herring? Omega-3 fatty acids may have only a modest treatment effect in heart failure, but they've performed swimmingly in randomized and observational studies considering how few new HF drugs have been reeled in lately.

Heart failure

Hospital efficiency gauged by resource use vs outcomes

Oct 13, 2009 16:00 EDT

An analysis of Medicare data from heart-failure patients at six California hospitals challenges the notion advanced by some studies that hospital efficiency can be measured by looking back at resource use on behalf of patients who ultimately died.

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.

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.

Heart failure

Acute heart-failure prediction model blends clinical gestalt with natriuretic peptides

Oct 5, 2009 17:00 EDT

Its developers say the prediction model for guiding management of patients presenting with dyspnea can make a difference when clinicians aren't sure about the diagnosis based on clinical signs. An editorial takes issue.

Clinical cardiology

New "principles" on authorship and COI from PhRMA get mixed response

3 COMMENTS - Oct 2, 2009 12:00 EDT

The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.

Heart failure

REVERSE, MADIT-CRT make case for extending CRT to mild heart failure: Should guidelines change?

2 COMMENTS - Oct 1, 2009 10:30 EDT

Now in print after having been presented at meetings, the REVERSE randomized trial's European-cohort two-year results are consistent with the recently published, much larger MADIT-CRT trial in showing both clinical and LV structural benefits from resynchronization therapy in patients with NYHA class 1-2 heart failure.

Heart failure

Doctor-led "hospital-at-home" care subs for hospitalization in acute heart failure

5 COMMENTS - Sep 29, 2009 12:00 EDT

They lived just as long, but in a small randomized trial, patients with acute decompensated heart failure who received hospital-quality care in their homes as an alternative to hospital admission after presentation to the emergency department benefited in ways missed by those managed as inpatients in the traditional manner.

Heart failure

New biomarker, galectin-3, shows risk-stratification potential in chronic heart failure

2 COMMENTS - Sep 28, 2009 15:00 EDT

The proposed biomarker, which seems to apparently play a role in the progression of cardiomyopathy and heart failure, predicted mortality or HF hospitalization in a post hoc analysis from the already published COACH randomized trial.

Heart failure

BNP-boosting gene variant hints at possible screening, cardioprotective roles

1 COMMENT - Sep 25, 2009 10:45 EDT

A single-nucleotide polymorphism associated with chronically raised natriuretic-peptide levels is common enough to potentially influence interpretation of BNP and NT-proBNP assays under some circumstances, researchers say; there is increasing evidence that the gene variant may enhance survival in some patient groups.

Interventional/Surgery

Changing PARTNER: Program tweaks overshadow updates from transcatheter-valve studies

Sep 23, 2009 09:15 EDT

A packed session of interventionalists eager to hear more about long-term safety and efficacy were caught off-guard by news that a new co-primary end point has been added to cohort B.

Heart failure

Mixed start to planned MARVEL trial of post-MI autologous skeletal-myoblast therapy

Sep 22, 2009 14:00 EDT

A pilot analysis suggests the cell therapy can improve functional capacity, but amiodarone may be needed to prevent ventricular arrhythmias; its investigators say they plan to switch gears on the remainder of the study.

Heart failure

Added to diuretics, low-dose dopamine renoprotective in small acute-HF trial

Sep 21, 2009 12:30 EDT

Better late than never in the age of evidence-based medicine, a randomized test of an established strategy might have confirmed the value of adding dopamine to loop diuretics to allow the latter at reduced, less kidney-damaging dosages.

Heart failure

Physician, teach thyself: IMPROVE-HF initiative boosts use of evidence-based outpatient care

Sep 16, 2009 17:45 EDT

The two-year prospective registry-based study of a performance-improvement initiative's effectiveness saw significant jumps, >70% in some cases, in the appropriate use of six out of seven measured evidence-based treatments for patients with chronic heart failure.

Acute Coronary Syndromes

CAD hospitalizations decline, but HF admissions increase

1 COMMENT - Sep 16, 2009 15:15 EDT

	Very important
	Moderately important
	Not very important