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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.

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.

Interventional/Surgery

Baseline function data from STICH no help in pinpointing patients who benefit from SVR

Nov 18, 2009 10:45 EST

Measures of left ventricular dysfunction or wall motion identified by different imaging modalities at baseline offer no clues as to whether a subset of patients treated with surgical ventricular reconstruction might benefit from the procedure.

Heart failure

JCHF: Are low doses of carvedilol effective in heart failure?

4 COMMENTS - Nov 18, 2009 09:00 EST

Doses of carvedilol as low as 2.5 mg daily may be effective in Japanese patients with heart failure, according to this study. But experts said the trial was far too small to draw any meaningful conclusions.

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.

Heart failure

HeartMate II continuous-flow VAD sets new benchmark in destination-therapy trial

Nov 17, 2009 08:00 EST

UPDATED WITH COMMENTARY // Thoratec's HeartMate II continuous-flow VAD keeps about half of patients alive and stroke- or reintervention-free after two years in pivotal destination therapy trial.

Arrhythmia/EP

RECORD AF: Better success with rhythm control, but no difference in outcomes

Nov 16, 2009 17:00 EST

New registry data presented this week showed that cardiologists are more likely to select rhythm control over rate control for the treatment of atrial fibrillation, and this strategy is more likely to lead to successful treatment of AF than the rate-control-based approach. Both strategies are equivalent in terms of their effect on clinical outcomes.

Clinical cardiology

Plasma renin activity associated with cardiovascular events and mortality in HOPE

1 COMMENT - Nov 16, 2009 14:45 EST

Patients with elevated baseline plasma renin activity levels had a twofold increased risk of total or cardiovascular mortality compared with those with low levels, and the strength of the association persisted after multiple adjustments, including the HOPE score, CRP, and BNP.

Arrhythmia/EP

REPLACE registry finds 15.3% six-month complication rate with pacer and ICD lead replacements

Nov 16, 2009 09:30 EST

The REPLACE registry finds "sobering" comprehensive risk rates with pacemaker and ICD upgrades.

Arrhythmia/EP

PACE: BiV pacing protects against RV pacing's adverse ventricular effects in randomized trial

Nov 15, 2009 16:30 EST

In patients with conventional indications for pacing and normal systolic function, preservation of synchrony with biventricular pacing prevented the adverse remodeling effects of right-ventricular-only pacing. But some question the trial's methods.

Interventional/Surgery

FRANCE: Transcatheter-valve registry permits "observation" of CoreValve, Sapien differences

Nov 15, 2009 09:45 EST

Results from one of the first registries to evaluate contemporary use of both the Edwards Sapien transcatheter valve and the CoreValve bioprosthesis show that complication rates are low and similar, following a short training period, and that mortality, at least out to six months, is "acceptable" for both types of devices.

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.

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.

Heart failure

One in four discharged after heart-failure hospitalization are back within a month

3 COMMENTS - Nov 10, 2009 16:00 EST

What's behind the high rehospitalization rate, the same one seen year after year, for patients discharged after a hospitalization for heart failure, in an analysis covering three years of Medicare data? The authors propose one reason.

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.

Murmurs

Interventional cardiologist Donald Baim dies

19 COMMENTS - Nov 6, 2009 18:22 EST

UPDATED // Interventional cardiologist Dr Donald Baim, chief medical and scientific officer at Boston Scientific, has died.

Heart failure

CORONA analysis reopens door for statins in heart failure

1 COMMENT - 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.

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