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.)
Drawing on data from over 18 000 transplant recipients, researchers say their findings support a policy of matching donor hearts to recipients, "if all else is equal." (American Heart Association 2008 Scientific Sessions.)
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.)
Contrary to recent research suggesting antidepressant use increases mortality in heart-disease patients, a new study suggests that, at least when it comes to selective serotonin-reuptake inhibitors, this is not the case. (O'Connor CM et al. Arch Intern Med 2008; 168:2232-2237.)
Heart-failure patients participating in an exercise-training program improved their quality of life, with the improvement occurring early and sustained for three years, new HF-ACTION data show. Investigators say the results are consistent with the overall clinical findings and support the use of exercise training in this patient population. (American Heart Association 2008 Scientific Sessions.)
Four years of treatment with irbesartan, usually on top of other drugs that affect the renin-angiotensin-aldosterone system, didn't improve outcomes in patients with the common but poorly understood form of heart failure. The trial follows previous negative studies of an ACE inhibitor and a different angiotensin-receptor blocker, respectively, in similar populations. (American Heart Association 2008 Scientific Sessions.)
A novel biomarker of vascular status is a better predictor of mortality at three months than brain natriuretic peptide among acute heart-failure patients presenting at the emergency department with shortness of breath. One expert, however, said it doesn't matter if the high-risk patients are separated from very high-risk patientsthey should all be receiving optimal medical therapy. (American Heart Association 2008 Scientific Sessions.)
A phase 2 trial has shown that interferon beta-1ba drug currently used to treat multiple sclerosismay be effective in chronic viral cardiomyopathy. But a phase 3 trial is needed for definitive proof of concept, say the study investigators and discussant. (American Heart Association 2008 Scientific Sessions.)
Investigators failed to show a difference in the primary end point of all-cause mortality and all-cause hospitalizations, but a secondary analysis that took into account prognostic factors did show significant reductions in hard clinical events. One expert believes it should strengthen exercise guidelines. (American Heart Association 2008 Scientific Sessions.)
The microvolt TWA test's battered imaged as a risk stratifier for ICD candidates suffered several more blows in the past few weeks with publication of two major studies that conclude against it as a predictor of sudden cardiac death in low-LVEF patients. But the noninvasive test has its proponents who see the data a bit differently. (Chow T et al. J Am Coll Cardiol 2008; 52:1607-1615. Gold MR et al. Circulation; published online before print October 27, 2008.)
Individuals who receive implantable cardiac defibrillators after a sudden cardiac event are more than twice as likely to die within five years if they experience symptoms of posttraumatic stress disorder, regardless of disease severity. (Ladwig et al. Arch Gen Psychiatry 2008; 65:1324-1330.)
The 75% drop in how often ACS patients develop shock during hospitalization accounted for almost all the difference in a Swiss registry study; the ranks of those presenting already in shock didn't change. (Jeger RV et al. Ann Intern Med 2008; 149:618-626.)
The statement outlines situations in which benefits of contrast outweigh risks and could ultimately improve patient outcomes, experts say. (Mulvagh SL et al. J Am Soc Echocardiogr 2008; 21:1179-1201.)
Physicians and patients need to be aware that sudden death is more common during the first few weeks post-MI and that the development of heart failure, at any time, increases the risk of sudden death in MI survivors. (Adabag AS et al. JAMA 2008; 300:2022-2029.)
A decline in deaths from MI in recent decades appears to have been accompanied by an increase in the incidence of heart failure, according to a new analysis from the Framingham Heart Study. The likely explanation is that sicker patients, who would have died from MI in earlier years, are now surviving but going on to develop HF, say the researchers. (Velagaleti RS et al. Circulation; published online before print October 27, 2008.)
OSA not accompanied by daytime symptoms might still suggest increased cardiovascular risk, according to researchers. (Kohler M et al. Am J Respir Crit Care Med 2008; 178:984-988.)
A French start-up company has announced it has received millions of dollars in funding, some from the defense industry, even as other replacement hearts in development globally seem stymied by disappointing long-term results or lack of funds.
Race per se shouldn't be a barrier to lowering the risk of new heart failure in African Americans, because the main causes are treatable, according to investigators for the longitudinal cohort study. (Bahrami H et al. Arch Intern Med 2008; 168:2138-2145.)
A previously observed cut in hospitalization risk has been shown in a follow-up analysis to have come at a cost within the typically accepted range. (Hebert PL et al. Ann Intern Med 2008; 149:540-548.)
Is cardiovascular care poised to enter the brave new world of pharmacogenomics? A test for a pair of genetic markers seems to distinguish heart-failure patients who are likely or unlikely to respond to a beta blocker now under FDA review. (Heart Failure Society of America 2008 Scientific Meeting.)
The finding may be new, retrospective, and in need of further exploration, researchers note, but it at least suggests care should be taken to make sure patients with heart failure are screened for osteoporosis. (van Diepen S et al. Circulation 2008; published online before print October 20, 2008.)
The issue of when, or even if, antibiotics should be given for the prevention of infective endocarditis has been hotly debated of late. heartwire interviewed one expert on the subject, Dr Bernard Prendergast, to gauge his views.
Join Drs Yancy, Jessup, Lindenfeld, Saxon, and Stevenson as they discuss how similar databases can be interpreted differently. Device-based therapy is effective when selected for the right patient; but there is considerable underuse of devices, in part due to ambiguity in the guidelines.
The overall heart failure-related mortality rate in the United States has almost doubled in the past two decades. Which patients will benefit the most from the use of ICDs? Join our panel of experts, Drs Abraham, Fonarow, Francis, and Gold as they discuss the latest evidence from clinical trials.