Interventional/Surgery

Acute Coronary Syndrome

New anti-inflammatory compound promising in ACS

Nov 21, 2008 13:30 EST

A new anti-inflammatory compound, VIA-2291, has shown promise in a phase 2 trial in patients with acute coronary syndrome. The results provide sufficient basis to move forward with additional studies of the drug, says the lead investigator, but another expert disagrees. (American Heart Association 2008 Scientific Sessions.)

Acute Coronary Syndrome

ACC/AHA publishes new performance measures for STEMI patients

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.)

Interventional/Surgery

OCT imaging suggests low rates of uncovered/malapposed struts following DES for AMI

Nov 18, 2008 11:30 EST

An OCT study conducted in a subset of HORIZONS-AMI patients suggests that exposed and malapposed stent struts in the setting of AMI are more common with drug-eluting stents than with bare-metal stents but still relatively rare. (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.)

Interventional/Surgery

Patients believe elective PCI prevents MI and saves lives, but who's to blame?

8 COMMENTS - Nov 12, 2008 16:15 EST

Two-thirds of patients surveyed after undergoing elective PCI for angina relief said they believed the procedure would save their lives; still more believed they'd avoid a future MI. Experts say patients may not be digesting information appropriately, but doctors are also at fault. Indeed, the majority of patients also said they were not offered any therapy other than PCI. (American Heart Association 2008 Scientific Sessions.)

Interventional/Surgery

New meta-analysis of beta blockers in noncardiac surgery: Time to abandon their use, or not?

2 COMMENTS - Nov 12, 2008 14:00 EST

The use of beta blockers perioperatively to prevent cardiovascular events in patients undergoing noncardiac surgery is not justified by current evidence, according to the authors of a new meta-analysis. An update to the guidelines on this issue is under way, says one member of the writing committee, who incidentally does not agree with this overall conclusion. (Bangalore S et al. Lancet; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

Acute Coronary Syndrome

TIMACS: Early invasive management safe in non-ST-elevation ACS, improves outcomes in high-risk cases

Nov 11, 2008 09:00 EST

The findings appear to mandate early intervention in high-risk cases and to support the use of either an early or delayed strategy for patients considered at low to intermediate risk. (American Heart Association 2008 Scientific Sessions.)

Thrombosis Risk

Tailoring clopidogrel loading on the basis of responsiveness testing reduces stent thrombosis

5 COMMENTS - Nov 10, 2008 16:30 EST

Investigators who adjusted clopidogrel dose on the basis of VASP index found they could reduce risk of stent thrombosis as well as MACE at 30 days. (American Heart Association 2008 Scientific Sessions.)

Interventional/Surgery

Revascularization, MI, and mortality benefits at three years in diabetic patients treated with drug-eluting stents

2 COMMENTS - Nov 10, 2008 15:45 EST

The results highlight the preserved efficacy of drug-eluting stents observed in other randomized trials and also point to no increased safety concerns in long-term follow-up. Investigators say drug-eluting stents should be favored over bare-metal stents on a patient-by-patient basis, with their ability to take dual antiplatelet therapy the primary caveat. (Garg P et al. Circulation; published online before print November 10, 2008. American Heart Association 2008 Scientific Sessions.)

Acute Coronary Syndrome

Registry: Cardiogenic shock rates plunge over decade thanks to PCI, statins

1 COMMENT - Nov 6, 2008 16:45 EST

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.)

Heart failure

HF up in recent decades as MI deaths fall

Nov 4, 2008 11:45 EST

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.)

Clinical cardiology

Alain Carpentier spearheads new total artificial heart endeavor

1 COMMENT - Oct 31, 2008 08:30 EDT

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.

Interventional/Surgery

Medtronic says it will sell Endeavor with rapid exchange in US

Oct 30, 2008 16:30 EDT

Acute Coronary Syndrome

Six-month TRANSFER-AMI data show persistent benefit

Oct 30, 2008 15:00 EDT

Investigators observed persistent trends toward a reduction in reinfarction and say that the data support the 30-day results that showed a benefit of PCI within six hours of fibrinolytic therapy in STEMI patients. (Canadian Cardiovascular Congress 2008.)

Acute Coronary Syndrome

Door-to-balloon times of less than 90 minutes possible

2 COMMENTS - Oct 30, 2008 14:30 EDT

A new Mayo Clinic protocol resulted in sustainable and durable improvements for four years. (American College of Emergency Physicians Scientific Assembly 2008,)

Interventional/Surgery

Twenty-year aortic bioprosthesis data show good durability and "satisfying outcomes"

Oct 30, 2008 10:15 EDT

New results suggest that while the bioprosthesis may begin to degenerate at around the seven-year mark, valve-related complications are rare, even out to 20 years. (Eichinger WB et al. Ann Thorac Surg 2008; 86:1204-1211.)

Clinical cardiology

Endocarditis twice as likely to kill the elderly

Oct 29, 2008 18:30 EDT

The largest prospective multicenter study of infective endocarditis ever conducted has found that elderly patients with the disease have distinctive characteristics compared with their younger counterparts and that they are twice as likely to die from it. (Durante-Mangoni E et al. Arch Intern Med 2008; 168:2095-2103.)

Interventional/Surgery

Endoscopic harvesting of radial artery: Less painful, but approach fails to reduce infections

Oct 29, 2008 08:45 EDT

Endoscopic harvesting of the radial artery for CABG surgery significantly reduces postoperative wound pain and improves patient satisfaction with the cosmetic results, but there was only a trend toward a reduction in wound infection, a new study has shown. (Canadian Cardiovascular Congress 2008.)

Clinical cardiology

Beta blockers up risk of MI, death after noncardiac ops

6 COMMENTS - Oct 28, 2008 16:00 EDT

A new retrospective cohort study has found that those taking beta blockers prior to noncardiac surgery had higher rates of MI and death at 30 days than those not taking beta blockers. The findings are similar to those of the landmark POISE study, says the senior author, although he acknowledges that there are some differences and that the new study has limitations. (Kaafarani HMA et al. Arch Surg 2008; 143:940-944.)

Interventional/Surgery

Radial-access PCI reduces major bleeding 73% compared with femoral approach

6 COMMENTS - Oct 27, 2008 17:00 EDT

In addition to the reduction in major bleeding, there were trends toward a reduction in ischemic events, although these did not reach statistical significance. A second study also showed that radial-access PCI in STEMI patients does not compromise reperfusion times. (Canadian Cardiology Congress 2008.)

Brain/Kidney/Peripheral

Promising percutaneous CoreValve data from Europe leave US trialists itching for green light from the FDA

Oct 24, 2008 18:00 EDT

New data from 18 European countries on the fully percutaneous aortic valve speak to low 30-day mortality and improved valve function sustained over the longer term. So why the holdup in the US, where nary a feasibility study has been conducted? (TCT 2008.)

Interventional/Surgery

Court lifts injunction that keeps Endeavor from rapid exchange: Medtronic mum on plans

1 COMMENT - Oct 23, 2008 09:30 EDT

Currently, Endeavor is the only DES in the US that cannot be used with the newer delivery system.

Brain/Kidney/Peripheral

COOL-RCN: Hypothermia does not prevent contrast-induced nephropathy during cath procedures

Oct 21, 2008 18:00 EDT

The COOL-RCN investigators used a catheter that essentially acts as an "intravenous refrigerator," cooling the body from the inside out, but it failed to decrease the risk of acute kidney damage caused by iodinated contrast agents. (TCT 2008.)

Interventional/Surgery

New trial results support broader role for carotid stenting, but CMS again refuses to expand Medicare coverage—Updated

Oct 21, 2008 17:15 EDT

Critics say the CMS should have waited for pending publications of the SAPPHIRE, CAPTURE 2, and EXACT data before announcing its decision, especially as new results from PROTECT, EMPIRE, and EPIC indicate that stroke, death, and MI rates are continuing to decline. (TCT 2008.)

Interventional/Surgery

PREPARE: Proximal embolic protection with aspiration improves immediate ST-segment resolution

1 COMMENT - Oct 20, 2008 17:15 EDT

An embolic-protection and aspiration device delivered proximally to the lesion in primary PCI results in better immediate microvascular flow in STEMI patients compared with primary PCI alone. Although the immediate benefits did not hold up over time, investigators believe the early reperfusion will translate into better outcomes. (TCT 2008.)

	Yes, in the next 2 years
	Yes, in the next 5 years
	Yes, in the next 10 years
	No, these therapies will not be widely performed