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heartbriefs

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.

Medscape Medical News

Stroke incidence related to PCI steady over 15 years

2 COMMENTS - Nov 20, 2009 13:00 EST

Mayo Clinic researchers report that their stroke rate related to PCI has stayed steady for the last 15 years, something they interpret as good news, given that substantially older, sicker patients with more complex anatomy are now undergoing PCI.

Acute Coronary Syndromes

Oral anticoagulants REDEEMed? Daily dabigatran "safe" with dual antiplatelets after MI

Nov 19, 2009 11:00 EST

A dose-finding study saw what were characterized as low bleeding rates associated with triple-drug antithrombotic therapy that included the oral anticoagulant dabigatran in patients with a recent ACS event and other cardiovascular risk factors.

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

BARI 2D cost-effectiveness analysis favors medication over PCI for less severe CVD in diabetic patients

1 COMMENT - Nov 18, 2009 15:45 EST

New data from the BARI 2D trial comparing medical therapy vs revascularization in diabetics shows higher up-front costs of revascularization are only partially offset by long-term savings.

Thrombosis Risk

Ticagrelor effects unraveled in new phase 2 trials

Nov 18, 2009 15:00 EST

New and unique phase 2 data add to the growing body of evidence explaining the pharmacologic effects of the new antiplatelet agent ticagrelor.

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.

Acute Coronary Syndromes

ACC/AHA focused update of guidelines for STEMI, PCI

9 COMMENTS - Nov 18, 2009 09:00 EST

The latest evidence for the treatment of STEMI and PCI has been incorporated into a fast-track update of US guidelines. But questions remain about the quality of some of the evidence informing the guidelines and about the composition of the writing committees.

Interventional/Surgery

POPE: No benefit of diclofenac on pericardial effusion

Nov 17, 2009 10:00 EST

Mean pericardial effusion grade postcardiac surgery was not reduced with 14 days of treatment with the NSAID.

Interventional/Surgery

CASCADE: No significant benefit of clopidogrel in reducing graft disease after CABG

4 COMMENTS - Nov 17, 2009 09:00 EST

Dual antiplatelet therapy did not significantly reduce vein graft intimal hyperplasia compared with aspirin alone over 12 months.

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.

Brain/Kidney/Peripheral

Bypassing the blues: How simple collaborative care can help tackle depression after CABG surgery

Nov 16, 2009 18:45 EST

Depression after coronary artery bypass surgery is often overlooked by physicians but is associated with worse outcomes. A new US study illustrates a simple telephone-based approach to tackle this, with nurses encouraging patients to seek help from their primary-care doctors and providing ongoing feedback and review.

Interventional/Surgery

Postop anemia in high-CV-risk patients: No CV gains from fixed hemoglobin target in trial

Nov 16, 2009 17:45 EST

A randomized trial found no protection from in-hospital cardiovascular events with a strategy of blood transfusions to maintain hemoglobin above 10 g/dL, compared with a more conservative approach to transfusion therapy, in patients with CV disease or risk factors who underwent hip surgery.

Interventional/Surgery

Massachusetts data show similar STEMI PCI outcomes in hospitals with or without surgery

Nov 16, 2009 16:15 EST

Data from a Massachusetts registry add to the growing evidence that hospitals without bypass-surgery capabilities can match the acute coronary intervention outcomes of surgery-on-site centers.

Acute Coronary Syndromes

Cangrelor in CHAMPION: What went wrong?

2 COMMENTS - Nov 16, 2009 15:15 EST

Discussion is abounding on why cangrelor did not show benefit over clopidogrel despite the fact that it did inhibit platelet activity more effectively.

Acute Coronary Syndromes

Good news continues for ticagrelor in PLATO STEMI subanalysis

1 COMMENT - Nov 15, 2009 19:30 EST

Ticagrelor, an investigational antiplatelet agent, may become a new standard of care for the management of patients with STEMI heading for primary PCI, said the lead investigator of the STEMI subset of the PLATO trial. Reporting the new findings here today, he said they were consistent with the overall PLATO results.

Thrombosis Risk

Nov 15, 2009 14:15 EST

None of the eight platelet assays studied were able to predict bleeding, but four of the eight, based on ADP-induced platelet aggregation, produced results that correlated with adverse CV outcomes. By contrast, four tests that use shear-stress-induced adhesion-based methods were not predictive.

Interventional/Surgery

PEPCAD-3: Paclitaxel-coated-balloon/stent system misses mark in de novo coronary lesions

Nov 15, 2009 10:30 EST

Inflation of the paclitaxel-delivering balloon followed by a bare-metal stent failed a randomized noninferiority test against the Cypher sirolimus-eluting stent in previously untreated coronary lesions.

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.

Interventional/Surgery

Two-year EXPIRA results suggest mechanical aspiration with primary PCI may reduce mortality

Nov 15, 2009 09:00 EST

Two-year follow-up results from the EXPIRA study show mechanical thrombectomy during primary PCI improves myocardial perfusion and may reduce mortality.

Interventional/Surgery

Experienced operators can switch easily and rapidly to radial-access PCI: RAPTOR

5 COMMENTS - Nov 15, 2009 08:30 EST

Experienced interventional cardiologists can rapidly shift their practice from the femoral-artery to the radial-access approach, with no increase in procedure time and radiation exposure for PCI. Also, the transradial approach leads to a more economic use of hospital resources, say researchers.

Acute Coronary Syndromes

CHAMPION: Negative trials but some positive angles for cangrelor?

2 COMMENTS - Nov 15, 2009 08:00 EST

Although neither CHAMPION-PCI nor CHAMPION-PLATFORM showed significant reductions in the primary end point with this new IV antiplatelet agent, some positive effects were seen, suggesting that the drug may yet have a future.

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.

Interventional/Surgery

DES fractures occur more often than thought

4 COMMENTS - Nov 12, 2009 13:15 EST

A new postmortem study using high-resolution imaging has found that fractures in drug-eluting stents may be more common than thought. However, the majority of such fractures appear to be low-grade and silent, with likely few clinical implications, say the researchers.

Interventional/Surgery

ASTRAL finds no benefit of revascularization over medical therapy alone for renal-artery stenosis

9 COMMENTS - Nov 11, 2009 17:00 EST

Percutaneous revascularization of atherosclerotic renal arteries improves patency, but its benefits on renal function have been evaluated only in small studies. The 806-patient ASTRAL trial found no evidence of benefit from revascularization.

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