theHeart.org: Lipid and Metabolic news related to heart conditions.

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.

Lipid/Metabolic

Niacin not beneficial in patients at goal with statins: NIA Plaque

19 COMMENTS - Nov 18, 2009 09:00 EST

The addition of niacin to statin therapy in secondary-prevention patients resulted in a significant improvement in lipids but failed to significantly alter atherosclerotic disease progression as measured by MRI. Researchers say it's a win for treating patients to target and suggest this trumps raising HDL.

Lipid/Metabolic

Statins do not eliminate risk of low HDL-cholesterol levels

4 COMMENTS - Nov 17, 2009 14:45 EST

Researchers say a new study shows that statins don't alter the risks associated with low HDL-cholesterol levels and that raising HDL cholesterol 10 mg/dL could prevent an additional eight MIs per 1000 patient-years.

Lipid/Metabolic

ARBITER 6-HALTS: HDL raising with niacin superior to ezetimibe

54 COMMENTS - Nov 15, 2009 18:00 EST

Extended-release niacin is superior to ezetimibe in its effect on carotid intima-media thickness. While experts say the trial tells clinicians little about ezetimibe, it is a big win for niacin given the substantial regression of atherosclerosis observed at eight and 14 months.

Prevention

Canadian confusion: Primary-care docs lack knowledge of CVD risk factors, prevention

8 COMMENTS - Nov 15, 2009 09:00 EST

Family doctors and general practitioners in Canada are confused about cardiovascular risk assessment in primary prevention, a new survey reveals.

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.

Lipid/Metabolic

Total- and HDL-cholesterol levels, not triglycerides, predict vascular risk

Nov 12, 2009 10:00 EST

Clinicians can simplify their existing risk-assessment tools by measuring either total- and HDL-cholesterol levels or apolipoproteins, and this assessment can effectively be done in patients who did not fast before the test.

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.

Prevention

No benefits of aspirin for primary prevention in diabetics, meta-analysis suggests

6 COMMENTS - Nov 10, 2009 17:15 EST

Most guideline documents recommend aspirin for primary prevention in people with diabetes, but a new meta-analysis has found no benefit of the widely used drug across a range of different cardiovascular end points. The results speak to the need for dedicated randomized trials, investigators say.

Medscape Medical News

Low-cholesterol/cancer studies should "dispel lingering doubts" of causal link

Nov 5, 2009 14:15 EST

Two new papers should help put to rest concerns that low serum cholesterol levels may increase cancer risk.

Lipid/Metabolic

Not all metabolic syndrome is created equal: Framingham Offspring analysis

3 COMMENTS - Nov 5, 2009 11:45 EST

The syndrome (defined by ATP III criteria) can predict increased cardiovascular and mortality risk or not, depending on which three of five risk factors contributed to the diagnosis, a cohort study suggests; its investigators caution that their observations are only preliminary.

Interventional/Surgery

VELETI in print: Plaque sealing of SVGs a strategy "ahead of its time"?

Nov 4, 2009 15:30 EST

The imaging study was the first to show that stenting a non-flow-limiting stenosis of an SVG may help slow or halt the accelerated atherosclerosis that takes place in these vessels. An accompanying editorial cautions that the study does little more than "infer a trend toward anatomic benefit."

Hypertension

Adding fuel to the J-curve fire; debate is reignited

2 COMMENTS - Nov 4, 2009 14:30 EST

More discussion about the J-curve in hypertension is published this week; one expert believes the undue attention being paid to this subject might discourage doctors from treating high blood pressure aggressively.

Imaging

CAC scoring plus SPECT provide long and short view of cardiac risk

7 COMMENTS - Nov 3, 2009 17:00 EST

UPDATED // An 1126-patient trial shows that SPECT and CAC scoring imaging tests are independent and complementary predictors of short- and long-term cardiac risk, respectively.

heartbriefs

FDA expands exenatide use; warns of renal-failure risk

Nov 3, 2009 13:15 EST

The FDA has issued a warning about exenatide the same day the agency approved its first-line use along with diet and exercise to improve glycemic control in patients with type 2 diabetes mellitus.

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.

Imaging

Imaging study shows plaque regression with niacin vs placebo

19 COMMENTS - Oct 30, 2009 16:00 EDT

Just weeks before ARBITER-HALTS 6 results come out at AHA 2009, an MRI study suggests that niacin is better than placebo in statin-treated patients with low HDL, at least for reducing carotid wall area. Experts say they'd also like to see insights into niacin effects on lipid-rich plaque volumes—the more commonly seen end point with MRI.

Lipid/Metabolic

Lifestyle-based diabetes prevention seen to endure for at least a decade

1 COMMENT - Oct 30, 2009 10:00 EDT

The protective effects of diet modification, exercise, and other lifestyle changes against new-onset diabetes showcased in the three-year Diabetes Prevention Program continued out to 10 years in a follow-up analysis.

heartbriefs

Combination drugs for weight loss

2 COMMENTS - Oct 29, 2009 15:30 EDT

Two studies presented this week have shown positive effects on weight loss using a combination of agents.

Medscape Medical News

CRP predicts mortality and MI, but not stroke

Oct 29, 2009 12:00 EDT

A new analysis from the Northern Manhattan Study finds that high-sensitivity C-reactive protein was modestly associated with mortality and MI but not ischemic stroke in this multiethnic population, suggesting the predictive value may depend on other factors.

Acute Coronary Syndromes

Sex differences in changing MI prevalence, mortality challenge conventional wisdom

Oct 29, 2009 10:30 EDT

Two well-known observational registries highlight such changes in women and men over a decade or more: Do women younger than 55 still have an advantage over men in the same age group?

Lipid/Metabolic

Schizophrenia plus diabetes linked with higher CAD yet lower revascularization rates

Oct 28, 2009 16:30 EDT

Individuals with schizophrenia and diabetes—as opposed to diabetes only—have a greater risk of CAD but a smaller likelihood of receiving CABG or PCI, a large cohort study suggests.

Prevention

Lorcaserin passes weight-loss and valvular hurdles in BLOSSOM study

1 COMMENT - Oct 27, 2009 16:15 EDT

Among overweight patients, including those with preexisting echocardiographic valvulopathy, the average weight loss was approximately 5 kg with lorcaserin. Importantly, there were no concerns raised about new or worsening cardiac valve problems with the 5HT2C-receptor agonist.

Lipid/Metabolic

ACCORD update: "One size fits all" may not be best glucose-lowering strategy

1 COMMENT - Oct 27, 2009 10:00 EDT

While post hoc analyses of ACCORD data suggest there are subgroups of diabetic patients who may not benefit from an aggressive glucose-lowering approach, similar analyses with ADVANCE data did not identify subgroup differences.

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