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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.
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.
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.
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.
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.
Now that the US House of Representatives has passed a healthcare reform bill, organized medicine anticipates another votepossibly next weekon a second bill that would rewrite Medicare's controversial sustainable-growth-rate formula for physician reimbursement.
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.
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.
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.
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.
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."
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.
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.
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.
Statins for heart failure? After they failed to show much effect in two large randomized trials? Yesmaybe; 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.
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 volumesthe more commonly seen end point with MRI.
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.
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.
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?
Individuals with schizophrenia and diabetesas opposed to diabetes onlyhave a greater risk of CAD but a smaller likelihood of receiving CABG or PCI, a large cohort study suggests.
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.
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.
Reducing CV Risk: What Add-On Therapies Do You Use? Click to take the survey and compare answers. The results will help us create future CME programming
How will the results of JUPITER expand the universe of cardiovascular risk evaluation? Join Drs Ballantyne, Ridker, and Chapman as they discuss this important biomarker study and its implication for clinical practice.
Dr. Michael Davidson, a nationally recognized cardiologist and clinical lipidologist, will lead a targeted discussion focusing on the interpretation and application of results presented at this year's AHA meeting. Joining him will be a distinguished faculty panel, including: Dr. Christie Ballantyne, Director of the Center for Cardiovascular Disease Prevention at Baylor College of Medicine; Dr. Vera Bittner, Section Head of Preventive Cardiology at the University of Alabama at Birmingham and President of the National Lipid Association; and Dr. Roger Blumenthal, Director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.
Join Drs. Blumenthal and Ridker as they inform our community about upcoming consensus guidelines which will address this current medical debate, as well as the limitations of existing treatments as they formulate their management strategies.