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Thrombosis

Warfarin genotyping reduces hospitalizations

Mar 16, 2010 16:00 EDT

Although there was a suggestion that some of the effect could have simply been due to more attention being paid to the patients, most agree that any intervention that helps warfarin control is worthwhile.

Atlanta, GA - Genotyping warfarin patients resulted in a 30% reduction in all-cause hospitalizations and hospitalizations for bleeds/thromboemboli, a new study suggests.

Presenting the Medco-Mayo Warfarin Effectiveness Study (MM-WES) at the American College of Cardiology (ACC) 2010 Scientific Sessions today, Dr Robert Epstein (Medco Research Institute, Franklin Lakes, NJ) said: "Our study shows that genetic testing is a tool clinicians can use to more accurately predict the best warfarin dose early on. Patients may get to a stable dose more quickly and therefore have a lower risk of negative outcomes." Read full article »

Inside: Thrombosis

Accredited educational programs, supported by industry, developed by theheart.org

Thrombosis

Secondary Prevention of Venous Thromboembolism: Current Controversies and Emerging Therapies

Mar 10, 2010 16:26 EST

Patients who have had a primary VTE event are at an increased risk for recurrence, but the risk is not uniform and secondary prophylaxis is associated with bleeding risk. The challenge then is to identify patients at high risk for recurrence who would benefit the most from extended secondary prophylaxis. Dr. Alexander G. G. Turpie presents a clinical update on the issues surrounding this rapidly evolving area and the agents in clinical development which have the potential to replace existing therapies.

Thrombosis

Preventing Symptomatic, Recurrent Deep Vein Thrombosis or Pulmonary Embolism: The Need for Long-Term Thromboprophylaxis

Dec 23, 2009 11:49 EST

Join Dr. Graham Turpie as he discusses exciting new data on novel oral anticoagulation therapy released at ASH.

Thrombosis

Best practices in VTE prophylaxis: apply the guidelines in patients with cancer

Jan 29, 2010 14:06 EST

Dr. Khorana summarizes the risk factors for VTE in patients with cancer and describes the current strategies for prophylaxis.

Acute Coronary Syndromes

Meeting the Challenges in Long-Term Anticoagulation: Opportunities to Improve Patient Care

Aug 7, 2009 09:10 EDT

Management of long-term anticoagulation therapy in STEMI patients is challenging. Please join our expert panel, Drs. Elaine Hylek, Ander Cohen, Greg Lip, and Jack Ansell, as they discuss current challenges and strategies to optimize the benefit of and provide insights to the future of anticoagulation therapy.

Hypertension

ACE inhibitor/ARBs still used in pregnancy despite teratogenicity

Mar 19, 2010 14:15 EDT

New research from the UK has found that doctors are still prescribing ACE inhibitors and angiotensin-receptor blockers in women of child-bearing age, despite evidence that they are teratogenic. Reasons include a lack of awareness of the issue among GPs and obstetricians and ambiguity in hypertension guidelines, says the researcher.

Arrhythmia/EP

Watchman delayed: FDA wants more data on the LAA-closure device before approving

Mar 19, 2010 11:15 EDT

Atritech, the maker of the Watchman device, announced that the FDA requested another study to provide more safety and effectiveness data before it will approve the LAA-closure device.

Heart failure

Broaden CRT indications to include mild heart failure, recommends FDA advisory panel

Mar 19, 2010 09:00 EDT

The panel unanimously recommended that cardiac resynchronization therapy indications be extended to include patients in NYHA functional class 1 or 2, with a few added twists aimed at excluding subgroups that are least likely to benefit from the device therapy.

Hypertension

Mar 18, 2010 16:00 EDT

A new BP-lowering drug that acts in a similar way to omapatrilat—an agent that never quite made it to the market—has shown promise in a preliminary trial. Crucially, this dual inhibiting agent, named LCZ696, blocks angiotensin II rather than angiotensin-converting enzyme; there was no indication of angioedema in the study.

Interventional/Surgery

PLATO CABG analysis confuses cardiologists

6 COMMENTS - Mar 16, 2010 17:15 EDT

Cardiologists here at the ACC meeting were confused by a new analysis of PLATO, this time in ACS patients who subsequently underwent CABG surgery. Those in the ticagrelor group were 50% less likely to die, despite the fact that there was no difference in bleeding or MIs between these patients and those who got clopidogrel. The investigator admitted he didn't have the answers, and further analyses "are ongoing."

Interventional/Surgery

Is triple antiplatelet therapy after PCI the way forward?

1 COMMENT - Mar 16, 2010 11:00 EDT

Adding cilostazol to clopidogrel and aspirin did not significantly reduce event rates, but it did improve posttreatment platelet reactivity in the CILON-T trial, and the study was underpowered for hard clinical events.

Hypertension

Is BP variability a stronger determinant of CV outcomes than mean pressure?

1 COMMENT - Mar 16, 2010 09:45 EDT

A host of new analyses published in the Lancet journals, some of which were also reported at the ACC meeting, suggest that variability in blood pressure is a much stronger determinant of both stroke and coronary disease outcome than average blood pressure. And calcium-channel blockers have the strongest effect of all antihypertensives on reducing BP variability, say the researchers.

Interventional/Surgery

Cardiologists voice concern on FDA clopidogrel warning

3 COMMENTS - Mar 16, 2010 09:00 EDT

Several experts have questioned why the FDA has issued a warning about poor metabolizers of clopidogrel when there are no firm data about what to do for these patients.

Interventional/Surgery

Polymer-free, dual-drug DES shows little late catch-up in ISAR-TEST-2

Mar 15, 2010 18:45 EDT

Two-year ISAR-TEST-2 results show that the safety and efficacy of dual-drug DES are maintained out to two years.

Arrhythmia/EP

New factor Xa inhibitor betrixaban safe in phase 2 AF trial

Mar 15, 2010 14:45 EDT

A novel oral factor Xa inhibitor, betrixaban, was safe and well tolerated when compared with warfarin in a phase 2 trial in patients with AF. Along with other new anticoagulants, this could represent an advance on warfarin, but betrixaban first needs to be evaluated in a much larger phase 3 trial, said the lead researcher.

Thrombosis

Optimal dual antiplatelet duration in REAL-LATE, ZEST-LATE: Too little, too soon

3 COMMENTS - Mar 15, 2010 10:30 EDT

UPDATED // Cardiologists of every stripe are eager for any new information on just how long their patients should be taking dual antiplatelet therapy after receiving a drug-eluting stent. But the REAL-LATE/ZEST-LATE analysis seems to provide more questions than answers. The question everyone now seems to be asking now is, so what?

Clotblog with Dr Samuel Goldhaber

Anticoagulation "bridging" for patients with VTE

Fri Feb 26 12:50:00 EST 2010

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Editorial Programs

The Cardiology Show

ACC 2010 Review from Atlanta: INVEST, ACCORD, EVEREST II, and NAVIGATOR

Mar 17, 2010 16:25 EDT

Dr Valentin Fuster sits down with Drs Peter Berger, Anne Curtis, Tim Gardner, Tony Gershlick, Harlan Krumholz, Darren McGuire, Ileana Piña, and Rita Redberg to discuss the lessons learned at the ACC 2010 Scientific Sessions, including why lower may not be better for blood pressure, why preventing diabetes does not necessarily reduce cardiovascular risk, and the future of the mitral-valve clip.

Editorial series

Informed consent, clinical research, and patient care

1 COMMENT - Mar 11, 2010 14:20 EST

Does informed consent protect patients or shield researchers? Join the debate with Dr Bob Harrington and his guests Drs Deepak Bhatt and Harvey White.

Editorial series

Women in cardiology: Is gender an issue?

4 COMMENTS - Mar 4, 2010 10:15 EST

Do gender perceptions affect the way female physicians are treated in cardiology? Drs Melissa Walton-Shirley, Judith Hochman, Suzanne Oparil, and Lynne Warner Stevenson tackle this important question.