A randomized trial found that two ultrasound-based strategies were similarly effective at determining the need for anticoagulation in symptomatic patients with suspected deep-vein thrombosis; both have strengths and weaknesses. (Bernardi E et al. JAMA 2008; 300:1653-1659.)
Chicago, IL - Two ultrasound-based evaluations, both with their advantages and disadvantages, are about equally effective at guiding the management of patients with suspected lower-extremity deep-vein thrombosis (DVT), conclude the authors of a randomized trial reported in the October 8, 2008 issue of Journal of the American Medical Association [1]. But the writer of an accompanying editorial [2] gives the edge to one of the techniques, the one that's been around longer and is simpler and probably more widely available, and notes that a clinical prediction rule not evaluated in the study can also play a role in the initial evaluation of DVT.
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(Bernardi E et al. JAMA 2008;300:1653-1659.)
Inside: Thrombosis Risk
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Join Drs Harrington, Bode, Verheugt and Halperin as they discuss the spectrum of patients at risk for thrombotic events, strategies to prevent thrombosis on both sides of the circulation and recent clinical trial data which will impact patient care in the near future.
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Documentation of the care of patients in a nationwide health plan suggests that less than half of patients with atrial fibrillation are prescribed an anticoagulant. (Walker AM, Bennett D. Heart Rhythm 2008;5:1365-1372.)
A familiar message has emerged from a new review of stem-cell therapy for acute MIa moderate improvement was seen, but much more research is needed. (Martin-Rendon E et al. Cochrane Database Syst Rev 2008; 4: CD006536. Eur Heart J 2008; 29:1807-1818.)
It addresses a common clinical problem for which there is little clinical-trial-quality data for guidance and gives a starring role to proton-pump inhibitors in treating GI ulcers and bleeding and, in high-risk groups, in their prevention. (Bhatt DL et al. J Am Coll Cardiol; Circulation; published online before print October 3, 2008.)
Low-risk patients with uncomplicated lesions can have elective PCI safely performed using dual antiplatelet therapy without systemic anticoagulation, according to a new randomized study. An accompanying editorial begs to differ, however. (Stabile E et al. J Am Coll Cardiol 2008; 1293-1298.)
The Indian government appears to have heeded the warnings of medical experts highlighting the immense problem of smoking in the country, with the introduction this week of a nationwide ban on smoking in public places.
Important new information on HRT and the risk of MI has emerged from a Danish observational study, which finds that the type of HRT used could be key when it comes to the likelihood of a heart attack. (Lokkegaard E et al. Eur Heart J; published online before print September 30, 2008.)
Reporting on his own initial experience with a miniaturized ventricular assist device used as a bridge to transplant in small children, a leading pediatric heart surgeon is hoping that the pumpwidely available in Europewill soon be approved for use in the US. (Gandhi SK et al. Circulation 2008; 118:S89-S93.)
A new Italian study has shown, for the first time, that consuming moderate amounts of dark chocolate can significantly reduce CRP levels. (di Giuseppe R et al. J Nutr 2008; 138:1939-1945.)
Whether the benefits are due to restenosis reduction, the additional months of dual antiplatelet therapy, or other effects of the DES itself are unclear, authors note. (Mauri L et al. N Engl J Med 2008; 359:1330-1342.)
Chinese researchers have reported, for the first time, a link between exposure to passive smoke and peripheral arterial disease in a cohort of women who have never smoked. They call for urgent public-health measures to protect individuals from secondhand smoke. (He Y et al. Circulation: published online before print September 22, 2008.)
Serial blood samples in patients with deliberately induced MIs (actually, they were the normal result of alcohol septal ablation therapy for hypertrophic obstructive cardiomyopathy) showed elevations in several molecules that could, in theory, help identify ongoing infarction as soon as 10 minutes after onset. (Lewis GD et al. J Clin Invest; published online before print September 2, 2008.)