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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.

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.

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.

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

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.

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.

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.

Arrhythmia/EP

PACE: BiV pacing protects against RV pacing's adverse ventricular effects in randomized trial

Nov 15, 2009 16:30 EST

In patients with conventional indications for pacing and normal systolic function, preservation of synchrony with biventricular pacing prevented the adverse remodeling effects of right-ventricular-only pacing. But some question the trial's methods.

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.

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.

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.

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.

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.

Clinical cardiology

Walking speed predicts CV mortality in older people

4 COMMENTS - Nov 10, 2009 19:01 EST

Fast walkers should find themselves less likely to succumb to cardiovascular death, according to a new French study in older adults. Measuring general fitness in this way could easily be incorporated into a general global assessment of cardiovascular risk, say the researchers.

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.

Acute Coronary Syndromes

Clopidogrel effects in men vs women

Nov 10, 2009 16:15 EST

A new meta-analysis has suggested that clopidogrel reduces cardiovascular events and increases bleeding in both men and women, without significant differences between the sexes.

Arrhythmia/EP

Obesity may top hypertension as risk factor for LA enlargement

Nov 9, 2009 17:00 EST

Obesity and hypertension were major independent risk factors for left atrial enlargement (itself a risk factor for atrial fibrillation) in an observational, population-based study, but obesity was the strongest predictor.

Acute Coronary Syndromes

Latest European and US STEMI guidelines compared and contrasted

7 COMMENTS - Nov 6, 2009 17:15 EST

The latest recommendations for the treatment of ST-elevation MI issued by American cardiology associations and the European Society of Cardiology are compared and contrasted in a new paper.

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.

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