theheart.org: Thrombosis Risk news and education

Acute Coronary Syndromes

Latest European and US STEMI guidelines compared and contrasted

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.

Interventional/Surgery

US updates advice on perioperative beta-blocker use in noncardiac surgery

5 COMMENTS - Nov 3, 2009 14:30 EST

A US update on the perioperative use of beta blockers for noncardiac surgery is, says the lead author, "similar" to recent European guidance on this issue.

Hypertension

Combined home/GP hypertension control program successful in Pakistan

3 COMMENTS - Nov 2, 2009 17:00 EST

A synergistic approach of educating general practitioners about hypertension control together with a program to send lay workers into people's homes to educate them about the management of high blood pressure has proven successful in low- to middle-income households in Pakistan.

Imaging

Imaging study shows plaque regression with niacin vs placebo

15 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.

heartbriefs

Distribution of body fat important in VTE

Oct 26, 2009 16:00 EDT

The distribution of body fat, as well as the amount, is important when it comes to the risk of venous thromboembolism, Danish researchers have discovered.

Clinical cardiology

Cardiovascular disease increases risk of hip fracture

Oct 20, 2009 16:00 EDT

Swedish researchers have confirmed a link between stroke and subsequent hip fracture in older people and identified for the first time that a diagnosis of heart failure also increases the risk for this fracture. They also identify a large genetic component to this association, via their use of a twin registry.

Clinical cardiology

ACE inhibitors of benefit in ischemic heart disease patients with preserved LV function

8 COMMENTS - Oct 19, 2009 17:00 EDT

Patients with ischemic heart disease and preserved LV function on standard therapy will gain additional benefit from taking ACE inhibitors, a new review concludes. The same cannot be said for ARBs, a drug class for which the evidence is much weaker, but these are a good substitute in those who cannot tolerate ACE inhibitors, the authors say.

Thrombosis Risk

TYCOON: One year of dual-antiplatelet therapy with DES isn't enough

3 COMMENTS - Oct 19, 2009 12:45 EDT

New results from an Italian registry reopen the question of how long drug-eluting stent recipients should stay on a dual antiplatelet regimen to prevent late thrombosis.

Heart failure

Transfusion in acute HF: No extra mortality risk

Oct 19, 2009 11:00 EDT

Blood transfusions for anemia in acute decompensated heart failure don't exacerbate outcomes, as may happen in some ACS cases, suggests a one-year experience of hospitals in Israel. On the contrary . . .

Imaging

Zero CAC score not 100% reassuring in those presenting to ER with chest pain

14 COMMENTS - Oct 16, 2009 12:45 EDT

In those presenting to the ER with chest pain, a prior zero calcium score cannot completely rule out a coronary obstruction, a new analysis of the MESA study has shown. This is likely due to the presence of soft plaques not detected by calcium screening, the researchers say.

Acute Coronary Syndromes

Racial background woefully underreported in CV trials

1 COMMENT - Oct 15, 2009 13:15 EDT

Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.

Interventional/Surgery

Scripps starts routine genetic testing for clopidogrel responsiveness

5 COMMENTS - Oct 14, 2009 11:00 EDT

Scripps Health has announced that it is now offering patients undergoing elective stenting a test for the gene variants associated with an inability to convert clopidogrel to its active metabolite so that antiplatelet therapy can be individualized.

Hypertension

Diuretics effective as second-line therapy for hypertension

21 COMMENTS - Oct 13, 2009 12:00 EDT

Diuretics, especially hydrochlorothiazide, are as effective when given as second-line therapy for high blood pressure as they are when used as initial treatment, according to the first review to look at this issue.

Thrombosis Risk

Hopes build for natriuretic-peptide risk stratification before noncardiac surgery

Oct 13, 2009 10:00 EDT

Could a preoperative blood assay take the place of imaging studies or other more costly assessments of cardiovascular risk? A meta-analysis suggests yes. A massive randomized trial is looking into it now.

heartbriefs

Glucocorticoids seen to double risk of atrial arrhythmias

Oct 12, 2009 16:00 EDT

In a case-control study from Denmark, the risk of atrial fibrillation or flutter was significantly increased with current but not previous use of glucocorticoids for chronic obstructive pulmonary disease, rheumatoid arthritis, and other conditions.

Features

Target HbA_1c levels still the subject of much debate, but tailored therapy should be the aim

35 COMMENTS - Oct 9, 2009 16:45 EDT

Diabetologists are trying to tease out the best message to convey when it comes to target HbA_1c levels for primary-care physicians and other nonspecialists who might be treating patients with type 2 diabetes.

Thrombosis Risk

Coronary thrombosis—the culprit is not just plaque rupture

3 COMMENTS - Oct 8, 2009 17:45 EDT

Clots derived from a different source—erosions of the arterial wall—may be an important cause of MI and sudden death, particularly in younger women, who may need a different approach to treatment, new research suggests.

Prevention

New review confirms homocysteine lowering does not prevent CVD events

Oct 8, 2009 15:30 EDT

The latest review to look at the effects of homocysteine lowering with vitamin-B supplementation has come to much the same conclusions as most other studies and analyses in this field.

Thrombosis Risk

Lupus anticoagulant a major risk factor for stroke and MI in young women

Oct 7, 2009 10:00 EDT

Results of the RATIO study suggest lupus anticoagulant, but not anticardiolipin or antiprothrombin antibodies, is associated with increased stroke risk and to a lesser extent MI.

Hypertension

China death toll due to hypertension worse than predicted

1 COMMENT - Oct 6, 2009 14:15 EDT

The first prospective study using real data to inform the number of people suffering from and dying due to high blood pressure in China finds the problem is much worse than previously thought. A number of initiatives are planned to try to tackle this crisis.

Interventional/Surgery

20 000-patient DAPT clinical trial starts enrolling with eight industry sponsors on board

1 COMMENT - Oct 5, 2009 16:45 EDT

The trial, rumored to cost more than $100 million, is a first for collaboration: eight drug and device companies are backing the trial, along with the FDA. The study is powered to detect a difference in stent thrombosis and major adverse events between patients taking 12 or 30 months of aspirin plus clopidogrel or prasugrel.

Lipid/Metabolic

Hypoglycemia associated with increased risk of MI among US veterans with diabetes

Oct 5, 2009 13:45 EDT

Close attention should be paid to diabetes patients who experience an episode of hypoglycemia, because a new case-control study suggests a 65% increased risk of MI in the immediate two-week aftermath of such an event. Doctors should tailor diabetes therapies to minimize the risk of hypoglycemia occurring, say the researchers.

Clinical cardiology

New "principles" on authorship and COI from PhRMA get mixed response

3 COMMENTS - Oct 2, 2009 12:00 EDT

The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.

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