theHeart.org - Meeting coverage

How to diurese in acute HF: Dosing strategies get an evidence base

Wed, 17 Mar 2010 11:00:24 EDT

Is it safe to start patients with acute decompensated heart failure on loop diuretics at higher-than-standard doses? And is it more effective to administer them in a continuous infusion or intermittent boluses? Until the DOSE trial asked those questions, IV diuretic strategies in ADHF had never or rarely been put to a randomized, controlled test.

Long-term, but small, PASSION and DEDICATION studies raise concern about DES in STEMI

Tue, 16 Mar 2010 18:15:09 EDT

There was an increased risk of cardiac death observed in the DEDICATION trial with the drug-eluting stents and a trend toward an increase in stent thrombosis in PASSION, but experts still caution the studies are small and should not be overinterpreted.

PLATO CABG analysis confuses cardiologists

Tue, 16 Mar 2010 17:15:08 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."

Patency for radial-artery no better than saphenous-vein grafts at one year

Tue, 16 Mar 2010 16:15:13 EDT

The study results may surprise some surgeons, who have tended to think that the radial artery might perform more like the LIMA, which has demonstrated superiority to the saphenous vein for CABG procedures. But 12 months is not enough.

Warfarin genotyping reduces hospitalizations

Tue, 16 Mar 2010 16:00:26 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.

Platinum-chrome DES performs heroically in PERSEUS

Tue, 16 Mar 2010 12:00:12 EDT

Taxus Element paclitaxel-eluting stent performs especially well in small vessels in PERSEUS trial.

Is triple antiplatelet therapy after PCI the way forward?

Tue, 16 Mar 2010 11:00:46 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.

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

Tue, 16 Mar 2010 09:45:22 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.

Cardiologists voice concern on FDA clopidogrel warning

Tue, 16 Mar 2010 09:00:44 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.

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

Mon, 15 Mar 2010 18:45:30 EDT

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

STOP-AF and CABANA: Trials show effectiveness of ablation over drugs in AF

Mon, 15 Mar 2010 15:45:27 EDT

In STOP-AF, patients with paroxysmal AF treated with a novel cryoablation technology were significantly more likely to be free of arrhythmia at one year compared with antiarrhythmic drug therapy. In addition, feasibility results of the CABANA pilot study were also presented.

New factor Xa inhibitor betrixaban safe in phase 2 AF trial

Mon, 15 Mar 2010 14:45:23 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.

Faster CONNECTions: Remote monitoring reduces event-to-decision time

Mon, 15 Mar 2010 13:30:13 EDT

Remote monitoring of ICDs reduces the time from clinical events to a clinical decision by about three weeks, on average, results of the CONNECT study of Medtronic's CareLink ICD remote-monitoring system show.

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

Mon, 15 Mar 2010 10:30:00 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?

SORT OUT III: Cypher bests Endeavor at 18 months

Mon, 15 Mar 2010 10:30:00 EDT

UPDATED // A head-to-head stent comparison has shown that patients treated with the zotarolimus-eluting stent had more major adverse cardiac events at 18 months than patients treated with the sirolimus-eluting stent.

Safely switch from amiodarone to dronedarone in two days, suggests analysis

Mon, 15 Mar 2010 08:30:00 EDT

Most patients, at least, who are in sinus rhythm after cardioversion from atrial fibrillation and for whom a transition from the old drug to the new one is planned can switch in two days. The post hoc analysis points to two signals that waiting longer might be safer, according to researchers.

"Lenient" as good as "strict" ventricular rate control in permanent AF: RACE-2 trial

Mon, 15 Mar 2010 08:00:00 EDT

UPDATED // The standard heart-rate target of <80 bpm doesn't lead to better clinical outcomes and is harder to achieve than a target of <110 bpm, a prospective randomized trial found.

New meta-analysis: Routine invasive strategy betters selective care for non-ST-elevation ACS

Sun, 14 Mar 2010 18:45:26 EDT

A more aggressive routine invasive strategy is clearly better than a conservative selective invasive strategy for all patients with non-ST-elevation acute coronary syndromes, a new meta-analysis shows. And the highest-risk patients had the most to gain, indicating that risk stratification is crucial, says the lead researcher.

INVEST: Mortality hazard with lowest blood pressures in diabetics with CAD?

Sun, 14 Mar 2010 18:00:36 EDT

Diabetic patients whose systolic blood pressure was lowered to 130 to 140 mm Hg had a better outcome than those with systolic pressures over 140. But reductions below 130 did not appear to offer any additional benefit and had a higher mortality rate in this retrospective analysis.

Abdominal CT exams may reveal patients at higher risk for cardiovascular disease

Sun, 14 Mar 2010 14:15:58 EDT

A small study of patients who have had both abdominal CT scans and coronary angiography found that abdominal aortic calcification is a predictor of obstructive coronary disease.

Psoriasis "firmly established" as risk factor for CV disease

Sun, 14 Mar 2010 10:15:33 EDT

Psoriasis patients should be considered at increased cardiovascular risk and prioritized for earlier medical risk-factor intervention for heart disease, the authors of a new study say.

No increased atherosclerotic-plaque burden in cops and firefighters

Sun, 14 Mar 2010 08:45:28 EDT

The atherosclerotic-plaque burden among cops and firefighters is no higher than in a cohort of age-matched controls, suggesting that something else, possibly increased emotional and physical stress, is causing the increased risk of on-the-job cardiac-related events.

Nanoparticle detonations may be able to burn vascular plaques

Sun, 14 Mar 2010 08:15:33 EDT

Biophotonic destruction of plaques with laser-activated nanoparticles shows promise in early clinical studies.

ACCORD BP: Intensive BP lowering futile in diabetics

Sun, 14 Mar 2010 08:00:00 EDT

The ACCORD BP study shows that there is no benefit to be gained from intensively lowering systolic blood pressure to less than 120 mm Hg in type 2 diabetics; for now, a goal of <140 mm Hg seems reasonable in this population, say the authors.

ACCORD: Fenofibrate no benefit to statin therapy in high-risk diabetic patients

Sun, 14 Mar 2010 08:00:00 EDT

UPDATED // The findings do not support the use of combination fibrate-statin therapy to reduce cardiovascular risk in the majority of patients with type 2 diabetes who are at high risk for cardiovascular disease, according to the ACCORD investigators.

EVEREST II: Mitral-clip device noninferior to surgical repair or replacement

Sun, 14 Mar 2010 08:00:00 EDT

UPDATED // Much-anticipated results from EVEREST II show that the novel device—a percutaneous version of edge-to-edge mitral-valve repair—may be safer than traditional valve repair or replacement, with "noninferior" efficacy out to one year.

NAVIGATOR off course to diabetes prevention with valsartan, nateglinide

Sun, 14 Mar 2010 08:00:00 EDT

UPDATED // In a population with impaired glucose tolerance and CV disease or risk factors, the angiotensin receptor blocker had a slight effect and the short-acting insulin secretagogue had no favorable impact on progression to diabetes; neither drug prevented cardiovascular events.

Women more likely to be referred for cath

Sat, 13 Mar 2010 17:00:10 EST

There appears to have been a paradigm shift in the way cardiologists refer to the cath lab, a new registry study suggests.

Fitness more important than fatness for thrombotic risk in firefighters

Sat, 13 Mar 2010 16:45:36 EST

Despite looking fit and healthy, a third of firefighters examined in a new study were at high risk of a thrombotic event, and improving their fitness is more likely to reduce this risk than tackling excess body weight, say the researchers.

Coffee associated with lower risk of arrhythmias

Tue, 09 Mar 2010 15:00:49 EST

Drinking four or more cups of java per day is associated with an 18% lower risk of hospitalization for arrhythmias, new research shows. While the data are observational and researchers don't advocate for greater consumption, they say it is good news that coffee doesn't appear to be harmful to the heart's electrical system.

Dieting by DNA? Popular diets work best by genotype, research shows

Mon, 08 Mar 2010 15:45:45 EST

Data presented last week suggest the secret to weight loss might lie in DNA and that the best way to shed excessive pounds is to diet according to genotype.

Weight fluctuations among normal-weight individuals increases CVD risk

Fri, 05 Mar 2010 10:15:47 EST

Normal-weight individuals whose weight fluctuated, defined as a change in one BMI unit over a two-year period, had a risk of cardiovascular-disease events similar to individuals who were overweight. Overweight individuals who cycled did not experience an increased risk of cardiovascular events.

Vigorous physical activity modestly more protective than moderate activity

Thu, 04 Mar 2010 09:30:27 EST

Researchers say the incremental benefit of vigorous activity over moderate physical activity is small and that as long as individuals are burning a certain number of calories per week they lower their risk of cardiovascular disease.

RE-LY subanalysis suggests similar benefit, fewer bleeds with dabigatran in AF patients with prior stroke or TIA

Wed, 03 Mar 2010 14:15:32 EST

A subanalysis shows that dabigatran is at least as efficacious and may be even safer than warfarin in this higher-risk subgroup. A trend toward increased MI in the overall study with dabigatran was not seen in patients with prior stroke or TIA.

Studies find disparities in stroke incidence and AF treatment

Mon, 01 Mar 2010 18:15:20 EST

Blacks are more likely than whites to suffer a stroke and less likely to be treated for atrial fibrillation, new research shows.

Diets high in fat, particularly trans fat, raise risk for ischemic stroke

Fri, 26 Feb 2010 15:00:28 EST

Researchers say their study is the first to confirm a link between dietary fat and stroke in older women and should serve as a reminder to clinicians to educate their patients about food choices.

CREST: Stenting and endarterectomy show similar net safety and efficacy for carotid stenosis

Fri, 26 Feb 2010 13:15:20 EST

UPDATED // Results suggest some advantage for stenting in younger patients and for surgery in older patients.

Experts ponder expanding transcatheter valves indication to lower-risk patients

Thu, 25 Feb 2010 17:15:00 EST

A variety of experts at the CRT conference discuss what it will take to bring minimally invasive transcatheter-valve implants to patients beyond those ineligible for open-heart surgery.

Is there too much excitement for ticagrelor?

Wed, 24 Feb 2010 16:15:31 EST

One expert argues for a more cautious approach to the potent antiplatelet drug ticagrelor, but not everyone shares his trepidation.

No time like the present: Study supports early mitral-valve repair in asymptomatic patients

Mon, 01 Feb 2010 13:45:30 EST

In a study of 4586 patients with severe degenerative mitral regurgitation, even mild heart-failure symptoms are associated with decline in cardiac function, suggesting that early valve surgery will yield better long-term outcomes than surgery after symptoms become manifest.

Best timing of surgery for active mitral endocarditis remains controversial

Mon, 01 Feb 2010 11:30:23 EST

A small study suggests supports the safety of early surgery for mitral regurgitation in the setting of endocarditis, instead of waiting for the usual six weeks for antibiotics to work.

Looking after their own: Surgeons may provide better care than intensivists in ICU

Thu, 28 Jan 2010 18:30:00 EST

A single-center study suggests that physicians trained as cardiac surgeons are better suited to care for cardiac critical-care patients than general intensivists.

Study finds delaying surgery after PCI prevents kidney injury

Wed, 27 Jan 2010 17:15:00 EST

An observational study in Maine finds that patients who went home between PCI and cardiac surgery had a significantly lower risk of acute kidney injury than patients undergoing PCI and surgery in the same hospital admission.

Society of Thoracic Surgeons' national database effort comes of age

Tue, 26 Jan 2010 10:00:20 EST

Researchers have successfully "linked" the Society of Thoracic Surgeons' national surgery database to CMS records to facilitate the study of long-term outcomes of cardiothoracic surgery.