theheart.org: Cardiology news, educational programming, and opinions

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.

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.

Lipid/Metabolic

Less exposure to cardiovascular risk factors with intensive diabetes intervention: Look AHEAD

1 COMMENT - Oct 26, 2009 10:00 EDT

Intensive lifestyle intervention in the management of diabetes produces sustained weight loss and improvements in fitness, as well as improvements in glycemic control, systolic blood pressure, and HDL-cholesterol levels.

Prevention

Experts weigh in on calorie lists on menus, despite "mixed" science

2 COMMENTS - Oct 26, 2009 16:45 EDT

Results showing that people eat less when they know how many calories are in that Big Mac are mixed, but experts say that menu labeling provides only upside, with no public-health cost, and that over time results will show the information to have a positive effect on obesity rates in the US.

Interventional/Surgery

Blood products should be used conservatively in heart-surgery patients, trial shows

4 COMMENTS - Oct 27, 2009 12:15 EDT

Administration of blood products to stable patients post-cardiac surgery increases their risk of death, renal failure, and sepsis, according to new research.

Interventional/Surgery

Underutilization of ICDs in CABG patients is worst in women and elderly, Halifax study shows

1 COMMENT - Oct 28, 2009 16:45 EDT

Only 101 of 1169 post-bypass-surgery patients eligible for an ICD got one over a 13-year period in Nova Scotia.

Lipid/Metabolic

Thiazolidinediones have a role for appropriate diabetic patients

5 COMMENTS - Oct 20, 2009 12:45 EDT

After 10 years of clinical use of TZDs, "we are still at the beginning," and randomized controlled trials shed light on their use in appropriate diabetic patients, speakers at a diabetes symposium reported.

Prevention

Current risk equations may overestimate CVD risk in diabetic patients

Oct 21, 2009 10:00 EDT

Researchers using different international databases report that the Framingham and UKPDS risk equations overestimate the probability of CV events in diabetic patients.

Prevention

Time to act: Cardiologists, diabetes docs, and psychiatrists urged to work together to tackle CVD in the mentally ill

Sep 30, 2009 14:00 EDT

Doctors from across the specialties of cardiology, diabetes, and psychiatry are being urged to collaborate to improve care for the mentally ill, who are more likely to die from cardiovascular disease than any other cause.

heartbriefs

Insulin glargine and cancer: Association, no causal link

1 COMMENT - Oct 2, 2009 15:00 EDT

That was the conclusion of a recent panel of experts, perhaps alleviating concerns raised by several recent studies.

Heart failure

Who should get CRT? Resynchronization benefits seen in heart failure with LVEF >35%

Sep 14, 2009 17:15 EDT

Heart-failure patients with ejection fractions >35% aren't necessarily excluded from the clinical and reverse-remodeling benefits of cardiac resynchronization therapy, suggests yet another study questioning the limits of CRT's current eligibility criteria.

Heart failure

FAST enough? Intrathoracic monitor bests weight gain in predicting worsening heart failure

1 COMMENT - Sep 15, 2009 14:30 EDT

Can an intrathoracic fluid-status monitor, added to an already-indicated ICD or CRT-D device in patients with heart failure, serve as the decompensation early-warning system now provided—unreliably but as recommended in the guidelines—by the bathroom scale?

Interventional/Surgery

ENDEAVOR IV: Revascularization rates similar for Endeavor and Taxus at three years, with Endeavor "pulling ahead" for safety

Sep 22, 2009 09:45 EDT

Rates of cardiac death and MI actually statistically favor the Endeavor stent at three years, new data show. Stent thrombosis occurred just once after one year for Endeavor, as compared with 11 cases after the one-year mark in the Taxus-treated patients.

Interventional/Surgery

Three-year SPIRIT III results show enduring edge for Xience V over Taxus

Sep 22, 2009 11:45 EDT

Three-year target vessel failure remained statistically lower for the everolimus-eluting Xience V stent (which is also marketed as the Promus) than for the paclitaxel-eluting Taxus stent.

Clinical cardiology

Ghost authorship on the wane, but guest authorship still common

Sep 11, 2009 11:00 EDT

UPDATED // Compared with a 1996 survey by JAMA editors, a 2008 survey indicates that the practice of having ghost writers pen papers, then not appear as authors, is down to 8%, from 12% in 1996. The practice of inviting a prominent name to appear in the list of authors, without requiring that person to contribute to the research, has held steady at roughly 20%.

Clinical cardiology

Sponsorship of med-school textbooks in Denmark exposes vulnerable minds to commercial bias

Sep 14, 2009 11:45 EDT

Results of a new survey showed that a surprising 15% of textbooks had one or more drug or device sponsors and, in two cases, those sponsors had tried to influence the content of the textbooks.

The Cardiology Show

Best of Barcelona: PLATO and RE-LY

Sep 2, 2009 11:15 EDT

Dr Valentin Fuster returns to the city where he was born for a scintillating discussion with Drs Fox, Gershlick, Marrouche, Messerli, Spaulding, Vergheugt, Virmani, and Yancy about the miracle of RE-LY and the striking success of ticagrelor in the PLATO study.

Acute Coronary Syndromes

PLATO shows benefits of ticagrelor over clopidogrel

6 COMMENTS - Aug 30, 2009 02:00 EDT

UPDATED WITH COMMENTARY // A new nonthienopyridine antiplatelet agent, ticagrelor, has trumped clopidogrel in a phase 3 pivotal trial comparing the two agents and appears not to have the bleeding risks associated with prasugrel. But ticagrelor, which has the advantage of being reversible, has some unique side effects that could prove problematic.

Hypertension

HCTZ a "paltry" antihypertensive, with no effect on outcomes, new analysis suggests

22 COMMENTS - Jun 15, 2009 15:00 EDT

The lead investigator for a controversial new analysis of hydrochlorothiazide says the drug is a "paltry" antihypertensive at the usual doses prescribed (12.5 mg-25 mg/per day) and should not be used as initial therapy. Others, however, offered plenty of caveats for the "provocative" conclusions.

Hypertension

Some surprises in update to European hypertension guidelines?

3 COMMENTS - Jun 15, 2009 11:15 EDT

The European Society of Hypertension is set to stir up the field of BP guidelines later this year, when it publishes an update to its 2007 recommendations. One key change is the recognition of a level of blood pressure below which could be dangerous to high-risk individuals, the so-called J-curve phenomenon. And the new guidelines will advise tailoring therapy to individual patients, rather than recommending a first-, second- and third-line drug therapy approach.

Lipid/Metabolic

Avandia on the RECORD: No "overall" CV risk increase, but trial remains controversial

20 COMMENTS - Jun 5, 2009 19:30 EDT

The trial concluded with the rosiglitazone being "noninferior" to metformin/sulfonylurea therapy with respect to CV death or hospitalization as adverse events over a follow-up of about five years. Researchers and observers disagree sharply, however, over what those results and other findings in the trial mean for diabetes therapy.

Lipid/Metabolic

No mortality, CV-event differences between revascularization and medical therapy in diabetics: BARI 2D

4 COMMENTS - Jun 8, 2009 13:35 EDT

Overall rates of major CV events also were no different between revascularization and medical therapy, although CABG alone—but not PCI—was associated with a reduction in the risk of cardiovascular events, particularly nonfatal MI, compared with medical therapy, investigators note.

Hypertension

Most hypertension drugs, except ARBs, better than no treatment for CHD risk reduction

2 COMMENTS - May 7, 2009 09:30 EDT

Although most patients receive more than one drug for high blood pressure, two new meta-analyses show that, in terms of initial drug therapy, only angiotensin receptor blockers were not significantly better than placebo or no treatment for the prevention of coronary heart disease events, while all antihypertensive drugs were better than placebo for the prevention of stroke.

Clinical cardiology

Return of the J-curve: TNT analysis shows that BP can be too low in CAD patients

4 COMMENTS - May 8, 2009 11:15 EDT

In a group of patients with coronary artery disease, despite substantial lowering of LDL-cholesterol levels, a J-curve relationship exists between systolic and diastolic blood pressure and cardiovascular events, suggesting that low blood pressure can be harmful.

Interventional/Surgery

Possible "class effect" for proton-pump inhibitors on top of clopidogrel therapy

11 COMMENTS - May 6, 2009 17:15 EDT

UPDATED // One-year risk of cardiovascular events is 50% higher in patients taking a proton-pump inhibitor on top of clopidogrel and similar for four PPIs, according to a retrospective cohort study of more than 16 700 patients who received clopidogrel poststenting.

Thrombosis Risk

Stent thrombosis responsible for an increasing proportion of STEMI

13 COMMENTS - May 7, 2009 13:15 EDT

The regional study highlights the need for studies addressing whether stent-thrombosis-STEMI patients should be treated the same as other STEMI patients.

Interventional/Surgery

Pooled five-year results for Endeavor support durability of TLR, low adverse events

May 19, 2009 12:00 EDT

The findings should help quell fears of a late catch-up phenomenon with a stent some have referred to as "DES-lite" and dispel concerns raised in meeting presentations last year about increased adverse events with this device.

Interventional/Surgery

The return of the reservoir DES: Nevo stent impresses against Taxus at six months

May 19, 2009 14:30 EDT

Early results for the novel stent are reviving hopes for a concept that many people agreed was a good idea to begin with—reservoir-based elution of an antiproliferative drug, using a bioerodable polymer.

Arrhythmia/EP

New HRS consensus statement on lead extraction sets volume benchmarks for operators

2 COMMENTS - May 13, 2009 16:40 EDT

Physicians trained in lead extraction should extract a minimum of 40 leads as the primary operator under the supervision of a qualified training physician and should extract a minimum of 20 leads annually as the lead operator. These numbers, however, are a "bare-bones" minimum, say researchers, stressing that patient care should always be individualized.

Arrhythmia/EP

HRS urges upgrades to process of recognition, reporting of ICD lead performance issues

May 14, 2009 09:15 EDT

One crucial goal of the newly minted document is to foster realistic expectations for lead capabilities among regulators, industry, clinicians, and even patients.

ACS

What's going to be hot at ACC 2009?

Mar 24, 2009 11:00 EDT

JUPITER still burns brightly, if this year's ACC program is any indication. Program chairs for the ACC and i2 Summit programs say there are a range of other important trials that may prove "disruptive" to the status quo.

Interventional/Surgery

Quality-of-life and cost analyses for SYNTAX can help hone treatment decisions, researchers say

Mar 28, 2009 07:30 EDT

UPDATED WITH COMMENTARY // CABG-treated patients have more angina relief at one year, but PCI is the more cost-effective strategy, at least in low- and moderate-risk patients. During the first month, quality-of-life analyses clearly favor PCI, but these differences evaporate over the first year. In high-risk patients, CABG remains the clear winner.

Interventional/Surgery

Carotid stenting safe and effective with experienced operators, European registry suggests

Oct 13, 2008 09:15 EDT

Investigators caution that the data are preliminary, but the 30-day risk of stroke and death observed in clinical trials is lower when more experienced operators perform the procedure. (TCT 2008.)

Interventional/Surgery

No increased risk, but no MI/mortality benefit with DES, experts cautiously conclude

Oct 13, 2008 11:45 EDT

Leaders of some of the more provocative DES studies in recent years seem to agree that other factors may be contributing to the apparent survival benefit with DES seen in recent registries but that it is at least safe to conclude that risk of death or MI is not increased with their use. But many also argue for a bigger role for bare-metal stents. (TCT 2008.)

HeartWire clips

Face-to-face with Dr Melissa Walton-Shirley: From the AHA with Dr Sidney Smith

Dec 16, 2008 13:00 EST

Join theheart.org's forum moderator in these in-depth interviews filmed on location at major congresses

Clinical cardiology

JUPITER hits New Orleans: Landmark study shows statins benefit healthy individuals with high CRP levels

73 COMMENTS - Nov 9, 2008 09:00 EST

There are a number of adjectives being thrown at the JUPITER study—groundbreaking and paradigm shifting are just two—but many experts believe the study, which showed significant cardiovascular risk reduction among healthy individuals with elevated CRP levels, is likely going to shake up the field of primary prevention. (Ridker PM et al. New Engl J Med; published online before print November 9, 2008. American Heart Association 2008 Scientific Sessions.)

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