theheart.org

Salt in the wound: Experts debate lowering worldwide sodium intakes

Mon, 17 Jun 2013 11:00:40 EDT

At the ESH meeting, two experts took opposing views concerning the current war on salt. One believes the current salt/sodium targets were simply pulled out of a hat and have no scientific basis at all, while the other believes the targets are necessary to help start a low-sodium environment for future generations, lowering their potential risks of hypertension and cardiovascular disease.

Spironolactone provides benefit in resistant hypertension, small study shows

Mon, 17 Jun 2013 09:45:22 EDT

Daytime blood pressure measured by 24-hour ambulatory blood-pressure monitoring was reduced by 8.9/3.7 mm Hg, report investigators. The data suggest that the addition of spironolactone might be beneficial in this hard-to-treat patient population already receiving multiple antihypertensive medications, they add.

Disappointing real-world results with renal denervation: BP reductions small with ABPM

Mon, 17 Jun 2013 08:45:19 EDT

While the office-measured 17.6-mm-Hg reduction in systolic blood pressure is within the range of clinical-trial data, 24-hour ambulatory blood-pressure monitoring revealed a much smaller reduction. Investigators say that renal denervation for resistant hypertension needs to be further studied and should be used only as a last resort, preferably in a research context.

New European hypertension guidelines released: Goal is less than 140 mm Hg for all

Sat, 15 Jun 2013 12:40:35 EDT

The new guidelines make <140 mm Hg the treatment target for all individuals, with a few minor exceptions, and say that all the drug classes have a role in reducing blood pressure. In addition, the ESH/ESC guidelines emphasize a role for ABPM and reiterate their emphasis on combination therapy.

Revised ACC/AHA HF guidelines address aldosterone, device use, quality of life

Fri, 14 Jun 2013 17:30:39 EDT

The just-released 2013 ACC/AHA HF guidelines present a strong evidence-based approach that covers the spectrum from screening for the disease, through treatments, to discussing end-of-life care.

EMA committee concludes diclofenac poses similar risks as COX-2 inhibitors

Fri, 14 Jun 2013 14:45:09 EDT

The committee says the benefits of diclofenac exceed the known risks and that physicians should take the same precautions to minimize thromboembolic risk as they do with patients treated with selective COX-2 inhibitors.

Publish "invisible" and "abandoned" clinical trials. Or else

Fri, 14 Jun 2013 11:15:19 EDT

Experts have proposed using sponsors' clinical-study reports to publish unpublished trials and correct misreported trials, as well as to let others publish the unpublished data.

Yaz, Yasmin BCPs linked to 23 deaths in Canada

Thu, 13 Jun 2013 16:50:22 EDT

At least 23 deaths and 600 adverse-event reports have been collected by Health Canada since 2007. The agency says it still believes the benefits of the drospirenone-containing birth-control pills outweigh the risks, although VTE risk is higher with these pills than with earlier-generation ones.

Oversized 2-mg warfarin tablets recalled

Thu, 13 Jun 2013 10:30:54 EDT

One lot (#MM5767) made by Zydus Pharmaceuticals may include pills that contain an increased pharmacological effect, due to their larger size.

Low diastolic blood pressure linked to brain atrophy

Thu, 13 Jun 2013 10:30:04 EDT

A new study presents more evidence of the importance of target blood-pressure levels in middle-aged patients.

Severe sleep apnea may almost double risk of sudden cardiac death

Wed, 12 Jun 2013 17:00:08 EDT

In a large observational study, severe sleep apnea and nocturnal drops in oxygen saturation were independent predictors of sudden cardiac death; this points to the need to identify and treat moderate to severe sleep apnea, the researchers say.

Dabigatran 110 mg similar in benefit to 150 mg in weighted analysis

Wed, 12 Jun 2013 15:45:09 EDT

European, Canadian, and Australian regulators all approved both the 110-mg and 150-mg doses studied in the RE-LY trial, while the FDA approved only the higher dose. A new analysis is once again calling this decision into question.

Vegetarian diet linked to longer life, less CVD mortality

Tue, 11 Jun 2013 17:00:58 EDT

However, this was a short, observational study in a cohort that is not representative of the general population, experts point out. The take-away message is not that everyone should all convert to a vegetarian diet, but the study does add support for following a "heart-healthy" diet.

Radial-access PCI on the rise in the US

Tue, 11 Jun 2013 17:00:04 EDT

The proportion of radial-PCI procedures increased from 1.2% in 2007 to 16.1% in 2013, with radial PCI accounting for 6.3% of all procedures in the CathPCI registry during this five-year period.

ADA calls for independent review of incretins/cancer concerns

Tue, 11 Jun 2013 13:15:41 EDT

The ADA is the latest organization to call for an independent review into GLP-1-based therapies for type 2 diabetes to see whether they increase the risk of pancreatitis and pancreatic cancer.

Niacin use increased nearly 200% over seven-year period

Mon, 10 Jun 2013 16:00:00 EDT

Nearly 700�000 prescriptions per month were written in the US at the end of 2009, an increase of 191% from 2002. In Canada, the use of niacin increased sevenfold, with nearly 14�000 prescriptions written at the end of 2009.

BMJ digs deep into diabetes drug, pancreatic-cancer debate

Mon, 10 Jun 2013 15:15:11 EDT

BMJ, together with the UK's Channel 4, says greater transparency could better inform the debate about pancreatitis and pancreatic cancer associated with incretins for type 2 diabetes.

Insulin sensitizers slash PAD risk in BARI 2D analysis

Mon, 10 Jun 2013 14:15:15 EDT

The same week that two FDA panels voted to keep rosiglitazone on the market, a new analysis from BARI 2D finds that insulin sensitizers such as this lower PAD risk in patients with diabetes and CAD.

Higher LV mass after preeclampsia predicts later hypertension

Fri, 07 Jun 2013 17:00:00 EDT

Postpartum CV risk goes up in women who had preeclampsia, but their CVD still tends to be identified late. What if they could be identified sooner?

AASM calls for sleep apnea check in diabetes, hypertension

Fri, 07 Jun 2013 15:45:00 EDT

Patients with type 2 diabetes or hypertension should be evaluated for sleep apnea, the American Academy of Sleep Medicine advised this week on the strength of new data on risk in these populations.

Varenicline for alcohol dependence? CV events and suicide concerns linger

Fri, 07 Jun 2013 14:45:00 EDT

New research suggests the smoking-cessation drug varenicline may aid in the treatment of alcohol dependence, but reaction to the study suggests this approach may face some hurdles.

AF linked to earlier, more rapid cognitive decline

Fri, 07 Jun 2013 14:00:00 EDT

A new study suggests that patients with AF meet thresholds for cognitive impairment and dementia more rapidly than those without AF.

New obesity drug, lorcaserin, in US pharmacies next week

Fri, 07 Jun 2013 11:45:00 EDT

The second new obesity drug in recent years, lorcaserin (Belviq), will finally be launched in the US next week. The news comes as the European regulatory agency details why it rejected the product.

Fitter football fans, four years and counting: Celtics/Rangers Football Health Study

Fri, 07 Jun 2013 11:00:51 EDT

An unfit, overweight, middle-aged football fan is unlikely to show up at the community center's "Thighs, Tums, and Bums" aerobics class. That's where an underused soccer stadium and gym might come in handy for CV prevention, a novel study proposes.

Rosiglitazone restrictions should be eased, says FDA advisory panel

Thu, 06 Jun 2013 21:45:43 EDT

Influenced by a recent RECORD readjudication showing lack of significant harm, a joint FDA advisory panel voted to keep rosiglitazone on the US market and to ease current prescribing restrictions but not remove them entirely.

Aspirin unneeded with anticoagulation/clopidogrel after MI, PCI in AF

Thu, 06 Jun 2013 17:00:08 EDT

A large national cohort study somewhat confirms what the WOEST trial suggested: that an oral anticoagulant plus one antiplatelet is sufficient in patients with multiple indications for antithrombotic therapy.

SNP influencing warfarin dose identified in African Americans

Thu, 06 Jun 2013 15:45:17 EDT

Patients carrying the SNP, which is located in the CYP2C9 gene, require a significantly lower stable dose of warfarin than do those without the variant, say researchers. The addition of the SNP also improved the International Warfarin Pharmacogenetics Consortium treatment algorithm by 21%.

Kentucky cardiologist admits to healthcare fraud in stenting case

Thu, 06 Jun 2013 12:30:04 EDT

Dr Sandesh Rajaram Patil, who practiced at St Joseph's Hospital, admitted that he lied about the severity of coronary disease and submitted this false data to the Centers for Medicare and Medicaid to receive payment for the procedure.

FDA says again: Rosiglitazone does not up CV risk

Thu, 06 Jun 2013 12:15:25 EDT

The first day of a two-day meeting on rosiglitazone included presentations from the FDA, GlaxoSmithKline, Duke University reviewers, and one dissenting FDA official. Today the panel will vote on the drug's future.

Statins linked with risk of musculoskeletal injury

Wed, 05 Jun 2013 16:15:57 EDT

Researchers suggest the full range of musculoskeletal adverse events might not be fully known and that further studies are needed, especially in active individuals.

SPS3: Systolic BP <130 beneficial in lacunar stroke

Wed, 05 Jun 2013 14:30:13 EDT

Although the primary end point was not quite significant, results did suggest a reduction in stroke with lower blood pressure. The secondary end point of hemorrhagic stroke was significantly reduced.

Mixed results for PCSK9 inhibition in homozygous familial hypercholesterolemia

Wed, 05 Jun 2013 12:30:03 EDT

A new proof-of-concept study has shown for the first time that the investigational monoclonal antibody lowers LDL cholesterol in this rare inherited disorder, but only in patients who have residual LDL-receptor activity, and not in those with none.

Recombinant human LCAT raises HDL in rare lipoprotein disorder

Wed, 05 Jun 2013 12:00:30 EDT

Researchers have, for the first time, successfully replaced the defective enzyme found in this rare inherited disorder, demonstrating safety as well as significant improvements in HDL and markers of renal function.

Aspirin effective for VTE prevention after hip replacement

Wed, 05 Jun 2013 11:30:03 EDT

Aspirin is as effective as dalteparin for venous-thromboembolism prevention after hip replacement, according to a multicenter randomized controlled trial of 778 patients.

AMI, sudden death tracked with seismic activity during East Japan quake

Wed, 05 Jun 2013 08:30:02 EDT

For these events, say the authors, the original quake and aftershocks may have been more important in terms of acute physical and psychological stress than the tsunami and the displacement it caused.

Myocardial perfusion imaging not helpful for syncope

Tue, 04 Jun 2013 17:00:17 EDT

Stress myocardial perfusion imaging had very low diagnostic yield in syncope patients without known heart disease.

Gastric bypass surgery for diabetes with nonmorbid obesity? Maybe

Tue, 04 Jun 2013 16:00:00 EDT

Patients with a BMI of 30 to 40 and uncontrolled diabetes appear to attain better outcomes a year after bariatric surgery vs nonsurgical therapy, but more long-term data are needed, researchers caution.

Chinese herbal medicine shows promise in HF in early trial

Tue, 04 Jun 2013 15:30:00 EDT

Adding capsules of qili qiangxin to standard therapy improved natriuretic-peptide levels in chronic heart failure patients in a trial that, although it had limitations, provides a "welcome step" in studying potential HF medications that have been used for centuries.

Four healthy lifestyle behaviors lower risk of death, slow CAC progression

Tue, 04 Jun 2013 15:00:43 EDT

Four easy-to-adopt lifestyle behaviors are associated with a significantly lower risk of death, according to a new MESA analysis. Not smoking, eating right, daily physical activity, and a healthy weight were associated with a slower progression of calcium in the coronary arteries.

Myopericardial inflammatory syndrome has favorable prognosis: Study

Tue, 04 Jun 2013 11:31:47 EDT

In a three-year prospective study of close to 500 patients with pericarditis with or without myocardial involvement, outcomes were good and recurrent pericarditis was the only significant complication.

Childhood BP linked to adult atherosclerosis, but reversing BP may help

Tue, 04 Jun 2013 08:45:44 EDT

The study shows once again that kids with high blood pressure are likely to remain hypertensive as adults, but in a glimmer of hope, young people who got their blood pressure under control did not appear to have the same atherosclerotic progression seen among those who remained or became hypertensive.

Mediterranean diet slows atherosclerosis progression in PREDIMED

Mon, 03 Jun 2013 19:30:00 EDT

High adherence to a Mediterranean diet, particularly one supplemented with nuts, appeared to slow the progression of atherosclerosis as measured by internal carotid artery intima-media thickness.

New EAS consensus document tackles familial hypercholesterolemia

Mon, 03 Jun 2013 19:00:00 EDT

According to the European Atherosclerosis Society, familial hypercholesterolemia is woefully underdiagnosed and undertreated. The society has recently completed a new consensus paper offering some advice.

Lomitapide should be approved for HoFH in Europe, EMA advised

Fri, 31 May 2013 17:30:48 EDT

An advisory committee to the European Medicines Agent gave a "positive opinion" on the drug for treating homozygous familial hypercholesterolemia.

Sparks fly within FDA over longstanding ARB-cancer controversy: WSJ

Fri, 31 May 2013 17:00:18 EDT

The Wall Street Journal today peeks behind the scenes at the FDA with a story depicting a high-level dispute over whether signals of a cancer risk from angiotensin-receptor blockers should be further explored, despite official stances by regulators on both sides of the Atlantic that such a risk likely doesn't exist.

Coenzyme Q10 supplementation reduces HF admissions and improves survival: Q-SYMBIO

Fri, 31 May 2013 16:00:27 EDT

To heartwire, a couple of doctors expressed caution and curiosity about the extraordinary results, including the 50% reduction in mortality, and say they need to see the data published in a peer-reviewed journal before jumping on the CoQ10 bandwagon. The Q-SYMBIO investigators say they are planning to submit the study for publication.

Smoking a bigger player in STEMI for younger patients

Fri, 31 May 2013 12:15:10 EDT

A STEMI patient younger than 35 is 11 times more likely to be a smoker than the STEMI population overall, Michigan data suggests.

New mineralocorticoid-receptor antagonist passes in phase 2 study

Thu, 30 May 2013 16:45:32 EDT

Patients treated with the drug, known only as BAY94-8862 at the moment, had a significantly lower risk of hyperkalemia than patients treated with spironolactone, as well as a lower risk of worsening renal failure. The drug also reduced BNP levels as much as spironolactone.

NSAID CV-event risk high overall, but predictable in individuals, says analysis

Thu, 30 May 2013 15:30:00 EDT

One standard NSAID stood out for having no significant effect on CV risk, consistent with past findings.

House GOP advances "doc fix" for SGR crisis

Wed, 29 May 2013 17:00:20 EDT

Draft legislation from Republicans would replace the SGR with a hybrid of fee-for-service and pay-for-performance and give physicians a choice of payment options.

"Healing" sirolimus-eluting coronary stent gets market approval in Europe

Wed, 29 May 2013 09:45:22 EDT

Now with the CE Mark, the stent elutes antiproliferative sirolimus but also features an anti-CD34 antibody coating to promote endothelialization, with the goal of cutting the risk of in-stent thrombosis.

Ventricular reshaping surgery rises again in heart failure: CONFIGURE-HF phase 1 results

Wed, 29 May 2013 09:30:17 EDT

The reshaping surgery, which utilizes titanium anchors to exclude scarred and acontractile myocardium from the ventricular chamber, improves left ventricular end-systolic volume and end-diastolic volumes in chronic heart-failure patients at six months and one year.

New guideline issued on thrombotic therapy management during procedures

Tue, 28 May 2013 15:30:26 EDT

Continuing aspirin is usually acceptable, but there is less guidance on how to manage other antithrombotic meds during surgery or other procedures in patients with cerebrovascular disease, according to the American Academy of Neurology document.

Obesity, hypertension prevalent in growing number of children

Tue, 28 May 2013 14:30:47 EDT

Excessive weight in young people suggests their risk for metabolic syndrome, hyperlipidemia, sleep disorders, type 2 diabetes, and kidney disease as adults will be high.

Heart-failure admissions and mortality highest in winter and on weekends

Tue, 28 May 2013 11:30:43 EDT

Heart-failure admissions and mortality rates were highest in January and February, while admissions on a Friday, Saturday, or Sunday were also associated with higher risks of death, report investigators.

No point to "aggressive" sodium, fluid restriction seen in acute HF

Tue, 28 May 2013 10:00:50 EDT

UPDATED // All it did in a small randomized trial was to make the patients thirsty; it didn't do anything for weight loss or clinical stability.

Serelaxin reduces dyspnea in HF-PEF patients in first 24 hours: RELAX-AHF analysis

Mon, 27 May 2013 17:45:00 EDT

Like the overall trial, which reported no improvement in cardiovascular death or hospitalization for heart or renal failure through day 60, there was no significant treatment effect in patients with HF-PEF or HF-REF.

More data show lower is not always better for BP in diabetes

Mon, 27 May 2013 17:30:00 EDT

More coronary heart disease was seen at both ends of the BP spectrum for younger type 2 diabetes patients, but among the elderly, low BP posed an even greater risk of CHD.

Quantified hydration status predicts hospital readmissions in acute-HF patients

Mon, 27 May 2013 14:00:00 EDT

Volume overload measured using a novel technique known as bioelectrical impedance vector analysis, which allows researchers to quantify hydration status, was significantly associated with an increased risk of hospital readmissions in patients with acute heart failure, according to the results of a new study.

HEAT-PPCI seeks AMI answers in all-comers, dead or alive

Mon, 27 May 2013 13:00:00 EDT

Blazing new ground, investigators in the UK have set themselves the lofty goal of randomizing every single acute-MI patient admitted to their hospital, without first getting their consent. That means even the patients who die in the early days of the study will be key participants, despite having never actually agreed to be in the trial.

Acute-HF patients fare better when admitted to cardiology ward—improved survival, better meds

Mon, 27 May 2013 11:45:00 EDT

Acute heart failure patients who are not seen by a cardiologist and receive no cardiology follow-up at discharge are at significantly increased risk of dying compared with those seen by heart specialists. In addition, heart-failure patients treated in general-medicine wards are significantly less likely to receive guideline-based therapy at discharge, UK research shows.

Drug-eluting balloons for in-stent restenosis: Guidelines, experts diverge

Mon, 27 May 2013 11:00:00 EDT

Drug-eluting balloons have been plagued, for years, by flawed technology and undersized trials. But some experts believe they are the best way forward for in-stent restenosis and that skeptical physicians should sit up and take notice.

Vildagliptin in HF patients with diabetes meets echo end point, but questions remain

Mon, 27 May 2013 09:30:15 EDT

While the study met its primary end point—statistical noninferiority in change in LVEF vs placebo—investigators did observe an increase in left ventricular end-diastolic and end-systolic volumes, as well as increased stroke volume.

Sprint Fidelis ICD leads: Common in kids, account for most of their lead failures

Fri, 24 May 2013 16:15:39 EDT

The lead failure rate was about 14% overall in a registry of young people with ICDs; the slim Fidelis made up more than two-thirds of their failed leads. There are special considerations when selecting ICD leads for this age group.

In-hospital strokes get worse care than those presenting to ER, study finds

Fri, 24 May 2013 15:45:49 EDT

There are time-tested protocols for responding to strokes in the emergency department, says one observer, but "we just haven't worked it out for the inpatient setting because it's much less common."

Massachusetts health reform didn't increase hospital costs, study finds

Fri, 24 May 2013 15:00:00 EDT

The study of more than two million patients found about the same rate of increase as before healthcare reform was implemented in Massachusetts.

Elective PCI ischemic preconditioning: Clinical gains durable up to six years

Fri, 24 May 2013 14:01:13 EDT

Low-tech myocardial protection: six-month event-free-survival gains from the procedure, reported in 2009, are mostly still evident years later in the randomized CRISP Stent study.

Stroke costs to double by 2030: AHA statement

Fri, 24 May 2013 13:30:35 EDT

The statement calls for greater awareness of this "looming crisis" by policy makers at all levels of governance so that practical ways to avert it can be considered.

Rivaroxaban approved for ACS secondary prevention in Europe

Fri, 24 May 2013 13:15:09 EDT

The European Commission has approved a 2.5-mg twice-daily dosage based on the ATLAS ACS 2 TIMI 51 trial.

EnligHTN-1: BP drops durable, safe at one year, as renal-denervation mania grows

Fri, 24 May 2013 11:00:25 EDT

Twelve-month durability and safety results are exciting with this device, one investigator says. This year's EuroPCR program is jam-packed with new data and how-to sessions and included at least one live case where things did not go entirely according to plan.

Two studies address diabetes risks with statins—one good news, one so-so

Thu, 23 May 2013 18:30:00 EDT

While one study is reassuring for older patients treated with statins, with researchers finding no evidence of an increased risk of diabetes in acute coronary syndrome patients, the other suggests that the more potent statins, such as rosuvastatin, atorvastatin, and simvastatin, do pose an increased risk compared with pravastatin.

RIPCORD: FFR during diagnostic angio may radically alter treatment plans

Thu, 23 May 2013 12:15:25 EDT

Results of a small proof-of-concept study, if confirmed in a larger series, have implications for noninterventional cardiologists who currently perform diagnostic angiography and for other kinds of noninvasive tests that might no longer be needed to decide a patient's treatment course.

Regional density of cardiologists affects MI and HF mortality risk

Wed, 22 May 2013 16:30:32 EDT

Patients who have an MI or develop heart failure in a part of the country with a low density of practicing cardiologists have a slightly higher risk of death at 30 days and one year compared with those who have the same clinical events in an area more densely populated with cardiologists.

SOURCE XT one-year numbers may be best TAVR survival data so far

Wed, 22 May 2013 11:30:24 EDT

CORRECTED // In an intriguing new finding, survival rates were actually better for women than for men. Paravalvular leaks were also much lower in this registry cohort.

Study raises doubt about thromboembolism prophylaxis

Wed, 22 May 2013 10:30:12 EDT

The use of venous thromboembolism prophylaxis does not curb events, new research shows.

Girl trouble: Rising tide of STEMI in young women "clearly not acceptable"

Wed, 22 May 2013 08:10:49 EDT

At a meeting famous for showcasing flashy new interventional devices, one session sought to shine a light on a tenacious old problem. It's time for interventionalists to step up and take action, say two leaders in this field.

MRI evidence of plaque progression in aliskiren-treated patients

Wed, 22 May 2013 08:00:22 EDT

Although the totality of the evidence did show a significantly increased risk of plaque progression with aliskiren, the increase was driven by a change in aortic plaque among individuals treated with it in combination with an ACE inhibitor or angiotensin-receptor blocker.

SCAAR: Could cheap heparin replace pricy bivalirudin in PCI for non-STE-ACS?

Tue, 21 May 2013 13:50:35 EDT

Investigators for a new SCAAR registry analysis point out that bivalirudin has been widely studied only against a combination of GP IIb/IIIa inhibition and heparin, but that heparin alone is cheaper and yielded similar 30-day mortality rates in this patient group.

Cardiac-arrest survival highest at hospitals with the fewest

Tue, 21 May 2013 11:30:41 EDT

Hospitals that excel at preventing cardiac arrests also have higher survivor rates when an arrest occurs.

BIOFLOW II: New bioabsorbable-polymer/thin-strut sirolimus stent shows promise

Tue, 21 May 2013 11:30:00 EDT

The new sirolimus-eluting stent boasting a biodegradable polymer and a thin-strut design that is 25% thinner than the market-leading permanent-polymer stents looks similar to a market leader, at least on angiographic follow-up.

ADVANCE one-year data reassuring on mild PV leaks with CoreValve

Tue, 21 May 2013 08:00:04 EDT

Full clinical outcomes presented at EuroPCR today "demonstrate low one-year mortality, low stroke rates, and low rates of aortic regurgitation and paravalvular leak," investigators said.

EMA reviewing safety of dual RAS blockade for hypertension, HF

Mon, 20 May 2013 16:00:08 EDT

The European Medicines Agency is now reviewing the safety of using dual renin-angiotensin system blockade in clinical practice because of concerns of hyperkalemia, low blood pressure, and kidney failure.

Inhaled long-acting bronchodilators in COPD flagged again for CV hazard

Mon, 20 May 2013 16:00:00 EDT

The controversy continues over the cardiovascular side effects of both long-acting beta-agonist and long-acting anticholinergic drugs when newly prescribed for the management of chronic obstructive pulmonary disease.

Hatha yoga reduces blood pressure in mildly hypertensive patients

Mon, 20 May 2013 14:45:53 EDT

Hatha yoga introduced to individuals with hypertension appears to lower blood pressure, and while the reductions in blood pressure aren't earth-shattering, they might just be enough to avoid starting antihypertensive medications, say researchers.

BP reductions with renal denervation durable to 30 months: SYMPLICITY HTN-2

Fri, 17 May 2013 17:45:00 EDT

New data from the Symplicity HTN-2 study confirm the long-term efficacy of renal denervation in patients with resistant hypertension. At 30 months, there was a sustained reduction in systolic blood pressure, but researchers say this is only the beginning in terms of understanding the potential of the procedure.

Dietary saturated fat has undeserved bad reputation, says review

Fri, 17 May 2013 16:45:39 EDT

It calls for a reappraisal of health recommendations that focus on cutting saturated-fat intake levels, as "mechanisms for adverse health effects are lacking."

Physician inertia to blame for small BP changes in BARBER-1

Fri, 17 May 2013 11:45:00 EDT

A new analysis of BARBER-1 suggests that physician inertia might be the reason African American men failed to reduce their blood pressure lower than hoped.

Never too old to get moving: Aerobic fitness lowers risk of death in elderly

Fri, 17 May 2013 10:30:00 EDT

If you don't use it, you're going to lose it—the old chestnut is supported by a new VA Medical Center study showing that fit elderly patients with hypertension had a lower risk of death than those with low levels of cardiorespiratory fitness.

EMA: Benefits outweigh VTE risks with hormone drugs for acne

Fri, 17 May 2013 09:30:10 EDT

The EMA has issued a recommendation that the benefits of the hormonal acne treatment Diane and its generics outweigh the risks, provided that several measures are taken to minimize the risk of thromboembolism.

HRS members support charitable ICD/pacemaker donation for reuse overseas

Thu, 16 May 2013 17:30:39 EDT

A survey of the society's physician members shows there is wide support for, although also some concerns about, the practice, which remains controversial in the US.

Ken Mahaffey leaves DCRI for Stanford

Thu, 16 May 2013 16:15:00 EDT

Mahaffey is the second Duke physician to head to Stanford in the past two years, following in the footsteps of Dr Robert Harrington.

How low should you go? Experts debate latest salvo in the war on sodium

Thu, 16 May 2013 09:30:28 EDT

Earlier this week, the Institute of Medicine stirred up controversy when it stated the data are insufficient to recommend lowering sodium levels beyond 2300 mg per day. The AHA came out against the IOM report, but hypertension experts heartwire spoke with say the recommendations are right on the money.

Dabigatran "real-life" results suggest caution needed

Wed, 15 May 2013 17:15:19 EDT

New data from real-life experience of dabigatran for stroke prevention in AF shows that it is often used outside prescribing recommendations, and the risk of both thromboembolism and bleeding may be raised in patients switched from warfarin.

No clinical gain, more risk: Preference for dual- vs single-chamber ICD again questioned

Wed, 15 May 2013 16:15:12 EDT

Applying only to primary-prevention patients with no pacing indications, an analysis suggests that more expensive dual-chamber implantable defibrillators, compared with single-chamber devices, pose a higher complication risk without any clinical advantage; yet they seem to be the ICD of choice for such patients, at least in the US.

IOM: No clear benefits to slashing sodium intake to 1500 mg/day

Wed, 15 May 2013 11:40:32 EDT

Citing a lack of evidence linking lower sodium targets to a reduction in hard events, the IOM concludes that while Americans are consuming more sodium than required for health, the low limits set for certain high-risk groups are not supported by current evidence. The AHA respectfully disagrees.

Gene-mutation discovery in congenital heart disease spells major shift in care

Wed, 15 May 2013 09:15:31 EDT

The finding will fundamentally alter how congenital cardiac defects are categorized and potentially treated, say the authors of a new report.

Rover Rx? Pet ownership may lower CVD risk, says AHA

Tue, 14 May 2013 16:00:38 EDT

The data suggest that owning a dog increases physical activity, but there are also good data on pets decreasing mental stress and decreasing blood pressure, according to the American Heart Association.

Hormone therapy associated with MI in male-to-female transsexuals

Tue, 14 May 2013 14:00:10 EDT

Hormone therapy given to transsexuals during gender reassignment appears to be associated with a greater likelihood of cardiovascular disease in men who subsequently become women.

Dr Allen Anderson joins Northwestern's Bluhm Cardiovascular Institute

Tue, 14 May 2013 13:45:24 EDT

Dr Allen Anderson is the new medical director of the advanced heart-failure program and director of network development at the Bluhm Cardiovascular Institute at Northwestern University.

How close am I? Shocks decline when ICD programmers reminded of evidence-based settings

Tue, 14 May 2013 10:45:58 EDT

When they saw reports documenting shortfalls in their programming of ICDs to guidelines, clinicians cleaned up their act and shock rates safely fell; but this kind of teaching might not accomplish enough, researchers say.

Sodium levels through the restaurant roof—no reductions in past six years

Mon, 13 May 2013 16:30:00 EDT

A new study published today showed that while the sodium content of processed foods declined from 2005 to 2011, the overall reduction was just 3.5%. Restaurants, on the other hand, fared even worse, with researchers reporting that sodium levels actually increased by 2.6% over the same six-year period.

Repeat ablation wins out over antiarrhythmic agents for recurrent paroxysmal AF

Mon, 13 May 2013 15:45:54 EDT

Not only was reablation more likely to banish recurrences in a randomized study, trying drugs the second time just made it worse for some patients.

Simple tool stratifies mortality risk in type 2 diabetes

Mon, 13 May 2013 14:15:38 EDT

By plugging values for nine common variables into an online calculator, physicians can determine whether a patient with type 2 diabetes is at high risk of all-cause 2-year mortality, researchers report.

Heparins not recommended in acute stroke

Mon, 13 May 2013 12:30:10 EDT

Analyzing individual patient data from the five largest trials of heparin in acute stroke has not been able to define a group of patients where the benefit outweighs the bleeding risk.

Risk factors help indicate which patients may be spared angiography

Mon, 13 May 2013 11:45:00 EDT

Cardiac-surgery patients without angina, MI, or diabetes show reduced risk of CAD and may be spared cost and comorbidities of conventional coronary angiography.

Early experience with valve-in-valve implantation shows positive outcomes

Fri, 10 May 2013 16:45:20 EDT

Results from use of the transcatheter valve-in-valve implantation in Nordic countries show few complications and low mortality rates.

Sliding-scale hydration reduces six-month clinical events in PCI patients

Fri, 10 May 2013 15:15:07 EDT

Hydration guided by left ventricular end-diastolic pressure significantly reduced the composite end point of death, MI, and the need for dialysis by 68% compared with a conventional hydration strategy.

Few failures show up in Durata, Riata ST Optim defibrillator-lead analysis

Fri, 10 May 2013 14:30:45 EDT

It has limitations, but an analysis of St Jude registries suggests the Optim-insulated leads won't suffer the same issues that plagued the company's recalled Riata and Riata ST leads.

Long-term PROTECT-AF analysis: Watchman attains efficacy superiority over warfarin in AF

Fri, 10 May 2013 10:00:00 EDT

The Watchman left-atrial appendage occluder had previously been found noninferior to warfarin in patients with nonvalvular atrial fibrillation; now, with an average of 45 months of follow-up, it's not only noninferior, it's superior, by some statistical measures.

Stent, then angioplasty, could increase the risk of stroke, suggests CREST analysis

Thu, 09 May 2013 15:45:35 EDT

The CREST analysis showed that poststent deployment angioplasty reduced the risk of restenosis by 64% but was associated with a nearly fourfold increased risk of stroke.

In vivo, VERITAS: Live case TAVR just as safe as closed-door procedures

Thu, 09 May 2013 14:50:10 EDT

The FDA forbids the use of investigational transcatheter aortic-valve devices in live-case presentations being broadcast from US centers. A new study is offering some much-needed data into whether the agency's concerns are justified.

High-volume gets demoted in new PCI-competence document

Thu, 09 May 2013 11:30:03 EDT

Professional societies have released an update to the "core competence" required of physicians wanting to perform percutaneous coronary interventions. In it, average annual volumes are lower, while patient-centered care, procedure appropriateness, and awareness of personal stats have moved to the forefront.

BRUISE CONTROL: Continued warfarin beats heparin bridging in ICD/pacemaker implants

Thu, 09 May 2013 11:00:00 EDT

UPDATED // Guidelines recommend that patients at high risk for thromboembolic events be bridged with heparin therapy, but few randomized trials have compared this strategy with simply maintaining patients on warfarin for their procedures.

Oral anticoagulants less used in paroxysmal than persistent AF: NCDR data

Thu, 09 May 2013 09:30:23 EDT

US cardiologists seem to have a double standard when it comes to managing thromboembolic risk in patients with paroxysmal vs persistent atrial fibrillation, despite guidelines calling for equality.

No worsening HF seen with Riata-like failure of St Jude QuickSite, QuickFlex CRT leads

Thu, 09 May 2013 09:00:00 EDT

Although nearly half of patients with the pacing leads at one center showed externalizations on fluoroscopy, their heart failure wasn't worse than in those without the problem.

No benefit of fish oil in high-risk patients

Wed, 08 May 2013 17:00:00 EDT

N-3 fatty-acid supplementation had no effect on the study's primary end point in this group of patients with multiple cardiovascular risk factors or atherosclerotic disease, but no previous MI. Researchers also saw no effects on the rate of death from coronary causes or sudden death from cardiac causes or major ventricular arrhythmias.�

TAVR numbers in Europe: High or not high enough?

Wed, 08 May 2013 16:00:14 EDT

Almost 35 000 patients in 11 European countries underwent a transcatheter aortic-valve replacement in the first five years following CE Mark approval of the Edwards Sapien and Medtronic CoreValve, according to a newly published tally.

Treating paroxysmal AF during cardiac surgery improves outcomes

Wed, 08 May 2013 13:00:48 EDT

A new study is shedding key new information on what one expert called an uncommon subject in the literature but a really common clinical problem.

Dick Cheney: "Coronary artery disease is just a part of who I am"

Wed, 08 May 2013 10:40:39 EDT

Speaking at the 2013 AATS meeting, Cheney describes his LVAD procedure the toughest of all his heart surgeries, while his transplant was a walk in the park. He and his cardiologist,�Dr Jonathan Reiner, are coauthoring a book about Cheney's four-decade-long CVD odyssey.�

Apixaban superior to warfarin across range of INR values, ARISTOTLE analysis

Tue, 07 May 2013 17:00:00 EDT

The reduction in the primary efficacy end point of stroke or systemic embolism with apixaban was observed across a broad range of INR control in the warfarin-treated patients.

Program tweak cuts ICD pacing/shocks in broad population: ADVANCE 3

Tue, 07 May 2013 16:00:00 EDT

The trial "confirms and reinforces" conclusions from last year's MADIT-RIT trial, that ICD programming that delays arrhythmia detection can prevent some inappropriate shocks and other unnecessary device treatments but extends the finding to patients with almost any kind of ICD.

No advantages, more surgery, with MitraClip at four years: EVEREST II

Tue, 07 May 2013 15:30:00 EDT

At four years, surgery for mitral-valve dysfunction was needed for one out of every five patients treated with the MitraClip compared with just 5.5% of patients who underwent surgery. These four-year results are in line with what was observed with the one-year data, say investigators.

What to do when the patient is hot

Tue, 07 May 2013 15:30:00 EDT

Patients who've had a nuclear imaging study with radioactive tracers become, themselves, radiation emitters; now researchers in Boston have tried to quantify that risk to others.

Study identifies pitfalls of current PCI-outcome reporting

Tue, 07 May 2013 15:30:00 EDT

The outcome measure of "30-day mortality after PCI" does not accurately reflect how well interventionalists and hospitals are performing PCIs, according to researchers who compared death-certificate reports vs detailed chart reviews in a single-center study.

Low-dose anticoagulation appears safe, effective with new-generation heart valve

Tue, 07 May 2013 14:45:20 EDT

Interim results show reduced risk of bleeding and no increased risk of thromboembolism when aortic-valve-replacement patients receive less aggressive anticoagulant therapy.

Aortic-valve repair shows durability, low mortality in younger patients

Tue, 07 May 2013 14:40:30 EDT

Five-year outcomes in patients with aortic regurgitation treated with surgical valve repair show few complications and low mortality, as well as device durability.

Dr Burt Sobel dies, age 75

Mon, 06 May 2013 16:40:57 EDT

A renowned cardiologist and scientist, Sobel was also the director of the Cardiovascular Research Institute at the University of Vermont.

Diabetes increases stroke risk, particularly in under-65s

Mon, 06 May 2013 16:00:12 EDT

A new study shows up to a 12-fold increase in risk of stroke in younger patients with diabetes compared with nondiabetics of similar age.

Patient-reported health status underutilized in practice, says AHA

Mon, 06 May 2013 16:00:00 EDT

The AHA is reminding physicians in clinical practice that the domains of patient-reported health status, including symptom burden, functional status, and health-related quality of life, remain underused despite their usefulness in informing clinical decision making and understanding disease burden.

FDA approves atorvastatin/ezetimibe combo tablet

Fri, 03 May 2013 16:41:30 EDT

The combination, known as Liptruzet, is approved for the treatment of elevated LDL-cholesterol levels in patients with primary or mixed hyperlipidemia as an adjunct to dietary changes.

Physical activity low among American adults

Fri, 03 May 2013 13:15:47 EDT

Approximately 50% of American adults meet the guidelines for aerobic activity, and only a quarter participate in muscle-strengthening activity.

Aortic-dissection mortality linked to low surgical volume

Fri, 03 May 2013 10:15:56 EDT

Mortality risk for aortic-dissection repair varies according to the operative volume of surgeons and institutions.

Lancet antitobacco series launches as ACC chides FDA inaction

Thu, 02 May 2013 18:30:00 EDT

One of the Lancet papers reviews the successes, failures, and ongoing challenges in beating back the "global tobacco epidemic," including a report from FDA scientists touting the impact of the 2009 Tobacco Control Act in the US.

ESC issues "practical guide" to new oral anticoagulants in AF

Thu, 02 May 2013 16:30:42 EDT

It used to be easier deciding which oral anticoagulant to use in patients with nonvalvular atrial fibrillation. With all the choices now available, a new document sorts out their differences and can guide their use in various clinical settings.

Midei malpractice suit settled before hearing Midei's testimony

Thu, 02 May 2013 13:30:28 EDT

More than 200 patients were part of a settlement reached between plaintiffs and Catholic Health Initiatives yesterday afternoon, Midei confirmed to heartwire. He says he was not a part of the settlement and regrets not having the chance to testify. The case deals with unnecessary-stenting allegations dating back to a period between 2007 and 2009.

No raised azithromycin CV-death risk seen in young or middle-aged adults

Wed, 01 May 2013 17:00:00 EDT

A nationwide cohort study in Denmark helps to soften the message from a 2012 study linking the antibiotic to an increased risk of cardiovascular death in the elderly, likely from ventricular arrhythmias, according to researchers; the hazard doesn't seem to apply to younger people in the general population.

Case made for metabolic bariatric-surgery eligibility criteria

Wed, 01 May 2013 11:15:20 EDT

Current eligibility criteria for gastric bypass and other bariatric surgeries mean it isn't offered to many patients for whom it might provide remission from diabetes, say researchers presenting at the PDMS sessions.

FDA limits use of heart-failure drug due to liver injury

Tue, 30 Apr 2013 17:00:19 EDT

The US Food and Drug Administration has announced new restrictions on the use of tolvaptan because of the potential risk for liver injury, including length of use.

Subclinical hyperthyroidism linked to heart-failure deaths

Tue, 30 Apr 2013 14:45:17 EDT

A massive observational study in half a million individuals has found a link between subclinical hyperthyroidism and cardiovascular death, which appears to be predominantly driven by heart failure.

Stopping dabigatran ups stroke risk: New boxed warning

Tue, 30 Apr 2013 13:30:21 EDT

It raises the profile of a caution already in the oral anticoagulant's prescribing information.

FDA okays Kcentra to reverse anticoagulation, stop bleeding

Tue, 30 Apr 2013 11:10:00 EDT

The plasma-derived product, like plasma itself, can stop major bleeding, but it can be deployed more quickly because it does not require blood-group typing or thawing.

To [vitamin] D or not to D? That is the question

Mon, 29 Apr 2013 17:00:00 EDT

In a lighthearted debate on whether everyone needs more vitamin D, endocrinologists here agreed, at least, that there are specific groups of people in whom sufficient vitamin D is mandatory.

Addition of naturopathic medicine boosts CV risk reduction

Mon, 29 Apr 2013 12:00:00 EDT

Experts who commented on the study, conducted by Canadian naturopathic physicians, said cardiologists should keep their minds open to whatever strategies might help patients do better at reducing their risk of future events.

Metabolic syndrome in throes of AMI often confirmed later and may up risk by itself

Fri, 26 Apr 2013 17:00:00 EDT

It's never been clear whether the telltale metabolic signs at hospitalization tell the same prognostic story as in the outpatient setting. Certainly it wasn't known whether they had their own story to tell.

CV risk factor management included in new type 2 diabetes treatment plan

Fri, 26 Apr 2013 13:30:57 EDT

Color-coded graphics address obesity, prediabetes, glucose-lowering drugs, and cardiovascular risk reduction in what is described as a "comprehensive" document.

ESC supports renal denervation as an option for treating resistant hypertension

Fri, 26 Apr 2013 10:00:15 EDT

The ESC says that catheter-based renal denervation can be considered a therapeutic option in patients with drug-resistant hypertension who cannot get to goal with a combination of lifestyle and pharmacologic therapy.

US cardiologists see incomes climb in changing healthcare climate

Fri, 26 Apr 2013 09:00:00 EDT

Salaries for US cardiologists climbed in 2012, making them the second-highest paid specialty, according to the 2013 Medscape Physician Compensation Report. Some intriguing new numbers suggest changes to healthcare delivery in the US may be influencing income.

Newest study confirms a soda a day ups diabetes risk by 20%

Thu, 25 Apr 2013 17:45:53 EDT

Drinking a can of sugary soda a day can increase the risk of type 2 diabetes by 22%. This latest rigorous research from Europe corroborates the findings of numerous other studies, say scientists.

Bariatric surgery in type 2 diabetes: Half in complete or partial remission at six years

Thu, 25 Apr 2013 17:15:57 EDT

Experience at a single busy center over a recent four-year period suggested one-fourth of patients are cured of diabetes. But there are limitations on the definition of "cure," and that's only one way diabetes-management-response terminology isn't straightforward.

Biventricular bests RV pacing in patients with AV block: BLOCK HF published

Thu, 25 Apr 2013 16:00:06 EDT

The study showed that patients randomized to biventricular pacing had a significantly lower incidence of the primary end point, a composite of all-cause mortality, hospitalization for heart failure requiring intravenous therapy, or a 15% or more increase in the left ventricular end-systolic volume index.

Side-effect concerns, herbal options among reasons for not filling statins scrips

Thu, 25 Apr 2013 12:45:01 EDT

More than half of patients reported not filling their statin prescriptions because of concerns about side effects, while two out of every three patients expressed general concerns about taking the lipid-lowering medication. A majority of patients also decided to try making changes to their lifestyle before filling the prescription at the pharmacy.

Beta-blockade boosts noncardiac-surgery outcomes in high-risk patients

Thu, 25 Apr 2013 10:00:08 EDT

Beta-blockade was cardioprotective when given during noncardiac surgery in an observational VA study. Some experts expect the findings to have an impact on the next guidelines.

Intestinal flora again implicated in CAD; but this time, also CV events

Wed, 24 Apr 2013 17:15:16 EDT

From the group that recently demonstrated links between dietary carnitine, gut bacteria, and atherosclerosis comes a study with analogous findings on a different molecule found in meat and eggs and a graphic demonstration that gut flora participate in human metabolism.

Progress in diabetes care in US, but still a way to go

Wed, 24 Apr 2013 17:00:00 EDT

A new "snapshot" of how the US is faring in terms of risk-factor control and preventive practices for patients with type 1 and 2 diabetes shows there is much room for improvement.

AHA forecasts rising burden of heart failure in the US

Wed, 24 Apr 2013 15:30:30 EDT

The AHA is predicting that more than eight million Americans will have heart failure by 2030 and that the total direct costs associated with the disease will rise from $21 billion in 2012 to $70 billion in 2030.

CDC support for new AMA initiative on CVD, prediabetes

Wed, 24 Apr 2013 14:00:04 EDT

One CDC doctor has given his support to a new initiative from the American Medical Association to help prevent cardiovascular disease and type 2 diabetes, calling it "a big endorsement."

Binge drinking impairs vascular function

Tue, 23 Apr 2013 16:30:50 EDT

Individuals with a history of binge drinking, an average of four years drinking to excess six times per month, had reduced flow-mediated dilation and flow-independent nitroglycerin-mediated dilation, as well as impairments in microvascular arterial beds.

New insights into traffic, air-pollution risks, and atherosclerosis

Tue, 23 Apr 2013 13:30:15 EDT

In an analysis that builds on a 2007 paper, investigators with the Heinz Nixdorf Recall study looked at thoracic aortic calcification in relation to traffic proximity, traffic noise, and particulate air pollution.

Low-glycemic diet seen to reverse diastolic dysfunction of diabetes

Mon, 22 Apr 2013 17:15:01 EDT

The randomized, partial-crossover study was quite small but provided echo evidence that a low-carbohydrate, high protein diet—but not a standard low-fat diet—can attenuate a common cardiac effect of insulin resistance.

Mortality advantage with CABG over PCI in Medicare patients

Mon, 22 Apr 2013 17:00:00 EDT

This reduction in mortality with CABG was significantly lower among patients with diabetes, a history of tobacco use, heart failure, and peripheral artery disease, providing strong evidence that clinical characteristics modify the CABG-PCI treatment effect, say researchers.

Bariatric-surgery metabolic gains in adolescents can stay despite some weight return

Mon, 22 Apr 2013 14:45:59 EDT

Not lipids, not HbA_1c, CRP, not even insulin levels: metabolic markers that had mostly normalized during the first year after weight-loss surgery didn't slip back among teens who regained pounds during year 2 in the small prospective AMOS study.

PREDIMED: Mediterranean diet costs more than standard diet

Mon, 22 Apr 2013 12:00:00 EDT

It's no small irony that the countries that gave the world the Mediterranean diet are, at least within Europe, those seeming least able to afford them. New PREDIMED data hint at what previous studies have warned about: a switch to a Mediterranean style diet may drive up food costs.

Cardiologists plead ignorance, lack of time, in helping smokers butt out

Mon, 22 Apr 2013 10:30:00 EDT

A survey of cardiologists in Spain reveals that only three out of four cardiologists are routinely asking patients whether they smoke, and the majority admit they seldom use tools and medications to help their patients quit.

Experts welcome canagliflozin approval, but questions remain

Fri, 19 Apr 2013 13:15:51 EDT

Cardiologists and endocrinologists weigh in with varying benefit/risk assessments of this new drug, the first in a novel class of agents.

Overall stroke rates decline in Sweden, but uptick in younger victims raises concerns

Fri, 19 Apr 2013 12:50:54 EDT

Overall ischemic stroke rates have declined sharply in Sweden over the past 25 years, as have overall mortality rates after a first stroke. But some troubling trends among young Swedes are cause for alarm.

"Shaking" the heart enhances stem-cell therapy in chronic HF: CELLWAVE

Fri, 19 Apr 2013 10:00:54 EDT

In this phase 1/2 randomized clinical trial of patients with a previous MI, pretreating the heart with shock waves before administering autologous bone-marrow-derived mononuclear cells resulted in "encouraging," modestly improved LVEF at four months.