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STS registry data on bypass surgery published for consumers

Sep 8, 2010 17:30 EDT

Risk-adjusted coronary bypass surgery outcomes data from one-fifth of US heart-surgery programs is now available to the public.

Acute Coronary Syndromes

Evidence of stress in hair predicts AMI

Sep 8, 2010 16:00 EDT

Canadian researchers find that chronic stress that leads to MI is signaled by high cortisol concentrations in the patient's hair.

Lipid/Metabolic

UK experts advised rosiglitazone withdrawal in July

Sep 8, 2010 15:30 EDT

It has emerged this week that UK experts recommended the withdrawal of the diabetes drug rosiglitazone from the British market in July, although this recommendation was not made public at the time. However, because the drug was approved centrally by the European Medicines Agency, only it can revoke the license, says the UK regulatory body; the EMA is discussing rosiglitazone today, although no final decision is expected on the product until the end of this month.

Brain/Kidney/Peripheral

NSAID use associated with future stroke in healthy population

1 COMMENT - Sep 8, 2010 10:00 EDT

The results are in line with the increased risk of MI seen with NSAIDs and strengthen the need for more careful regulation of these drugs, the study author says.

Arrhythmia/EP

First Europe-specific guidance on AF

1 COMMENT - Sep 7, 2010 17:15 EDT

The European Society of Cardiology announced new clinical guidelines for atrial fibrillation at its congress in Stockholm last week, the first time such recommendations have been prepared by European societies acting alone. Highlights include guidance on the use of dronedarone, better risk profiling for stroke in anticipation of new oral anticoagulants, the formal acceptance of ablation as a treatment option, and the recognition that lenient rate control is a satisfactory alternative to strict control.

Clinical cardiology

FDA does U-turn on midodrine; will keep it available

3 COMMENTS - Sep 7, 2010 13:30 EDT

The US FDA has done a U-turn on its decision two weeks ago to withdraw midodrine, a drug for orthostatic hypotension. The agency told heartwire it will allow patients continued access to the drug while it tries to resolve the issue of concern: postmarketing studies with the product.

Heart failure

CRT durability showcased in CARE-HF long-term analysis

Sep 3, 2010 14:30 EDT

One of the questions it sheds light on: if CRT is delayed in patients who qualify for it, will later device implantation recapture the lost early survival gains CRT would likely have provided?

Acute Coronary Syndromes

Nurse program provides good RESPONSE for ACS secondary prevention

2 COMMENTS - Sep 3, 2010 13:15 EDT

Reasonably good results were obtained using nurses to counsel patients on secondary prevention after ACS, with a 17% relative reduction in calculated 10-year mortality over and above that achieved with usual care in the RESPONSE study. Although more work needs to be done to better refine such programs, they are feasible and can be easily implemented worldwide, said the researcher and other commentators.

Medscape Medical News

Intensive blood-pressure control does not slow kidney disease in black patients

Sep 3, 2010 10:00 EDT

With the exception of patients with a protein/creatinine ratio of more than 0.22, blood-pressure control does not appear to slow progression of kidney disease in black patients.

Medscape Medical News

SCOUT: Sibutramine linked to increased risk of nonfatal vascular events in subjects with preexisting cardiovascular conditions

Sep 3, 2010 09:00 EDT

Subjects with preexisting CVD given long-term sibutramine treatment had an increased risk of nonfatal MI and nonfatal stroke but not of CV or all-cause death.

MediaPulse

Another Maryland cardiologist in hot water over unnecessary procedures

3 COMMENTS - Sep 2, 2010 10:30 EDT

Another cardiologist in Maryland has been accused of performing unwarranted procedures on multiple patients over a number of years. Dr John R McClean faces criminal charges and a possible 40 years in prison if convicted on all counts.

Interventional/Surgery

CURRENT-OASIS 7 published: Double-dose clopidogrel in PCI debated

3 COMMENTS - Sep 1, 2010 17:00 EDT

Although there was no benefit of doubling the clopidogrel dose in the overall ACS population studied, benefits were suggested in the PCI subgroup. But are these robust enough?

Heart failure

ESC guidelines give top recommendation to CRT for mild heart failure

4 COMMENTS - Sep 1, 2010 14:15 EDT

It's been in the wind on both sides of the Atlantic; now it's official in Europe: a class I A recommendation for cardiac resynchronization therapy for patients in sinus rhythm with NYHA class 2 systolic heart failure with a QRS duration >150 ms.

Hypertension

KYOTO and JIKEI HEART analyses show benefit of valsartan in Japanese hypertensive patients

Sep 1, 2010 10:45 EDT

Adding valsartan to therapy in high-risk hypertensive patients reduced the risk of cardiovascular events more than conventional non-ARB treatment in both the primary- and secondary-prevention setting, according to an analysis from KYOTO HEART, while JIKEI HEART investigators suggest a benefit with valsartan in coronary artery disease patients.

Arrhythmia/EP

REALISE-AF registry: Much still to do in atrial fibrillation

Sep 1, 2010 10:00 EDT

Preliminary data from a new registry of more than 10 000 patients with AF, the largest ever, spanning 26 countries, shows that that much remains to be done in this field. AF is frequently not controlled, and even when it is, patients are often symptomatic. In addition, physicians need better guidance on how to treat AF, and better drug and devices are required, say experts.

Arrhythmia/EP

PACE: Dyssynchrony leads to lower ejection fraction in RVA-paced heart-failure patients

Sep 1, 2010 09:15 EDT

About half the patients in the PACE trial developed systolic dyssynchrony after a month of right ventricular apical pacing, leading to a reduced left ventricular ejection fraction.

Murmurs

Maryland mulls Midei case as cardiology orgs ask legislators to leave policing procedures to doctors

2 COMMENTS - Sep 1, 2010 09:00 EDT

No word yet from the Maryland Medical Board as to whether it will be taking action against former St Joseph's department of cardiology chair Dr Mark Midei, accused of performing unnecessary stenting procedures, after a private meeting with him August 4, 2010.

Interventional/Surgery

Experts debate merits of DES for acute MI

1 COMMENT - Sep 1, 2010 07:30 EDT

Use of DES for AMI remains relatively low in Europe, despite short-term evidence pointing to reductions in target vessel revascularization. The problem is ascertaining likelihood of patient compliance to dual antiplatelet therapy in the middle of an emergency.

Arrhythmia/EP

Dual-chamber pacing beats single-chamber pacing for sick sinus syndrome in DANPACE

Aug 31, 2010 10:30 EDT

Dual-chamber pacing results in fewer new surgeries and less AF than single-chamber pacing in patients with sick sinus syndrome in the DANPACE trial.

Arrhythmia/EP

ANTIPAF: ARB, on its own, doesn't suppress paroxysmal atrial fib

Aug 31, 2010 10:00 EDT

Patients with symptomatic paroxysmal atrial fibrillation who took the angiotensin-receptor blocker olmesartan didn't show any reduction in AF burden over the course of a year.

Thrombosis

Rivaroxaban almost superior to usual care in treatment of DVT

Aug 31, 2010 09:30 EDT

The new anticoagulant rivaroxaban has shown noninferiority to standard medical therapy in a large trial in the treatment of deep vein thrombosis, catching up with its rival dabigatran, for which similar data in this indication have already been reported.

Interventional/Surgery

Black race an independent predictor of stent thrombosis after DES placement

1 COMMENT - Aug 31, 2010 08:30 EDT

Black race, in and of itself, appears to predict stent thrombosis after placement of a drug-eluting stent.

Arrhythmia/EP

AVERROES: Apixaban yields significant reductions in stroke, no increased bleeding

3 COMMENTS - Aug 31, 2010 06:55 EDT

Atrial-fibrillation patients in the trial treated with apixaban had a 54% lower risk of stroke or systemic embolic events, and, of note, the reduction came without an increase in bleeding events. The positive results now leave clinicians awaiting head-to-head comparisons of warfarin vs apixaban in the atrial-fibrillation setting.

Interventional/Surgery

FUTURA/OASIS-8: Standard-dose heparin recommended during PCI to avoid catheter thrombosis with fondaparinux

Aug 31, 2010 06:15 EDT

Results showed no major advantages of low-dose heparin over standard-dose heparin in such patients, and neither dose increased major bleeding compared with the historical control group of fondaparinux alone in the OASIS-5 trial.

Lipid/Metabolic

CTT meta-analysis: No cancer risk with statins, low LDL-cholesterol levels

Aug 30, 2010 16:30 EDT

Investigators report that statin therapy had no adverse effect on any cancer type, irrespective of how long patients took the cholesterol-lowering medications or their baseline LDL-cholesterol levels.