theheart.org : heartwire

Imaging

FDA advisory panel votes unanimously in favor of Medtronic's MRI-safe pacemaker

Mar 19, 2010 17:32 EDT

Medtronic's REVO MRI stands to be the first pacemaker FDA-approved specficially for patients undergoing MRI scans, after FDA's Circulatory System Devices advisory panel voted unanimously in favor of recommending the agency approve it.

Medscape Medical News

Highest simvastatin dose linked to increased risk of muscle injury, FDA warns

Mar 19, 2010 15:45 EDT

Simvastatin 80 mg is associated with increased risk of myopathy compared with lower doses and other statins, according to an FDA review of clinical-trial and other data.

Brain/Kidney/Peripheral

Abnormal ABI an indicator of cardiovascular events in low-risk elderly

Mar 19, 2010 15:00 EDT

An abnormal ankle-brachial index can predict an increased risk for future cardiovascular events in elderly people with low to intermediate Framingham risk scores, according to results from a new study.

Hypertension

ACE inhibitor/ARBs still used in pregnancy despite teratogenicity

Mar 19, 2010 14:15 EDT

New research from the UK has found that doctors are still prescribing ACE inhibitors and angiotensin-receptor blockers in women of child-bearing age, despite evidence that they are teratogenic. Reasons include a lack of awareness of the issue among GPs and obstetricians and ambiguity in hypertension guidelines, says the researcher.

Arrhythmia/EP

Watchman delayed: FDA wants more data on the LAA-closure device before approving

Mar 19, 2010 11:15 EDT

Atritech, the maker of the Watchman device, announced that the FDA requested another study to provide more safety and effectiveness data before it will approve the LAA-closure device.

Arrhythmia/EP

Confusion persists over ICD/CRT-D recall, but hopes high for swift resolution

Mar 19, 2010 10:00 EDT

Industry analysts have been rabidly trying to get to the bottom of the company's action since Monday, polling physicians and company reps to understand the reason for the "retrieval" notice and doctor's reactions.

Heart failure

Broaden CRT indications to include mild heart failure, recommends FDA advisory panel

Mar 19, 2010 09:00 EDT

The panel unanimously recommended that cardiac resynchronization therapy indications be extended to include patients in NYHA functional class 1 or 2, with a few added twists aimed at excluding subgroups that are least likely to benefit from the device therapy.

Interventional/Surgery

JETSTENT: Improved reperfusion and short-term clinical end points with thrombectomy

Mar 18, 2010 17:15 EDT

The results lead researchers to conclude that thrombectomy should be routine in PCI for patients with an increased thrombus burden. Others aren't sure the data are sufficient to justify its routine use, however.

Prevention

Death, CVD risk declines in people who "normalize" vitamin-D levels

4 COMMENTS - Mar 18, 2010 17:00 EDT

In a group of nearly 1000 subjects told they had low vitamin D at baseline, those who managed to up their levels over follow-up were significantly less likely to die or to suffer a combination of cardiovascular end points.

Hypertension

Mar 18, 2010 16:00 EDT

A new BP-lowering drug that acts in a similar way to omapatrilat—an agent that never quite made it to the market—has shown promise in a preliminary trial. Crucially, this dual inhibiting agent, named LCZ696, blocks angiotensin II rather than angiotensin-converting enzyme; there was no indication of angioedema in the study.

Features

MRI of implantable devices: Do we need safer devices, safer scanning procedures, or both?

Mar 18, 2010 14:30 EDT

The advent of new "MRI-safe" devices does not imply that MRI cannot be performed safely on older devices, according to the leaders of the MagnaSafe registry.

Medscape Medical News

Erectile dysfunction a red flag for mortality, cardiovascular events

Mar 17, 2010 13:45 EDT

New findings suggest erectile dysfunction is a marker for increased risk of death and heart attacks in men with heart disease.

Heart failure

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

Mar 17, 2010 11:00 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.

Interventional/Surgery

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

2 COMMENTS - Mar 16, 2010 18:15 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.

Interventional/Surgery

PLATO CABG analysis confuses cardiologists

6 COMMENTS - Mar 16, 2010 17:15 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."

Interventional/Surgery

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

Mar 16, 2010 16:15 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.

Thrombosis

Warfarin genotyping reduces hospitalizations

Mar 16, 2010 16:00 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.

Interventional/Surgery

Finally final? New STICH analysis finds no subset that benefits from ventricular reconstruction

1 COMMENT - Mar 16, 2010 14:45 EDT

STICH investigators examine whether baseline end-diastolic volume index and total volume reduction mark which CABG patients benefit from surgical ventricular reduction.

Interventional/Surgery

Platinum-chrome DES performs heroically in PERSEUS

2 COMMENTS - Mar 16, 2010 12:00 EDT

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

Interventional/Surgery

Is triple antiplatelet therapy after PCI the way forward?

1 COMMENT - Mar 16, 2010 11:00 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.

Hypertension

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

1 COMMENT - Mar 16, 2010 09:45 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.

Interventional/Surgery

Cardiologists voice concern on FDA clopidogrel warning

3 COMMENTS - Mar 16, 2010 09:00 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.

Interventional/Surgery

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

Mar 15, 2010 18:45 EDT

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

Arrhythmia/EP

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

Mar 15, 2010 15:45 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.

Arrhythmia/EP

New factor Xa inhibitor betrixaban safe in phase 2 AF trial

Mar 15, 2010 14:45 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.