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Sen Grassley questions top medical schools about ghostwriting

Nov 20, 2009 13:15 EST

As part of his mission to see more financial transparency in medicine, Sen Grassley has asked eight top US medical schools about their policies on ghostwriting.

Medscape Medical News

Stroke incidence related to PCI steady over 15 years

Nov 20, 2009 13:00 EST

Mayo Clinic researchers report that their stroke rate related to PCI has stayed steady for the last 15 years, something they interpret as good news, given that substantially older, sicker patients with more complex anatomy are now undergoing PCI.

Medscape Medical News

ALLHAT investigators report 10-year follow-up and stand by diuretics as first step antihypertensive treatment

Nov 19, 2009 14:00 EST

New 10-year mortality and morbidity data confirm the original trial conclusions, they say, that while amlodipine and lisinopril are not superior to chlorthalidone on any outcome, chlorthalidone is superior to these agents on one or more secondary end points. Full agreement with this conclusion in the community, though, is still hard to come by.

Acute Coronary Syndromes

Oral anticoagulants REDEEMed? Daily dabigatran "safe" with dual antiplatelets after MI

Nov 19, 2009 11:00 EST

A dose-finding study saw what were characterized as low bleeding rates associated with triple-drug antithrombotic therapy that included the oral anticoagulant dabigatran in patients with a recent ACS event and other cardiovascular risk factors.

News

EFFECT: Public reporting of hospital performance improves quality of care?

Nov 19, 2009 10:00 EST

Publicly released report cards based on hospital performance did not result in a measurably greater systemwide improvement in two composite AMI or CHF process-of-care indicators in a Canadian study. But they did appear to stimulate some important changes in delivery of care that could have led to some better outcomes.

Murmurs

Kenneth Baughman killed while jogging at AHA

22 COMMENTS - Nov 19, 2009 08:30 EST

UPDDATED // Dr Kenneth Baughman, a cardiologist at Brigham and Women's Hospital, died Monday morning in Orlando, FL, when he was struck by a car while out for a morning run.

Interventional/Surgery

BARI 2D cost-effectiveness analysis favors medication over PCI for less severe CVD in diabetic patients

1 COMMENT - Nov 18, 2009 15:45 EST

New data from the BARI 2D trial comparing medical therapy vs revascularization in diabetics shows higher up-front costs of revascularization are only partially offset by long-term savings.

Thrombosis Risk

Ticagrelor effects unraveled in new phase 2 trials

Nov 18, 2009 15:00 EST

New and unique phase 2 data add to the growing body of evidence explaining the pharmacologic effects of the new antiplatelet agent ticagrelor.

Imaging

CT-STAT: CT angiography rules out CAD faster and cheaper than standard care

4 COMMENTS - Nov 18, 2009 13:45 EST

The use of coronary CT angiography in the emergency room can successfully triage at-risk chest-pain patients and can do so faster and less expensively than standard diagnostic testing.

Interventional/Surgery

Baseline function data from STICH no help in pinpointing patients who benefit from SVR

Nov 18, 2009 10:45 EST

Measures of left ventricular dysfunction or wall motion identified by different imaging modalities at baseline offer no clues as to whether a subset of patients treated with surgical ventricular reconstruction might benefit from the procedure.

Acute Coronary Syndromes

ACC/AHA focused update of guidelines for STEMI, PCI

7 COMMENTS - Nov 18, 2009 09:00 EST

The latest evidence for the treatment of STEMI and PCI has been incorporated into a fast-track update of US guidelines. But questions remain about the quality of some of the evidence informing the guidelines and about the composition of the writing committees.

Heart failure

JCHF: Are low doses of carvedilol effective in heart failure?

3 COMMENTS - Nov 18, 2009 09:00 EST

Doses of carvedilol as low as 2.5 mg daily may be effective in Japanese patients with heart failure, according to this study. But experts said the trial was far too small to draw any meaningful conclusions.

Lipid/Metabolic

Niacin not beneficial in patients at goal with statins: NIA Plaque

16 COMMENTS - Nov 18, 2009 09:00 EST

The addition of niacin to statin therapy in secondary-prevention patients resulted in a significant improvement in lipids but failed to significantly alter atherosclerotic disease progression as measured by MRI. Researchers say it's a win for treating patients to target and suggest this trumps raising HDL.

Prevention

CDC data show LDL screening rate remains stagnant; many who could benefit go without lipid-lowering drugs

2 COMMENTS - Nov 17, 2009 17:45 EST

Editorialists discuss simplifying LD-management guidelines in light of a CDC study in which two-thirds of subjects who are at high risk for developing coronary disease within 10 years and eligible for lipid-lowering drugs were not on the medication.

Medscape Medical News

RE-LY: Post hoc analysis confirms benefit of dabigatran relative to warfarin at all INR levels

Nov 17, 2009 16:30 EST

A new analysis confirms that regardless of INR control achieved across participating centers, dabigatran remained noninferior at the lower dose and superior at the higher dose to warfarin for prevention of stroke and systemic embolism.

Clinical cardiology

Cardiologists shocked by new FDA alert on clopidogrel-PPI interaction

Nov 17, 2009 15:45 EST

The FDA has issued a new warning on an interaction between clopidogrel and the PPI omeprazole and other drugs that inhibit the CYP2C19 enzyme, just weeks after the only randomized trial on this issue reported no such interaction.

Lipid/Metabolic

Statins do not eliminate risk of low HDL-cholesterol levels

4 COMMENTS - Nov 17, 2009 14:45 EST

Researchers say a new study shows that statins don't alter the risks associated with low HDL-cholesterol levels and that raising HDL cholesterol 10 mg/dL could prevent an additional eight MIs per 1000 patient-years.

Medscape Medical News

Anthracycline cardiotoxicity appears limited in breast cancer in the short term

Nov 17, 2009 11:15 EST

No significant incidence of short-term cardiac toxicity was observed in breast-cancer patients on dose-dense anthracycline regimens, but longer-term follow-up is needed.

Interventional/Surgery

POPE: No benefit of diclofenac on pericardial effusion

Nov 17, 2009 10:00 EST

Mean pericardial effusion grade postcardiac surgery was not reduced with 14 days of treatment with the NSAID.

Interventional/Surgery

CASCADE: No significant benefit of clopidogrel in reducing graft disease after CABG

4 COMMENTS - Nov 17, 2009 09:00 EST

Dual antiplatelet therapy did not significantly reduce vein graft intimal hyperplasia compared with aspirin alone over 12 months.

Heart failure

HEAAL: High-dose trumps low-dose ARB for heart failure in the ACE-inhibitor intolerant

1 COMMENT - Nov 17, 2009 08:15 EST

UPDATED WITH COMMENTARY // The randomized trial, which compared losartan dosages of 150 mg/day and 50 mg/day, "makes a strong case for the value of incremental inhibition of the renin-angiotensin system," its authors say.

Heart failure

FAIR-HF: Symptom improvement, functional gains follow correction of iron deficiency in heart failure

2 COMMENTS - Nov 17, 2009 08:00 EST

UPDATED WITH COMMENTARY // The randomized, placebo-controlled study's intriguing wrinkle: the benefits after 24 weeks of treatment with an injectable form of iron were independent of whether the patients were anemic.

Heart failure

HeartMate II continuous-flow VAD sets new benchmark in destination-therapy trial

Nov 17, 2009 08:00 EST

UPDATED WITH COMMENTARY // Thoratec's HeartMate II continuous-flow VAD keeps about half of patients alive and stroke- or reintervention-free after two years in pivotal destination therapy trial.

Brain/Kidney/Peripheral

Bypassing the blues: How simple collaborative care can help tackle depression after CABG surgery

Nov 16, 2009 18:45 EST

Depression after coronary artery bypass surgery is often overlooked by physicians but is associated with worse outcomes. A new US study illustrates a simple telephone-based approach to tackle this, with nurses encouraging patients to seek help from their primary-care doctors and providing ongoing feedback and review.

Interventional/Surgery

Postop anemia in high-CV-risk patients: No CV gains from fixed hemoglobin target in trial

Nov 16, 2009 17:45 EST

A randomized trial found no protection from in-hospital cardiovascular events with a strategy of blood transfusions to maintain hemoglobin above 10 g/dL, compared with a more conservative approach to transfusion therapy, in patients with CV disease or risk factors who underwent hip surgery.

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