theHeart.org

Bevacizumab significantly increases venous thromboembolism

Tue, 18 Nov 2008 16:00:00 EST

The risk of venous thromboembolism was increased by 33%, compared with controls, concludes a new meta-analysis of 15 cancer trials. (Nalluri SR et al. JAMA 2008; 300:277-2285.)

ACC/AHA publishes new performance measures for STEMI patients

Tue, 18 Nov 2008 13:30:16 EST

Differing from guidelines, the new performance measures identify aspects of care with evidence so strong, such as prescribing a statin upon discharge or delivering reperfusion in a timely manner, that every patient should be receiving the same treatment. In other words, "If you're not doing things a certain way, then you're not providing the best care," says one expert. (Masoudi FA et al. J Am Coll Cardiol, Circulation; published online before print November 10, 2008.)

ECGs add little when it comes to prognosis in those with chest pain

Tue, 18 Nov 2008 12:45:28 EST

ECGs or exercise ECGs have little incremental value over and above clinical assessment for prognosis in patients with suspected angina, a new study has found. Hence, such tests should not be used to rule out future events in these patients, researchers say. (Sekhri N et al. BMJ; published online before print November 13, 2008.)

OCT imaging suggests low rates of uncovered/malapposed struts following DES for AMI

Tue, 18 Nov 2008 11:30:36 EST

An OCT study conducted in a subset of HORIZONS-AMI patients suggests that exposed and malapposed stent struts in the setting of AMI are more common with drug-eluting stents than with bare-metal stents but still relatively rare. (American Heart Association 2008 Scientific Sessions.)

Negative thinking predicts depression in heart-failure patients

Mon, 17 Nov 2008 18:00:49 EST

Negative thinking may play a major role in the development of depression in patients with heart failure, new research suggests. (American Heart Association 2008 Scientific Sessions.)

Depression, not SSRIs, linked to increased mortality in heart-failure patients

Mon, 17 Nov 2008 15:00:09 EST

Contrary to recent research suggesting antidepressant use increases mortality in heart-disease patients, a new study suggests that, at least when it comes to selective serotonin-reuptake inhibitors, this is not the case. (O'Connor CM et al. Arch Intern Med 2008; 168:2232-2237.)

Cardiovascular effects of air pollution, even in the comfort of home

Fri, 14 Nov 2008 16:45:06 EST

Researchers who fitted study subjects with "air-pollution vests" to continuously monitor exposure to both indoor and outdoor air pollutants say that people are probably exposed to much higher levels of pollutants than community monitoring stations typically indicate and that this exposure affects both endothelial function and systolic blood pressure. (American Heart Association 2008 Scientific Sessions.)

Music, like laughter, benefits heart health

Fri, 14 Nov 2008 09:15:18 EST

Listening to enjoyable music may be good for cardiovascular health in the same way that laughter is beneficial, new research suggests. (American Heart Association 2008 Scientific Sessions.)

APPROACH: Rosiglitazone doesn't affect atherosclerosis progression in diabetics with CV disease

Thu, 13 Nov 2008 15:00:51 EST

The thiazolidinedione, given for 18 months, didn't appear to reverse or slow disease progression compared with the same duration of treatment with a sulfonylurea, according to the IVUS-based study. Investigators point to hints that that rosiglitazone may have slowed atherosclerosis in such patients with longer-established diabetes. (American Heart Association 2008 Scientific Sessions.)

heartwire journalist wins American Heart Association writing award

Thu, 13 Nov 2008 14:00:49 EST

THINRS: Home INR monitoring as effective as clinic-based care

Thu, 13 Nov 2008 13:30:16 EST

A randomized comparison shows weekly home monitoring is safe but did not reduce stroke, major bleeds, or death vs monthly clinic INR testing, as had been suggested by previous studies. (American Heart Association 2008 Scientific Sessions.)

Patients believe elective PCI prevents MI and saves lives, but who's to blame?

Wed, 12 Nov 2008 16:15:39 EST

Two-thirds of patients surveyed after undergoing elective PCI for angina relief said they believed the procedure would save their lives; still more believed they'd avoid a future MI. Experts say patients may not be digesting information appropriately, but doctors are also at fault. Indeed, the majority of patients also said they were not offered any therapy other than PCI. (American Heart Association 2008 Scientific Sessions.)

HF-ACTION: Early and sustained quality-of-life improvements with structured exercise program

Wed, 12 Nov 2008 15:30:52 EST

Heart-failure patients participating in an exercise-training program improved their quality of life, with the improvement occurring early and sustained for three years, new HF-ACTION data show. Investigators say the results are consistent with the overall clinical findings and support the use of exercise training in this patient population. (American Heart Association 2008 Scientific Sessions.)

FIT HEART: Novel family-based intervention a good idea, but better methods needed

Wed, 12 Nov 2008 15:00:18 EST

A new study in which the family members of patients hospitalized for cardiovascular disease were given CVD risk screening and lifestyle advice has shown that it is useful to take advantage of such "motivational moments." But the results could be improved upon, illustrating that it is difficult to change behavior in the "toxic environment" of the US, said the discussant. She stressed that better interventions—such as adopting the Mediterranean diet—are urgently needed. (Mosca L et al. Circ Cardiovasc Qual Outcomes; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

New meta-analysis of beta blockers in noncardiac surgery: Time to abandon their use, or not?

Wed, 12 Nov 2008 14:00:45 EST

The use of beta blockers perioperatively to prevent cardiovascular events in patients undergoing noncardiac surgery is not justified by current evidence, according to the authors of a new meta-analysis. An update to the guidelines on this issue is under way, says one member of the writing committee, who incidentally does not agree with this overall conclusion. (Bangalore S et al. Lancet; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

I-PRESERVE: Strike three for RAAS inhibition in preserved-LVEF heart failure

Wed, 12 Nov 2008 10:45:42 EST

Four years of treatment with irbesartan, usually on top of other drugs that affect the renin-angiotensin-aldosterone system, didn't improve outcomes in patients with the common but poorly understood form of heart failure. The trial follows previous negative studies of an ACE inhibitor and a different angiotensin-receptor blocker, respectively, in similar populations. (American Heart Association 2008 Scientific Sessions.)

Higher nonfasting triglycerides associated with increased ischemic stroke risk

Wed, 12 Nov 2008 09:00:39 EST

A new observational study finds an association between higher levels of nonfasting triglycerides and increasing risk for ischemic stroke. (Freiberg JJ et al. JAMA 2008; 300:2142-2152. American Heart Association 2008 Scientific Sessions.)

MR-proADM better prognostic tool than BNP, but not everybody convinced of biomarker's merit

Tue, 11 Nov 2008 16:15:29 EST

A novel biomarker of vascular status is a better predictor of mortality at three months than brain natriuretic peptide among acute heart-failure patients presenting at the emergency department with shortness of breath. One expert, however, said it doesn't matter if the high-risk patients are separated from very high-risk patients—they should all be receiving optimal medical therapy. (American Heart Association 2008 Scientific Sessions.)

Interferon hope for chronic viral cardiomyopathy

Tue, 11 Nov 2008 15:15:21 EST

A phase 2 trial has shown that interferon beta-1b—a drug currently used to treat multiple sclerosis—may be effective in chronic viral cardiomyopathy. But a phase 3 trial is needed for definitive proof of concept, say the study investigators and discussant. (American Heart Association 2008 Scientific Sessions.)

HF-ACTION misses, but experts say results support intensive exercise in HF patients

Tue, 11 Nov 2008 14:30:39 EST

Investigators failed to show a difference in the primary end point of all-cause mortality and all-cause hospitalizations, but a secondary analysis that took into account prognostic factors did show significant reductions in hard clinical events. One expert believes it should strengthen exercise guidelines. (American Heart Association 2008 Scientific Sessions.)

Hibiscus tea reduces blood pressure

Tue, 11 Nov 2008 13:30:07 EST

Results of a small randomized trial show that hibiscus tea given three times daily reduced systolic blood pressure by about 7 mm Hg in prehypertensive and mildly hypertensive subjects. (American Heart Association 2008 Scientific Sessions.)

TIMACS: Early invasive management safe in non-ST-elevation ACS, improves outcomes in high-risk cases

Tue, 11 Nov 2008 09:00:04 EST

The findings appear to mandate early intervention in high-risk cases and to support the use of either an early or delayed strategy for patients considered at low to intermediate risk. (American Heart Association 2008 Scientific Sessions.)

Tailoring clopidogrel loading on the basis of responsiveness testing reduces stent thrombosis

Mon, 10 Nov 2008 16:30:03 EST

Investigators who adjusted clopidogrel dose on the basis of VASP index found they could reduce risk of stent thrombosis as well as MACE at 30 days. (American Heart Association 2008 Scientific Sessions.)

T-wave alternans sudden-death risk stratification strikes out twiceor does it?

Mon, 10 Nov 2008 16:00:00 EST

The microvolt TWA test's battered imaged as a risk stratifier for ICD candidates suffered several more blows in the past few weeks with publication of two major studies that conclude against it as a predictor of sudden cardiac death in low-LVEF patients. But the noninvasive test has its proponents who see the data a bit differently. (Chow T et al. J Am Coll Cardiol 2008; 52:1607-1615. Gold MR et al. Circulation; published online before print October 27, 2008.)

Revascularization, MI, and mortality benefits at three years in diabetic patients treated with drug-eluting stents

Mon, 10 Nov 2008 15:45:32 EST

The results highlight the preserved efficacy of drug-eluting stents observed in other randomized trials and also point to no increased safety concerns in long-term follow-up. Investigators say drug-eluting stents should be favored over bare-metal stents on a patient-by-patient basis, with their ability to take dual antiplatelet therapy the primary caveat. (Garg P et al. Circulation; published online before print November 10, 2008. American Heart Association 2008 Scientific Sessions.)

New factor Xa inhibitor rivaroxaban moves into phase 3 for ACS

Mon, 10 Nov 2008 14:15:09 EST

A phase 2 trial has demonstrated the feasibility of the novel oral factor Xa inhibitor rivaroxaban in patients with acute coronary syndromes already treated with aspirin and clopidogrel. A phase 3 study with the drug, beginning next month, will reveal whether the benefits outweigh the bleeding risks. (American Heart Association 2008 Scientific Sessions.)

Rock on: Keep iPod headphones away from pacemakers/ICDs to avoid interference

Mon, 10 Nov 2008 12:30:44 EST

Investigators say that as long as patients keep their headphones on their ears and out of their breast pockets, there is no chance of causing damage to their devices that could have clinical repercussions. (American Heart Association 2008 Scientific Sessions.)

JPAD: No effect of aspirin primary-CV-event prevention in diabetics

Sun, 09 Nov 2008 21:30:47 EST

Low-dose aspirin didn't cut the risk of cardiovascular events but may have reduced CV mortality, a secondary end point, in the randomized but open-label trial conducted in Japan; clinical events were unexpectedly few, compromising the study's statistical power. (Ogawa H et al. JAMA 2008; 300:2180-2181. American Heart Association 2008 Scientific Sessions.)

SEARCH me: Null trial "morphed" into positive meta-analysis

Sun, 09 Nov 2008 20:30:15 EST

The SEARCH trial showed no effect on major vascular events with either an intensive 80-mg dose of simvastatin compared with a 20-mg dose or with homocysteine lowering using folic acid and vitamin B₁₂. But the statin data fit with other trials in the field, showing a "clear picture" emerging when it comes to the more-vs-less data on statins, say the UK investigators. (American Heart Association 2008 Scientific Sessions.)

JUPITER casts a large shadow: Moving from efficacy data to the big picture

Sun, 09 Nov 2008 19:30:00 EST

Some back-of-the-envelope analyses suggest that the public-health implications of using statins in primary prevention, especially among individuals considered "healthy" by conventional definitions, is weighing heavily on the minds of some cardiologists. heartwire spoke with many experts to get their take on the new JUPITER data. (American Heart Association 2008 Scientific Sessions.)

No benefit of vitamin C or E for prevention of major cardiovascular events: Physicians' Health Study II

Sun, 09 Nov 2008 17:45:12 EST

Randomized results from the Physicians' Health Study II found no effect of either supplement on a composite of nonfatal MI, nonfatal stroke, or cardiovascular death after eight years of treatment. (Sesso HD et al. JAMA 2008; 300:2123-2133. American Heart Association 2008 Scientific Sessions.)

Flu shot linked to reduced risk of VTE

Sun, 09 Nov 2008 17:45:00 EST

The link between influenza vaccination and reduced pulmonary embolism or deep vein thrombosis was particularly marked in younger subjects, researchers say. (American Heart Association 2008 Scientific Sessions.)

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

Sun, 09 Nov 2008 09:00:00 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.)

PTSD symptoms more than double mortality risk in patients with ICDs

Fri, 07 Nov 2008 13:30:00 EST

Individuals who receive implantable cardiac defibrillators after a sudden cardiac event are more than twice as likely to die within five years if they experience symptoms of posttraumatic stress disorder, regardless of disease severity. (Ladwig et al. Arch Gen Psychiatry 2008; 65:1324-1330.)

Eliminating inequalities in CHD: Focus on classic risk factors

Thu, 06 Nov 2008 18:30:00 EST

Focusing on the classic risk factors for coronary heart disease and ensuring that best-practice interventions to reduce absolute risk are implemented across the board could largely eliminate socioeconomic differences in CHD deaths, a new British study predicts (Kivimäki M et al. Lancet 2008; 372:1648-1654.)

New ranolazine indication in US allows first-line use in angina

Thu, 06 Nov 2008 17:45:26 EST

Registry: Cardiogenic shock rates plunge over decade thanks to PCI, statins

Thu, 06 Nov 2008 16:45:15 EST

The 75% drop in how often ACS patients develop shock during hospitalization accounted for almost all the difference in a Swiss registry study; the ranks of those presenting already in shock didn't change. (Jeger RV et al. Ann Intern Med 2008; 149:618-626.)

New statement on appropriate use of echo contrast agents should reassure physicians after year of controversy

Thu, 06 Nov 2008 15:00:24 EST

The statement outlines situations in which benefits of contrast outweigh risks and could ultimately improve patient outcomes, experts say. (Mulvagh SL et al. J Am Soc Echocardiogr 2008; 21:1179-1201.)

Sanofi-Aventis scraps ongoing rimonabant research

Wed, 05 Nov 2008 17:30:50 EST

The company announced its decision after regulatory agencies asked for a discontinuation of the company's clinical trials.

Mixed findings cast doubt on HRT timing hypothesis

Wed, 05 Nov 2008 12:45:02 EST

A new study has shown mixed results with regard to the effects of hormone-replacement therapy on lipids in women around the time of menopause and also shows that HRT unfavorably affects inflammatory markers. The results muddy the waters somewhat for the so-called "time window" for the use of HRT, say the researchers. (Sowers MR et al. Arch Int Med 2008; 168:2146-2153.)

Medtronic updates failure rates for Sprint Fidelis ICD leads

Tue, 04 Nov 2008 17:30:43 EST

Eyes trained on JUPITER: Cardiologists seek details to understand how statin use may expand

Tue, 04 Nov 2008 16:45:33 EST

Full results from the JUPITER trial will be released during the opening late-breaking clinical-trials session at the American Heart Association 2008 Scientific Sessions.

Sudden cardiac death after MI has declined over the decades, but first 30 days and heart failure up risks

Tue, 04 Nov 2008 16:00:00 EST

Physicians and patients need to be aware that sudden death is more common during the first few weeks post-MI and that the development of heart failure, at any time, increases the risk of sudden death in MI survivors. (Adabag AS et al. JAMA 2008; 300:2022-2029.)

CPR by paramedics for cardiac arrest: First focus is to restore pulse in the field

Tue, 04 Nov 2008 14:00:54 EST

Adoption by Los Angeles of a protocol for out-of-hospital cardiac arrest that calls for at least 20 minutes of chest compressions and other measures before efforts to transport boosted in-the-field rates of restored spontaneous circulation by 70%. (American College of Emergency Physicians Scientific Assembly 2008.)

US Department of Justice investigating AtriCure

Tue, 04 Nov 2008 14:00:53 EST

The company is being probed over marketing practices and advice it allegedly gave to hospitals regarding billing codes for surgical ablation.

HF up in recent decades as MI deaths fall

Tue, 04 Nov 2008 11:45:04 EST

A decline in deaths from MI in recent decades appears to have been accompanied by an increase in the incidence of heart failure, according to a new analysis from the Framingham Heart Study. The likely explanation is that sicker patients, who would have died from MI in earlier years, are now surviving but going on to develop HF, say the researchers. (Velagaleti RS et al. Circulation; published online before print October 27, 2008.)

Doctors and lawyers butt heads over statins for primary prevention in women

Mon, 03 Nov 2008 17:00:00 EST

The data do not support statin use in primary prevention of cardiovascular events for women, and any advertising claims made by drugmakers are vulnerable to legal action, according to one legal expert. Cardiologists, however, argue that the absence of information doesn't mean the drugs don't work in women, and they continue to prescribe them. (Eisenberg T et al. J Empir Leg Stud 2008; 5:507-550.)

Endothelial dysfunction seen in "minimally symptomatic" obstructive sleep apnea

Fri, 31 Oct 2008 18:15:00 EDT

OSA not accompanied by daytime symptoms might still suggest increased cardiovascular risk, according to researchers. (Kohler M et al. Am J Respir Crit Care Med 2008; 178:984-988.)

Alain Carpentier spearheads new total artificial heart endeavor

Fri, 31 Oct 2008 08:30:00 EDT

A French start-up company has announced it has received millions of dollars in funding, some from the defense industry, even as other replacement hearts in development globally seem stymied by disappointing long-term results or lack of funds.

MESA ties diabetes, HTN to new heart-failure risk in African Americans

Thu, 30 Oct 2008 18:00:24 EDT

Race per se shouldn't be a barrier to lowering the risk of new heart failure in African Americans, because the main causes are treatable, according to investigators for the longitudinal cohort study. (Bahrami H et al. Arch Intern Med 2008; 168:2138-2145.)

Medtronic says it will sell Endeavor with rapid exchange in US

Thu, 30 Oct 2008 16:30:20 EDT

Six-month TRANSFER-AMI data show persistent benefit

Thu, 30 Oct 2008 15:00:00 EDT

Investigators observed persistent trends toward a reduction in reinfarction and say that the data support the 30-day results that showed a benefit of PCI within six hours of fibrinolytic therapy in STEMI patients. (Canadian Cardiovascular Congress 2008.)

Door-to-balloon times of less than 90 minutes possible

Thu, 30 Oct 2008 14:30:20 EDT

A new Mayo Clinic protocol resulted in sustainable and durable improvements for four years. (American College of Emergency Physicians Scientific Assembly 2008,)

Twenty-year aortic bioprosthesis data show good durability and "satisfying outcomes"

Thu, 30 Oct 2008 10:15:04 EDT

New results suggest that while the bioprosthesis may begin to degenerate at around the seven-year mark, valve-related complications are rare, even out to 20 years. (Eichinger WB et al. Ann Thorac Surg 2008; 86:1204-1211.)

Endocarditis twice as likely to kill the elderly

Wed, 29 Oct 2008 18:30:18 EDT

The largest prospective multicenter study of infective endocarditis ever conducted has found that elderly patients with the disease have distinctive characteristics compared with their younger counterparts and that they are twice as likely to die from it. (Durante-Mangoni E et al. Arch Intern Med 2008; 168:2095-2103.)

ADD-IFI: Improved exercise tolerance with ivabradine in stable angina patients

Wed, 29 Oct 2008 17:00:05 EDT

Adding the novel heart-rate-reducing medication to atenolol 50 mg in patients with stable angina improved exercise duration compared with beta-blocker use alone. Ivabradine was also shown to be safe and well tolerated, report investigators. (Canadian Cardiovascular Congress 2008.)

Genetic study undermines case for CRP as cause of vascular disease

Wed, 29 Oct 2008 17:00:00 EDT

Genetically elevated CRP levels were associated with but probably didn't influence cardiovascular and cerebrovascular risk in a huge combined analysis of four Danish cohort studies, researchers say. (Zacho J et al. N Engl J Med 2008; 359:1897-1908.)

MIs linked to daylight saving time may also help explain MI spikes on Mondays

Wed, 29 Oct 2008 17:00:00 EDT

Rest easy for now: MI rates appear to increase in the spring but dip marginally with the end of DST in autumn, due likely to the extra hour of sleep. (Janszky et al. N Engl J Med 2008; 359:1966-1967.)

HF disease-management program cost-effective in minority-prevalent population

Wed, 29 Oct 2008 11:15:55 EDT

A previously observed cut in hospitalization risk has been shown in a follow-up analysis to have come at a cost within the typically accepted range. (Hebert PL et al. Ann Intern Med 2008; 149:540-548.)

Endoscopic harvesting of radial artery: Less painful, but approach fails to reduce infections

Wed, 29 Oct 2008 08:45:00 EDT

Endoscopic harvesting of the radial artery for CABG surgery significantly reduces postoperative wound pain and improves patient satisfaction with the cosmetic results, but there was only a trend toward a reduction in wound infection, a new study has shown. (Canadian Cardiovascular Congress 2008.)

FDA warns Bayer about "unlawful" marketing of aspirin-supplement combinations

Tue, 28 Oct 2008 16:15:34 EDT

An aspirin-calcium combination marketed for women and an aspirin-phytosterol combination that purports to reduce heart-disease risk are illegal, the FDA says. Bayer, in response, says it "stands behind" its claims but is working with the FDA.

Beta blockers up risk of MI, death after noncardiac ops

Tue, 28 Oct 2008 16:00:26 EDT

A new retrospective cohort study has found that those taking beta blockers prior to noncardiac surgery had higher rates of MI and death at 30 days than those not taking beta blockers. The findings are similar to those of the landmark POISE study, says the senior author, although he acknowledges that there are some differences and that the new study has limitations. (Kaafarani HMA et al. Arch Surg 2008; 143:940-944.)

Radial-access PCI reduces major bleeding 73% compared with femoral approach

Mon, 27 Oct 2008 17:00:00 EDT

In addition to the reduction in major bleeding, there were trends toward a reduction in ischemic events, although these did not reach statistical significance. A second study also showed that radial-access PCI in STEMI patients does not compromise reperfusion times. (Canadian Cardiology Congress 2008.)

Metformin top oral antidiabetic for CV-risk reduction, says meta-analysis

Mon, 27 Oct 2008 16:00:00 EDT

Of all such agents used in 40 select clinical trials, only metformin significantly reduced cardiovascular mortality. An accompanying editorial highlights limitations of meta-analyses and the shortfalls in knowledge about the CV effects of these agents. (Selvin E et al. Arch Intern Med 2008; 168:2070-2080.)

Statin use reduces mortality after hospitalization for pneumonia

Mon, 27 Oct 2008 16:00:00 EDT

The decreased mortality rates among those pretreated with statin therapy became evident during the first weeks of hospitalization for pneumonia and persisted to at least 90 days, report investigators. (Thomsen R et al. Arch Intern Med 2008; 168:2081-2087.)

LV assist device manufacturer issues warning about damaged connector leads; new pumps may be needed

Mon, 27 Oct 2008 15:30:01 EDT

Promising percutaneous CoreValve data from Europe leave US trialists itching for green light from the FDA

Fri, 24 Oct 2008 18:00:00 EDT

New data from 18 European countries on the fully percutaneous aortic valve speak to low 30-day mortality and improved valve function sustained over the longer term. So why the holdup in the US, where nary a feasibility study has been conducted? (TCT 2008.)

Beleaguered NitroMed plans exit from BiDil business

Fri, 24 Oct 2008 10:30:00 EDT

The company has closed a deal to sell its only product to JHB Pharmaceuticals.

FDA delays decision on TriLipix, Abbott's new fenofibrate

Thu, 23 Oct 2008 17:00:49 EDT

The agency needs more time to complete a review of TriLipix, a newer, patent-protected fenofibrate from Abbott Laboratories.

Drug maker agrees to suspend rimonabant marketing in Europe

Thu, 23 Oct 2008 15:30:29 EDT

European regulators say rimonabant's benefits no longer outweigh its risks. Its manufacturer, however, says it remains committed to the drug and hopes to provide evidence to support its reevaluation in the future.

Hydrogen sulfide discovered to be a major player in the regulation of blood pressure

Thu, 23 Oct 2008 14:00:00 EDT

Nitric oxide, it turns out, is not alone in controlling blood-pressure levels. A new study points to hydrogen sulfide, a gas responsible for some noxious smells, as a major physiologic vasodilator and regulator of blood pressure. (Yang G et al. Science 2008; 322:587-590.)

Pascal Goldschmidt wins new $100 000 prize

Thu, 23 Oct 2008 10:45:21 EDT

Court lifts injunction that keeps Endeavor from rapid exchange: Medtronic mum on plans

Thu, 23 Oct 2008 09:30:40 EDT

Currently, Endeavor is the only DES in the US that cannot be used with the newer delivery system.

Reducing heart rate in hypertension is harmfulor is it just atenolol?

Wed, 22 Oct 2008 14:15:39 EDT

Slowing the heart rate with beta blockers in people with hypertension is associated with an increased risk of cardiovascular events and death, a new systematic review shows. But one expert points out the analysis was done mainly with studies that used atenolol and that it remains to be determined whether it is this drug per se or the reduction in heart rate that is harmful. (Bangalore S et al. J Am Coll Cardiol 2008; 52:1482-1489.)

Tissue-friendly polymer particles promising as anti-inflammatory drug carrier in acute MI

Wed, 22 Oct 2008 10:00:00 EDT

Injections of the drug-ferrying microparticles in a rat model were followed by signs of reduced inflammation and improved cardiac function (Sy JC et al. Nat Mater; published online before print October 19, 2008.)

COOL-RCN: Hypothermia does not prevent contrast-induced nephropathy during cath procedures

Tue, 21 Oct 2008 18:00:24 EDT

The COOL-RCN investigators used a catheter that essentially acts as an "intravenous refrigerator," cooling the body from the inside out, but it failed to decrease the risk of acute kidney damage caused by iodinated contrast agents. (TCT 2008.)

New trial results support broader role for carotid stenting, but CMS again refuses to expand Medicare coverageUpdated

Tue, 21 Oct 2008 17:15:42 EDT

Critics say the CMS should have waited for pending publications of the SAPPHIRE, CAPTURE 2, and EXACT data before announcing its decision, especially as new results from PROTECT, EMPIRE, and EPIC indicate that stroke, death, and MI rates are continuing to decline. (TCT 2008.)

Genetic testing to guide heart-failure therapy: Accolades and questions

Tue, 21 Oct 2008 15:00:58 EDT

Is cardiovascular care poised to enter the brave new world of pharmacogenomics? A test for a pair of genetic markers seems to distinguish heart-failure patients who are likely or unlikely to respond to a beta blocker now under FDA review. (Heart Failure Society of America 2008 Scientific Meeting.)

"Western" diet increases MI risk worldwide

Tue, 21 Oct 2008 15:00:27 EDT

The simple message that a "Western" diet, high in fried foods and meat products, increases the risk of heart attack and that a diet rich in fruits and vegetables is protective is applicable in all regions of the world, a new analysis of the INTERHEART study finds. (Iqbal R et al. Circulation; published online before print October 20, 2008.)

PREPARE: Proximal embolic protection with aspiration improves immediate ST-segment resolution

Mon, 20 Oct 2008 17:15:04 EDT

An embolic-protection and aspiration device delivered proximally to the lesion in primary PCI results in better immediate microvascular flow in STEMI patients compared with primary PCI alone. Although the immediate benefits did not hold up over time, investigators believe the early reperfusion will translate into better outcomes. (TCT 2008.)

Heart failure preliminarily linked to bone fractures

Mon, 20 Oct 2008 16:00:00 EDT

The finding may be new, retrospective, and in need of further exploration, researchers note, but it at least suggests care should be taken to make sure patients with heart failure are screened for osteoporosis. (van Diepen S et al. Circulation 2008; published online before print October 20, 2008.)

Prasugrel faces further delay in US

Mon, 20 Oct 2008 11:15:23 EDT

A decision on whether or not to approve the investigational antiplatelet agent prasugrel in the US will not be made until the early part of next year, reports suggest.

BBC ONE: Fewer MACE with provisional T-stenting for bifurcations

Fri, 17 Oct 2008 17:30:29 EDT

Provisional T-stenting using the Taxus stent, instead of the crush or culotte techniques, is associated with a lower rate of death, MI, and target vessel failure at one year, results from the BBC ONE trial show. (TCT 2008.)

Is prophylaxis for endocarditis essential, or just a habit that's hard to break?

Fri, 17 Oct 2008 14:30:18 EDT

The issue of when, or even if, antibiotics should be given for the prevention of infective endocarditis has been hotly debated of late. heartwire interviewed one expert on the subject, Dr Bernard Prendergast, to gauge his views.

Aspirin: Should it be used for primary prevention in diabetics?

Fri, 17 Oct 2008 13:45:26 EDT

A new study, POPADAD, has found no evidence that aspirin or antioxidants are of any benefit in the primary prevention of cardiovascular events in diabetic patients with asymptomatic peripheral arterial disease. The authors and accompanying editorialist say guidelines should be changed; others say more evidence is needed. (Belch Jet al. BMJ; published online before print October 16, 2008.)

The devil in the details: Sponsors still mulling nuts and bolts of DAPTUpdated

Fri, 17 Oct 2008 12:30:03 EDT

Device companies contacted by heartwire about their role in the Dual Antiplatelet Therapy Trial say nothing has yet been finalized about trial funding or "in-kind" sponsorship. Hammering out these details may yet jeopardize the $100M DES trial. (TCT 2008.)

Senate committees seek specifics on industry payments to CRF physicians

Fri, 17 Oct 2008 11:30:16 EDT

The request came during the Cardiology Research Foundation's flagship event in the nation's capital, held mere blocks from the Senate offices.

European data raise safety questions about Endeavor stentUpdated

Thu, 16 Oct 2008 16:30:02 EDT

In a comparison with the Cypher stent, SORT-OUT III showed an increased risk of MI and stent thrombosis with the Endeavor zotarolimus-eluting stent at nine months, while two-year registry data suggest an increase risk in all-cause mortality. While everybody urged caution in interpreting the findings, experts say the results are a warning signal. (TCT 2008.)

Treatment-safety advocate and HF specialist Sackner-Bernstein moves to the FDA

Thu, 16 Oct 2008 13:45:01 EDT

HORIZONS AMI: Drug-eluting stent safe and effective in the setting of STEMI

Wed, 15 Oct 2008 18:00:00 EDT

In addition to reducing TLR rates at 12 months, the Taxus stent was equivalent to its bare-metal counterpart in terms of major cardiovascular adverse events, including death, MI, stroke, and stent thrombosis, report investigators. (TCT 2008.)

$100M DAPT supplants CODA: Massive DES/dual antiplatelet therapy trial announced at TCT

Wed, 15 Oct 2008 17:00:00 EDT

Eight companies have agreed to sponsor the study, selecting the Harvard Clinical Research Institute to command the 33-month, $100-million dollar study. The announcement effectively shelves CODA, the dual antiplatelet study first proposed by Duke but rejected by the necessary industry funders. (TCT 2008.)

Cheney's AF recurs, electrical defibrillation scheduled

Wed, 15 Oct 2008 13:00:03 EDT

Current risk-stratification role for heart-rate turbulence monitoring defined

Wed, 15 Oct 2008 12:15:54 EDT

The Holter-based technique is especially effective in the post-MI setting and may be useful in patients with heart failure, according to a state-of-the-art review. (Bauer A et al. J Am Coll Cardiol 2008; 52:1353-1365.)

Left main and three-vessel disease subsets from SYNTAX: New answers, more questions

Wed, 15 Oct 2008 12:00:00 EDT

The analyses can be viewed only as "hypothesis generating," since SYNTAX was negative. But the data suggest that in low- or intermediate-risk patients with left main disease, DES and CABG are both "reasonable" options, but in three-vessel disease, only the lowest-risk patients should be considered as candidates for DES instead of surgery. (TCT 2008.)

Continuous amiodarone for sinus-rhythm maintenance upheld in randomized AF trial

Wed, 15 Oct 2008 10:30:54 EDT

An "episodic" amiodarone regimen was less safe and effective and didn't reduce complications from the drug's toxicity. (Ahmed S et al. JAMA 2008; 300:1784-1792.)

More than half of stable CAD patients go straight to PCI without stress test

Tue, 14 Oct 2008 18:30:00 EDT

The findings imply not only that some physicians are ignoring guidelines and subjecting patients to a higher-risk treatment than warranted but also that Medicare is spending too much on invasive therapies without first knowing whether an interventional approach is needed, investigators say. (Lin GA et al. JAMA 2008; 300:1765-1773.)

FAME! FFR-guided PCI significantly reduces clinical events

Tue, 14 Oct 2008 17:45:13 EDT

Investigators report that fractional flow reserve-guided PCI reduced the risk of death, MI, or repeat revascularization by 30% and death or MI by 35%, when compared with the current practice of using angiography to guide stenting decisions. (TCT 2008.)

Cypher, Taxus equal in left main disease: ISAR LM

Tue, 14 Oct 2008 14:30:35 EDT

Both types of drug-eluting stents performed similarly in left main subjects, leading to two-year outcomes comparable to those from CABG registries. (TCT 2008.)

Smoking cessation must not be an afterthought, new studies say

Tue, 14 Oct 2008 14:15:12 EDT

Two new studies suggest that smoking-cessation advice within hospitals needs to be much more structured to achieve better results. A related article finds that not only does smoking in midlife shorten life expectancy, but that the quality of that life is much reduced. (Dawood N et al. Rigotti NA et al. Strandberg AY et al. Arch Intern Med 2008; 168:1961-1967, 1950-1960, 1968-1974.)

Low 30-day and six-month mortality for transfemoral valve implantation in PARTNERS EU and SOURCE

Tue, 14 Oct 2008 09:30:06 EDT

High survival following transcatheter valve placement via the transfemoral approach reflects increased operator skill and lower-risk patients than the transapical arms of the study, experts say. (TCT 2008.)

New rofecoxib data will help inform treatment decisions with other coxibs, NSAIDs

Mon, 13 Oct 2008 18:30:00 EDT

New results from the extended follow-up of the APPROVE trial provide a more complete assessment of the cardiovascular toxicity of the COX-2 inhibitor rofecoxib than previously reported. The findings are still very relevant, because this is a class effect, say the researchers and editorialists. (Baron JA et al. Lancet; published online before print October 13, 2008.)

First-in-human data with novel polymer-coated stent: No thrombosis at 12 months

Mon, 13 Oct 2008 17:15:31 EDT

Investigators reported no cases of stent thrombosis at 12 months in patients implanted with the stent, as well as no adverse clinical events, despite stopping dual antiplatelet therapy at 30 days. (TCT 2008.)

Good and bad news on hypertension in US

Mon, 13 Oct 2008 16:00:00 EDT

A new report shows that more US adults have hypertension than ever before, and the increase is primarily due to the rising rates of obesity in recent times, say the NHLBI researchers. However, awareness, treatment, and control of blood pressure have also improved. Nevertheless, much work remains, specifically with certain subgroups, they say. (Cutler JA et al. Hypertension; published online October 13, 2008.)

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

Mon, 13 Oct 2008 11:45:30 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.)

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

Mon, 13 Oct 2008 09:15:09 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.)

New DES on the block: TAXUS Liberté receives FDA approval

Fri, 10 Oct 2008 16:45:00 EDT

Warfarin warning: Shortfalls in anticoagulation for AF up risks of ICH and embolic stroke

Fri, 10 Oct 2008 12:45:00 EDT

Documentation of the care of patients in a nationwide health plan suggests that less than half of patients with atrial fibrillation are prescribed an anticoagulant. (Walker AM, Bennett D. Heart Rhythm 2008; 5:1365-1372.)

NOMAS: Just a 2% overlap for PFO and migraine; St Jude shuts down ESCAPE trial

Thu, 09 Oct 2008 14:30:12 EDT

While both migraine and PFO occurred in roughly 15% of the NOMAS participants, the two were rarely found together. Experts agree: hopes are dimming that PFO closure may help migraineurs. Indeed, only one company is still testing this hypothesis in randomized trials. (Rundek T et al. Circulation 2008; 118:1419-1424.)

CT angiography predicts mortality from coronary disease, EBT scans show

Wed, 08 Oct 2008 17:15:39 EDT

The study, using EBT scans taken as long as 12 years ago, provides some of the first data suggesting that noninvasive angiography using CT can provide prognostic information. Similar outcome data for the newer CT scanners are likely many years away. (Ostrom M et al. J Am Coll Cardiol 2008; 52:1335-1343.)

Stem cells for AMI: New review finds same old story

Tue, 07 Oct 2008 19:00:00 EDT

A familiar message has emerged from a new review of stem-cell therapy for acute MI—a moderate improvement was seen, but much more research is needed. (Martin-Rendon E et al. Cochrane Database Syst Rev 2008; 4: CD006536. Eur Heart J 2008; 29:1807-1818.)

Ultrasound-based strategies comparable for DVT diagnosis, treatment guidance

Tue, 07 Oct 2008 17:30:00 EDT

A randomized trial found that two ultrasound-based strategies were similarly effective at determining the need for anticoagulation in symptomatic patients with suspected deep-vein thrombosis; both have strengths and weaknesses. (Bernardi E et al. JAMA 2008; 300:1653-1659.)

Questions raised about Northwestern use of valve device; prominent surgeon denies wrongdoing

Tue, 07 Oct 2008 15:30:20 EDT

Dr Patrick McCarthy and Edwards Lifesciences insist that the Myxo ETlogix annuloplasty ring 5100 that McCarthy invented was commercially available at the time it was used in a study describing the "initial experience" with the ring. The circumstances are now the subject of an FDA investigation and the focus of a lawsuit from a patient who says she was never told that McCarthy had invented the device.

Societies confront GI risks of antiplatelets, NSAIDs in consensus document

Tue, 07 Oct 2008 10:00:38 EDT

It addresses a common clinical problem for which there is little clinical-trial-quality data for guidance and gives a starring role to proton-pump inhibitors in treating GI ulcers and bleeding and, in high-risk groups, in their prevention. (Bhatt DL et al. J Am Coll Cardiol; Circulation; published online before print October 3, 2008.)

Elective PCI possible without "safety net" of anticoagulation

Mon, 06 Oct 2008 17:00:00 EDT

Low-risk patients with uncomplicated lesions can have elective PCI safely performed using dual antiplatelet therapy without systemic anticoagulation, according to a new randomized study. An accompanying editorial begs to differ, however. (Stabile E et al. J Am Coll Cardiol 2008; 1293-1298.)

Endovascular AAA repair cost-effective in high-risk patients

Mon, 06 Oct 2008 14:30:05 EDT

The average one-year costs for EVAR and open surgery were nearly identical, despite the significantly more expensive endovascular procedural costs. Patients undergoing endovascular repair spent less time in the hospital, and this reduced morbidity translated into lower nonprocedural costs. (Tarride JE et al. J Vasc Surg 2008; 48:779-787.)

India attempts to impose world's biggest smoking ban

Fri, 03 Oct 2008 11:30:39 EDT

The Indian government appears to have heeded the warnings of medical experts highlighting the immense problem of smoking in the country, with the introduction this week of a nationwide ban on smoking in public places.

Outcomes, quality of care largely unaffected by weekend admission for heart failure

Thu, 02 Oct 2008 18:15:32 EDT

The finding is contrary to what has been found for hospitalizations due to some other CV disorders. (Heart Failure Society of America 2008 Scientific Meeting.)

Pfizer to drop development of drugs for hyperlipidemia, atherosclerosis, and heart failure

Thu, 02 Oct 2008 17:00:34 EDT

UPDATED // Forbes reported the news online after obtaining an internal Pfizer memo.

Merck stops taranabant development: Will not seek FDA approval

Thu, 02 Oct 2008 13:30:29 EDT

Prospects for the drug were dim, with late-stage studies showing a significant increase in psychiatric and gastrointestinal side effects with the cannabinoid-receptor blocker.

Transapical valve data: Climbing survival rates speak to improved skill, technology, and patient selection

Thu, 02 Oct 2008 11:30:00 EDT

Surgeons say the bleak six-month survival rate of 55% in the preapproval PARTNER EU data set reflects the learning-curve period. Refinements to the technology, growing expertise, and better patient selection are captured in the later SOURCE data set and those of single European centers, where 30-day survival approaches 90%. (European Association for Cardiothoracic Surgery 2008 Meeting.)

Debating PCI-related delays and the management of STEMI patients

Wed, 01 Oct 2008 17:45:10 EDT

Should the ACC/AHA guidelines for the management of STEMI patients extend the acceptable PCI-related delay to as long as 120 minutes? A group of Danish researchers thinks so, but Dr Elliott Antman, who cochaired the writing committee of those guidelines, disagrees. (Terkelsen CJ et al. Antman E. J Am Coll Cardiol 2008; 52:1211-1215, 1216-1221.)

FDA finds no link between statin use and ALS

Wed, 01 Oct 2008 16:00:00 EDT

The meta-analysis, which included 41 clinical trials, revealed similar rates of ALS in the statin-treated and placebo-treated patients. The agency said further monitoring is still needed, however, because of the expansive use of the drugs and the dire consequences of this neurodegenerative disorder. (Colman E et al. Pharmacolepidemiol Drug Saf; published online September 29, 2008.)

New study finds type of HRT is key with regard to MI risk

Wed, 01 Oct 2008 13:45:14 EDT

Important new information on HRT and the risk of MI has emerged from a Danish observational study, which finds that the type of HRT used could be key when it comes to the likelihood of a heart attack. (Lokkegaard E et al. Eur Heart J; published online before print September 30, 2008.)

Subspecialty certification on the way for specialists in advanced heart failure

Tue, 30 Sep 2008 16:30:22 EDT

The certification is expected to encompass the management of patients with implantable defibrillators and biventricular pacemakers, although not device insertions.

Miniaturized heart pumps: Difference between life and death in small children

Tue, 30 Sep 2008 15:45:10 EDT

Reporting on his own initial experience with a miniaturized ventricular assist device used as a bridge to transplant in small children, a leading pediatric heart surgeon is hoping that the pump—widely available in Europe—will soon be approved for use in the US. (Gandhi SK et al. Circulation 2008; 118:S89-S93.)

Routinely screen for clinical depression in CHD, AHA formally recommends

Tue, 30 Sep 2008 09:45:21 EDT

Providers should take the opportunity in any setting in which they see CHD patients, according to a "science advisory" from the organization, which acknowledges a lack of direct evidence that such efforts will improve the patients' clinical outcomes. (Lichtman JH et al. Circulation 2008; published online before print September 29, 2008.)

Survival post-heart surgery just as good when surgical trainees hold the scalpel, study suggests

Mon, 29 Sep 2008 16:00:00 EDT

Even though trainees were more likely to do higher-risk procedures, their results, in terms of mid-term survival and freedom from cardiac rehospitalizations, were just as good as those of their teachers, a new single-center study shows. (Stoica SC et al. Circulation; published online before print September 29, 2008.)

Eating dark chocolate reduces CRP

Mon, 29 Sep 2008 13:30:32 EDT

A new Italian study has shown, for the first time, that consuming moderate amounts of dark chocolate can significantly reduce CRP levels. (di Giuseppe R et al. J Nutr 2008; 138:1939-1945.)

FDA once again postpones decision on prasugrel

Mon, 29 Sep 2008 09:00:27 EDT

Myosin-activating agent boosts systolic function, but please don't call it an "inotrope"

Fri, 26 Sep 2008 15:45:12 EDT

It's still in early-phase studies, but researchers hope the drug, which seems to prolong systole and enhance cardiac output without raising myocardial oxygen demand, will offer the benefits of conventional inotropic agents without their dark side. (Heart Failure Society of America 2008 Scientific Meeting.)

Aortic-valve bypass: A time-tested, minimally invasive alternative to valve-replacement surgery

Fri, 26 Sep 2008 15:00:28 EDT

Authors of a new report say AV bypass was eclipsed by surgical valve replacement, but the prospect of transcatheter valves has refocused interest in the older procedure, which can be used in very high-risk patients and has a number of advantages over percutaneous replacement. (Gammie J et al. Circulation; published online before print September 15, 2008.)

"Consider" candesartan for diabetic retinopathy

Fri, 26 Sep 2008 10:45:01 EDT

Despite meeting none of the primary end points in the three DIRECT studies in diabetic retinopathy, the angiotensin receptor blocker candesartan could still be considered a treatment option in certain patients with this condition, say the trial authors and accompanying editorialists. (Chaturvedi N et al. Sjølie AK et al. Lancet; published online before print September 25, 2008.)

Improved renal function and modest hemodynamic changes with adenosine-receptor antagonist

Thu, 25 Sep 2008 17:45:22 EDT

The agent modestly reduced pulmonary capillary wedge pressures at the highest doses, had a weak diuretic effect, and improved renal-function measures. More research into the effects of A1-receptor antagonists on morbidity and mortality are still needed, say investigators. (Heart Failure Society of America 2008 Scientific Meeting.)

Taxus "Atom" stent approved for small vessels; FDA also okays use in bare-metal-stent restenosis

Thu, 25 Sep 2008 17:30:10 EDT

Senate asks NIH for details on Dr Marvin Konstam's one-year contract with NHLBI

Thu, 25 Sep 2008 11:30:49 EDT

Konstam, hired as a senior advisor to the NHLBI director, also retains ties to Tufts and is the medical director for medical device company Orqis, prompting Sen Charles Grassley to question whether the NIH is avoiding strict conflict-of-interest policies by hiring experts as contractors, rather than full-time employees.

Enrollment stopped in NIH-funded trial studying chelation therapy for treatment of CAD

Wed, 24 Sep 2008 19:00:45 EDT

UPDATED WITH INTERVIEW // Enrollment into the Trial to Assess Chelation Therapy, a five-year, $30-million, National Institutes of Health-funded clinical study, has been "temporarily and voluntarily stopped." No word yet from investigators as to why enrollment into the controversial study is on hold.

Once-a-day carvedilol "noninferior" to twice-daily version in heart failure; need for it questioned

Wed, 24 Sep 2008 17:45:03 EDT

Some believe once-daily carvedilol for heart failure will improve compliance and therefore outcomes, compared with the twice-daily version; others wonder whether noninferiority is worth the extra cost. (Heart Failure Society of America 2008 Scientific Meeting.)

Two-year Massachusetts registry results support mortality benefit of DES in AMI

Wed, 24 Sep 2008 17:00:00 EDT

Whether the benefits are due to restenosis reduction, the additional months of dual antiplatelet therapy, or other effects of the DES itself are unclear, authors note. (Mauri L et al. N Engl J Med 2008; 359:1330-1342.)

Intrathoracic impedance predicts heart-failure events in PARTNERS-HF

Wed, 24 Sep 2008 15:45:39 EDT

Fluid indices crossing a predefined threshold significantly increased the risk of subsequent heart-failure decompensation, shortness of breath, peripheral edema, and fatigue, suggesting impedance data can help stratify patients at risk for worsening heart failure, report investigators. (Heart Failure Society of American 2008 Scientific Meeting.)

Poor and Medicaid recipients with MI have longest prehospital delays

Wed, 24 Sep 2008 13:45:26 EDT

New research shows that those with Medicaid insurance and those living in low-income neighborhoods are less likely than their better-off counterparts to get to the hospital quickly after an acute MI. This adds to prior studies that have shown that race, sex, age, and comorbid conditions can influence the time taken to get to the hospital following AMI. (Foraker RE et al. Arch Intern Med 2008; 168:1874-1879.)

Inhaled anticholinergics for COPD raise CV-event risk in meta-analysis

Tue, 23 Sep 2008 16:00:00 EDT

Chronic use of inhaled ipratropium or tiotropium bromide independently increased the risk of CV death by 80%; patients who took them for at least six months appeared the most vulnerable. A forthcoming randomized trial may provide more authoritative guidance on the issue. (Singh S et al. JAMA 2008; 300:1439-1450.)

Out-of-hospital cardiac arrest: Location is all

Tue, 23 Sep 2008 16:00:00 EDT

A new analysis of out-of-hospital cardiac arrest in 10 areas in North America has found a fivefold difference in survival rates. The researchers say an estimated 15 000 premature deaths could be prevented each year if survival could be increased in those places not performing well. A related article contends that to try to improve outcomes, attention should be focused on those most likely to survive. (Nichol G et al. Sasson C et al. JAMA 20082; 300:1423-1431, 1432-1438.)

Thyroid hormone analog fails in the treatment of heart failure

Tue, 23 Sep 2008 13:00:42 EDT

The phase 2 study was stopped early because the compound worsened heart-failure symptoms, although it did have a positive effect on weight and lipid profiles. (Heart Failure Society of American 2008 Scientific Meeting.)

Live what you advocate: The exercise habits of busy cardiologists

Tue, 23 Sep 2008 10:15:00 EDT

Sure, it's easy to throw the book at a patient, telling them to eat better and to get active, but are cardiologists practicing what they preach? And if they are, just what are they doing to stay in shape? heartwire has a look at the athletic lives of some cardiologists.

SADHART-CHF: Nurse intervention impresses for depression in heart failure, SSRI doesn't

Tue, 23 Sep 2008 09:30:00 EDT

The trial, underpowered for clinical outcomes, failed even to demonstrate that sertraline alleviated depression; observers attribute the finding to the unique nonpharmacologic therapy actively treated patients and controls both received. (Heart Failure Society of America 2008 Scientific Meeting.)

ICD effectiveness: Do patients appreciate their limits? The debate continues

Mon, 22 Sep 2008 17:00:00 EDT

A review casts a critical eye on how ICDs are used in the US and argues that their benefits have been overstated; a commentary from a key figure behind the latest device-therapy guidelines takes exception. (Tung R et al. J Am Coll Cardiol; published online before print September 22, 2008.)

Severe subclinical hypothyroidism ups risk of HF

Mon, 22 Sep 2008 17:00:00 EDT

A new study has found that older adults with severe subclinical hypothyroidism had almost double the risk of developing heart failure compared with those with normal thyroid function. The findings are important to inform the debate on whether to screen and treat subclinical hypothyroidism, say the researchers. (Rodondi N et al. J Am Coll Cardiol 2008; 52:1152-1159.)

Some MOMENTUM for continuous aortic flow therapy in heart failure

Mon, 22 Sep 2008 16:30:00 EDT

Chronic heart-failure patients with nonischemic etiology and without kidney dysfunction or severe N-terminal pro-brain-natriuretic peptide expression appear to benefit from the device. The data are hypothesis generating at this point, say investigators, and decisions will need to be made about where to go next with the aortic flow therapy. (Heart Failure Society of America 2008 Scientific Meeting.)

Passive smoking ups risk of PAD by 50%

Mon, 22 Sep 2008 16:00:00 EDT

Chinese researchers have reported, for the first time, a link between exposure to passive smoke and peripheral arterial disease in a cohort of women who have never smoked. They call for urgent public-health measures to protect individuals from secondhand smoke. (He Y et al. Circulation: published online before print September 22, 2008.)

theHeart.org

Bevacizumab significantly increases venous thromboembolism

ACC/AHA publishes new performance measures for STEMI patients

ECGs add little when it comes to prognosis in those with chest pain

OCT imaging suggests low rates of uncovered/malapposed struts following DES for AMI

Negative thinking predicts depression in heart-failure patients

Depression, not SSRIs, linked to increased mortality in heart-failure patients

Cardiovascular effects of air pollution, even in the comfort of home

Music, like laughter, benefits heart health

APPROACH: Rosiglitazone doesn't affect atherosclerosis progression in diabetics with CV disease

heartwire journalist wins American Heart Association writing award

THINRS: Home INR monitoring as effective as clinic-based care

Patients believe elective PCI prevents MI and saves lives, but who's to blame?

HF-ACTION: Early and sustained quality-of-life improvements with structured exercise program

FIT HEART: Novel family-based intervention a good idea, but better methods needed

New meta-analysis of beta blockers in noncardiac surgery: Time to abandon their use, or not?

I-PRESERVE: Strike three for RAAS inhibition in preserved-LVEF heart failure

Higher nonfasting triglycerides associated with increased ischemic stroke risk

MR-proADM better prognostic tool than BNP, but not everybody convinced of biomarker's merit

Interferon hope for chronic viral cardiomyopathy

HF-ACTION misses, but experts say results support intensive exercise in HF patients

Hibiscus tea reduces blood pressure

TIMACS: Early invasive management safe in non-ST-elevation ACS, improves outcomes in high-risk cases

Tailoring clopidogrel loading on the basis of responsiveness testing reduces stent thrombosis

T-wave alternans sudden-death risk stratification strikes out twiceor does it?

Revascularization, MI, and mortality benefits at three years in diabetic patients treated with drug-eluting stents

New factor Xa inhibitor rivaroxaban moves into phase 3 for ACS

Rock on: Keep iPod headphones away from pacemakers/ICDs to avoid interference

JPAD: No effect of aspirin primary-CV-event prevention in diabetics

SEARCH me: Null trial "morphed" into positive meta-analysis

JUPITER casts a large shadow: Moving from efficacy data to the big picture

No benefit of vitamin C or E for prevention of major cardiovascular events: Physicians' Health Study II

Flu shot linked to reduced risk of VTE

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

PTSD symptoms more than double mortality risk in patients with ICDs

Eliminating inequalities in CHD: Focus on classic risk factors

New ranolazine indication in US allows first-line use in angina

Registry: Cardiogenic shock rates plunge over decade thanks to PCI, statins

New statement on appropriate use of echo contrast agents should reassure physicians after year of controversy

Sanofi-Aventis scraps ongoing rimonabant research

Mixed findings cast doubt on HRT timing hypothesis

Medtronic updates failure rates for Sprint Fidelis ICD leads

Eyes trained on JUPITER: Cardiologists seek details to understand how statin use may expand

Sudden cardiac death after MI has declined over the decades, but first 30 days and heart failure up risks

CPR by paramedics for cardiac arrest: First focus is to restore pulse in the field

US Department of Justice investigating AtriCure

HF up in recent decades as MI deaths fall

Doctors and lawyers butt heads over statins for primary prevention in women

Endothelial dysfunction seen in "minimally symptomatic" obstructive sleep apnea

Alain Carpentier spearheads new total artificial heart endeavor

MESA ties diabetes, HTN to new heart-failure risk in African Americans

Medtronic says it will sell Endeavor with rapid exchange in US

Six-month TRANSFER-AMI data show persistent benefit

Door-to-balloon times of less than 90 minutes possible

Twenty-year aortic bioprosthesis data show good durability and "satisfying outcomes"

Endocarditis twice as likely to kill the elderly

ADD-IFI: Improved exercise tolerance with ivabradine in stable angina patients

Genetic study undermines case for CRP as cause of vascular disease

MIs linked to daylight saving time may also help explain MI spikes on Mondays

HF disease-management program cost-effective in minority-prevalent population

Endoscopic harvesting of radial artery: Less painful, but approach fails to reduce infections

FDA warns Bayer about "unlawful" marketing of aspirin-supplement combinations

Beta blockers up risk of MI, death after noncardiac ops

Radial-access PCI reduces major bleeding 73% compared with femoral approach

Metformin top oral antidiabetic for CV-risk reduction, says meta-analysis

Statin use reduces mortality after hospitalization for pneumonia

LV assist device manufacturer issues warning about damaged connector leads; new pumps may be needed

Promising percutaneous CoreValve data from Europe leave US trialists itching for green light from the FDA

Beleaguered NitroMed plans exit from BiDil business

FDA delays decision on TriLipix, Abbott's new fenofibrate

Drug maker agrees to suspend rimonabant marketing in Europe

Hydrogen sulfide discovered to be a major player in the regulation of blood pressure

Pascal Goldschmidt wins new $100 000 prize

Court lifts injunction that keeps Endeavor from rapid exchange: Medtronic mum on plans

Reducing heart rate in hypertension is harmfulor is it just atenolol?

Tissue-friendly polymer particles promising as anti-inflammatory drug carrier in acute MI

COOL-RCN: Hypothermia does not prevent contrast-induced nephropathy during cath procedures

New trial results support broader role for carotid stenting, but CMS again refuses to expand Medicare coverageUpdated

Genetic testing to guide heart-failure therapy: Accolades and questions

"Western" diet increases MI risk worldwide

T-wave alternans sudden-death risk stratification strikes out twiceor does it?

Reducing heart rate in hypertension is harmfulor is it just atenolol?

New trial results support broader role for carotid stenting, but CMS again refuses to expand Medicare coverageUpdated

The devil in the details: Sponsors still mulling nuts and bolts of DAPTUpdated

European data raise safety questions about Endeavor stentUpdated