theHeart.org - Brain/Kidney/Peripheral

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.)

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.)

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.)

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.)

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.)

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.)

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.)

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.)

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.)

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.

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.)

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.)

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.)

Cheney's AF recurs, electrical defibrillation scheduled

Wed, 15 Oct 2008 13:00:03 EDT

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.)

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.)

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.)

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.)

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.)

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.)

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.)

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.)

"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.)

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.)

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.)

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.)