Brain, kidney and peripheral medical news | theheart.org

Apixaban cuts stroke risk in all types of AF, says ARISTOTLE

Wed, 16 May 2012 09:30:43 EDT

The trial also had something to say about the degree of stroke risk according to type of atrial fibrillation—that is, whether paroxysmal or permanent/persistent.

TAVI to treat surgical valve failure shows potential, with caveats

Tue, 15 May 2012 13:00:30 EDT

The largest series to date looking at use of a transcatheter valve to treat the failure of a surgically implanted prosthetic has found high rates of survival at one year, but enough in the way of safety signals that investigators are cautioning against widespread use of the practice.

FDA: MS drug fingolimod gets CVD warnings

Tue, 15 May 2012 10:30:36 EDT

The agency completed review of a patient death after the first dose of fingolimod and has updated contraindications and monitoring recommendations for patients with multiple sclerosis.

Without warfarin, Watchman still prevents strokes, says registry

Tue, 15 May 2012 10:15:50 EDT

Patients with AF implanted with the left atrial appendage occluder in the earlier PROTECT-AF trial took warfarin the first six weeks; but in warfarin-contraindicated patients, Watchman still protects against stroke, suggests an observational study.

New guidance for young people with Wolff-Parkinson-White (WPW) syndrome

Mon, 14 May 2012 10:00:11 EDT

The "first-of-its-kind" consensus statement should help clarify which young people should undergo catheter ablation, authors of the document say.

Data gathering for Sunshine Act delayed

Fri, 11 May 2012 17:15:19 EDT

The CMS says that drug and device makers will not have to start collecting data on payments to physicians until 2013.

RAAFT 2: Catheter ablation can be first line of defense against paroxysmal AF

Fri, 11 May 2012 16:30:16 EDT

Recurrences were less common for patients who underwent catheter ablation vs antiarrhythmic drug therapy, but it took the right connections for catheter therapy to come out on top.

Moderate coffee intake protects against stroke

Fri, 11 May 2012 15:45:51 EDT

A new meta-analysis finds that one to three cups of coffee a day may reduce the risk of stroke in the general population and that an even higher intake of up to six cups a day also seems to offer some protection.

Telemonitoring by pharmacists boosts BP control

Thu, 10 May 2012 15:45:00 EDT

Initial findings from a US study employing an unusual approach to blood-pressure management—whereby pharmacists monitor patients by phone and can make alterations to their therapy—are proving encouraging.

Waist-hip ratio excels at SCD risk prediction in ARIC cohort

Thu, 10 May 2012 08:45:07 EDT

Greater waist-to-hip ratio—but not two more common obesity measures—meant a higher sudden death risk independently of diabetes, CV disease, and heart failure in the community-based cohort study.

Older female AF patients have higher stroke risk

Wed, 09 May 2012 17:00:02 EDT

Less aggressive care following warfarin prescription is a possible explanation, researchers say.

BP and lipid tests in pharmacies could boost risk-factor control

Tue, 08 May 2012 14:15:25 EDT

A nationwide campaign in Portugal—whereby pharmacy customers were encouraged to have their BP, cholesterol, and BMI assessed in-store—has demonstrated that this kind of approach is feasible and that pharmacists can act as good go-betweens for patients and physicians, says one of the researchers.

No advantage for warfarin in heart failure: WARCEF published

Fri, 04 May 2012 15:00:27 EDT

The authors of a commentary say this large randomized study has provided clinicians with clear answers regarding aspirin vs warfarin in heart failure.

WHF defends Dubai WCC, reimburses Israelis denied visas

Fri, 04 May 2012 13:35:21 EDT

The World Heart Federation is apologizing to Israeli cardiologists who, at the last minute, were denied visas to attend the WCC 2012 in Dubai. One of the Israelis who attended, however, has spoken out to clarify that he and his colleagues "only have good words to say" about their visit to the Emirate city.

More adverse events seen on dabigatran vs warfarin

Fri, 04 May 2012 13:15:32 EDT

UPDATED // A new study in patents switched from warfarin to dabigatran has shown a high rate of events necessitating discontinuation of the new drug.

Anhedonia, not depression or anxiety, linked with death following ACS

Fri, 04 May 2012 11:45:11 EDT

A psychological condition that results in a loss of interest or pleasure in daily activities, anhedonia is associated with an increased long-term risk of death in patients with ACS, new research shows.

Lives, money saved by protocol-guided transfusion use at cardiac surgery

Wed, 02 May 2012 16:00:08 EDT

The bottom line can benefit, if clinical gains aren't enough reason for wide-scale implementation of guidelines for blood-product use with cardiac surgery.

Ideal blood-pressure goals? "We have no idea"

Wed, 02 May 2012 14:00:36 EDT

Evidence is lacking for many of the issues that need to be addressed in the field of hypertension, not least the ideal blood-pressure goal for different groups of individuals, experts told the ESH meeting this past weekend.

CURE-AF: Success up as LA size declines for RF ablation at cardiac surgery

Tue, 01 May 2012 13:15:05 EDT

But arguably the trial's most important results, according to one expert, underscored a key difficulty in studying surgical procedures.

Mixed findings with vitamin D in hypertension

Mon, 30 Apr 2012 12:30:18 EDT

A small, short-term study looking at the effects of high-dose vitamin D on blood pressure in hypertensive subjects in Denmark during the winter months has shown somewhat discrepant results.

Friend or foe? Uric acid a "probable cause" of CVD

Mon, 30 Apr 2012 10:00:47 EDT

Using a unique approach, Israeli researchers have shown that people with so-called "normal" levels of uric acid have a 50% higher risk of hypertension and an almost doubling of diabetes, compared with those with naturally very low uric-acid levels.

Beware valve involvement in device-related infective endocarditis

Fri, 27 Apr 2012 17:00:42 EDT

A number of factors were related to higher mortality, but all seemed to have a common thread, in a large international study of infective endocarditis associated with implanted devices.

IMS 3 trial of mechanical embolectomy in stroke stopped

Fri, 27 Apr 2012 14:30:02 EDT

Investigators are disappointed at the move to suspend a trial that they hoped would demonstrate effectiveness of mechanical embolectomy, a stroke therapy increasingly used even without this evidence.

CHA2DS2-VASc score gives best prediction of stroke risk in AF

Thu, 26 Apr 2012 09:30:55 EDT

Another study has suggested that the newer CHA₂DS₂-VASc score may be more suitable than the CHADS₂ score, particularly in those at lower risk.

Rise of "hard-core" smokers warrants tailored approaches

Wed, 25 Apr 2012 17:30:11 EDT

Tobacco-control legislation, a powerful tool for reducing the number of smokers the world over, may also have the unintended consequences of driving up the numbers of so-called "hard-core smokers"—long-term smokers who say they've never attempted to quit and have no intention of trying to do so.

CARGO 2: AlloMap transplant-rejection test works in Europe

Tue, 24 Apr 2012 17:00:38 EDT

Researchers hope the findings will lead to wider European use of the gene-expressing profiling test, which they say could mean fewer surveillance endomyocardial biopsies.

Topol is most influential physician executive in new US poll

Tue, 24 Apr 2012 12:00:09 EDT

Dr Eric Topol, editor in chief of theheart.org, has been voted the number one most influential physician executive of 2012 in a poll run by Modern Healthcare, a US publication covering healthcare business news and research.

Dabigatran cuts ICH mortality vs warfarin: RE-LY analysis

Tue, 24 Apr 2012 11:00:21 EDT

Actually, once intracranial hemorrhage struck, mortality was about the same in the trial's different groups. But fewer ICHs with dabigatran made for big drop in ICH mortality overall.

Diabetes/statin link probed in EFFECT cohort

Tue, 24 Apr 2012 09:00:44 EDT

Digging into five years' worth of follow-up data, investigators found no differences in new-onset diabetes related to statin dose.

ACE inhibitors better ARBs in new meta-analysis in hypertensives

Mon, 23 Apr 2012 16:45:41 EDT

UPDATED WITH COMMENTARY // ACE inhibitors reduced deaths by 10% in a new meta-analysis in hypertensive patients already receiving good, contemporary therapy. In contrast, ARBs had a neutral effect on all-cause mortality. The researchers say the findings provide additional support for the use of ACE inhibitors as first-line treatment for high blood pressure.

Cutting, taxing salt would trim CVD deaths by 3% in half the world

Mon, 23 Apr 2012 15:30:10 EDT

A new study modeling the impact of a mere 10% reduction in sodium content in processed foods, combined with adding a 40% tax to salty products in 19 low- and middle-income countries, could lead to 250�000 fewer deaths per year.

No aliskiren with ACE inhibitors, ARBs in some patients: FDA

Fri, 20 Apr 2012 15:30:56 EDT

Aliskiren-containing BP drugs in combination with ACE inhibitors and ARBs are now contraindicated for patients with diabetes based on the aborted ALTITUDE study, the FDA announced.

Hands off my wife! Bahrain AED survey points to CPR barriers

Fri, 20 Apr 2012 13:00:49 EDT

Controversial findings from a small, survey-based study conducted in the Middle East suggest that Arab men would "not accept" men of other nationalities performing CPR, chest compressions, or applying an AED on a female companion.

Lung cancer? Yep, but smokers, globally, are less aware of CVD risks

Fri, 20 Apr 2012 09:30:10 EDT

Even more striking, smokers were largely unaware that secondhand smoke increases the risk of heart disease and stroke among nonsmokers, a number that spiked even higher when nonsmokers were questioned.

TIPS 2: Full-dose polypill boosts efficacy, with no increased side effects

Thu, 19 Apr 2012 09:15:07 EDT

The polypill tested in the large, primary-prevention TIPS trial included half-dose formulations of blood-pressure and lipid-lowering drugs, in the hopes of boosting tolerance. Now TIPS 2 shows that a full-dose combination may be feasible in secondary prevention.

Marked gender disparities in CVD treatment, outcomes seen in CREATE registry

Thu, 19 Apr 2012 02:00:00 EDT

Not only are women experiencing ACS in India less likely to receive appropriate care, they are also more likely to die following treatment, a new analysis shows.

Endovascular AAA repair safer than open repair in the long run, Medicare data show

Wed, 18 Apr 2012 17:15:57 EDT

Endovascular abdominal aortic aneurysm repair reduced 30-day and in-hospital mortality in randomized controlled trials compared with open surgical repair but has not been shown to improve long-term survival. A new study looks at Medicare data to compare the long-term outcomes of the endovascular and open repair of intact AAAs.

SCD risk increased in blacks with HTN, genetics may be key: LIFE analysis

Wed, 18 Apr 2012 09:30:18 EDT

Their elevated sudden-death risk was independent of a range of clinical and ECG risk factors, suggesting that "other factors must be playing a role," concluded researchers from the decade-old trial.

Tough sell: WCC 2012 course coaxes trainees toward preventive cardiology

Wed, 18 Apr 2012 09:15:57 EDT

How to convince young doctors to get involved in CVD prevention, when other areas of cardiology are so alluring—and more lucrative? That's a central conundrum underpinning a trainee course that kicked off this year's meeting, in a region where soaring CV risk factors make it a life-and-death question.

Report validates risk of high-dose simvastatin

Tue, 17 Apr 2012 16:00:00 EDT

Published as a letter to the editor in the Journal of the American Medical Association, a brief report confirms the higher risk of rhabdomyolysis in patients treated with high-dose simvastatin.

CPR training sessions offered during the Boston Marathon race exposition

Thu, 12 Apr 2012 15:00:00 EDT

The Boston Athletic Association, in conjunction with the American Heart Association and the American Red Cross, will be providing free CPR demonstrations for runners, family members, and spectators as they wander through the race exposition. There will be brief sessions to teach compression-only CPR in an attempt to reduce the risk of sudden cardiac death while running the marathon.

No mortality risk for losartan vs candesartan seen in heart failure

Thu, 12 Apr 2012 10:00:24 EDT

UPDATED WITH COMMENTARY // Nothing is rotten in the state of Denmark when it comes to the ARB losartan, compared with candesartan, in patients with heart failure—unlike what had seemed true in Sweden.

Mobile stroke unit cuts time to treatment

Wed, 11 Apr 2012 14:00:40 EDT

Ambulances specially equipped with a CT scanner, laboratory, and telemedicine connection cut "door-to-needle" time in half.

Hospitals launch medical practices to lure well-insured

Tue, 10 Apr 2012 16:00:00 EDT

America's hospitals are busier than ever expanding into new and affluent geographic markets to lure well-insured patients, a strategy that could drive up costs as well as jeopardize independent physician practices, according to a new study.

PCI bests meds in stable CAD, but message is "do better meds"

Thu, 05 Apr 2012 18:30:00 EDT

Is optimal medical therapy a pipe dream, at least right now? An analysis of clinical-practice data from NY State reopens the COURAGE-oriented debate.

Dr Gary Gibbons named director of the NHLBI

Thu, 05 Apr 2012 11:30:00 EDT

Currently at the Morehouse School of Medicine in Atlanta, Gibbons will begin his new role as director of the NHLBI this summer. He is taking over for Dr Susan Shurin, who was named acting director after Dr Elizabeth Nabel left in January 2010.

Mitral regurgitation: Early hazard, later gains following TAVI

Wed, 04 Apr 2012 17:00:00 EDT

Mortality in the first 30 days is higher among patients with moderate to severe mitral regurgitation undergoing transcatheter valve implantation. After the first month, however, MR tends to be diminished, supporting a role for TAVI in this high-risk group.

Medical societies list 45 dubious tests, therapies

Wed, 04 Apr 2012 16:00:00 EDT

The American College of Cardiology is one of nine societies that each identified five tests and procedures that are common but often unnecessary, running up the cost of care and sometimes harming a patient's health.

heartwire's Lisa Nainggolan picks up AHCJ award

Wed, 04 Apr 2012 14:15:00 EDT

Nainggolan's feature story "Lost in transition: The looming epidemic of grown-up congenital heart disease" has placed third in the Association of Health Care Journalists' annual journalism awards in the trade-publication category.

Longer HF hospitalizations cut risk of readmission in analysis

Tue, 03 Apr 2012 16:45:09 EDT

Within and outside the US, hospital length of stay was inversely related to 30-day readmissions. But another country had both the longest hospitalizations and the lowest readmission rate.

Low BMI may up complication, mortality risk at ICD implantation

Mon, 02 Apr 2012 11:15:52 EDT

Some simple precautions might help prevent the two most common complications that were seen in underweight patients.

Low rate of residual stroke with warfarin

Thu, 29 Mar 2012 17:10:44 EDT

A contemporary meta-analysis of trial data shows a 1.66% annual rate of stroke with current use of warfarin in patients with nonvalvular atrial fibrillation.

Antipsychotics linked to MI risk in dementia patients

Thu, 29 Mar 2012 16:30:12 EDT

Antipsychotic medications are associated with a modest and time-limited increase in risk for MI in elderly patients with dementia.

MOPETT: Is half-dose thrombolysis feasible for moderate PE?

Tue, 27 Mar 2012 16:30:08 EDT

New results from a pilot trial suggest that a half dose of the thrombolytic tPA, in combination with a reduced anticoagulation regime, could be used to successfully treat around 70% of patients presenting to the emergency room with pulmonary embolism, resulting in improved outcomes with no severe adverse effects. But others were not convinced.

ASCERT CABG, PCI analysis: Lower mortality with surgery

Tue, 27 Mar 2012 09:00:00 EDT

UPDATED WITH COMMENTARY // Four-year survival was significantly better with bypass surgery than PCI for patients with two- and three-vessel stable CAD. Did the analysis adequately control for risk, or does that miss the point?

ISSUE-3: DDD pacing can help suppress asystolic neurally mediated syncope

Mon, 26 Mar 2012 19:10:00 EDT

Patient selection was likely the key to the success of pacemaker therapy, according to researchers: all randomized patients had shown what was considered likely to be that form of syncope during implantable-loop-recorder monitoring.

STAMPEDE: Bariatric surgery betters standard diabetes treatment in the obese

Mon, 26 Mar 2012 11:30:00 EDT

UPDATED // Findings from two randomized trials showed that bariatric surgery was considerably better than traditional medical therapy for controlling type 2 diabetes in obese patients, independent of weight loss. But critics caution that much longer-term data are needed—to show actual changes in the serious complications of diabetes in years to come—before this "huge intervention" can be considered as a valid treatment for the condition.

Transcatheter valves in inoperable patients at two years: PARTNER B

Mon, 26 Mar 2012 09:00:00 EDT

Two-year outcomes in the PARTNER B trial, testing transcatheter aortic-valve replacement against best medical care in inoperable patients, have now been published.

Renal-denervation debate centers on response time

Sun, 25 Mar 2012 19:30:00 EDT

CORRECTED // A session updating attendees on the latest findings from studies on renal denervation for severe resistant hypertension attracted much attention today.

Low levels of LDL cholesterol predate cancer cases by nearly two decades

Sun, 25 Mar 2012 17:45:00 EDT

The analysis, which used data from the Framingham Heart Study and included patients not currently taking lipid-lowering medications, puts a kibosh on hypotheses suggesting that cancer causes low LDL-cholesterol levels, say investigators.

C-PORT E nine-month results: Elective PCI doesn't need surgery safety net

Sun, 25 Mar 2012 09:00:00 EDT

UPDATED WITH INTERVIEW // Consistent with the trial's already-reported six-week outcomes, the rate of major adverse complications at nine months was about the same regardless of the presence of on-site cardiac surgery.

TAVI registry updates ADVANCE the field, raise hopes for lower stroke rates

Sat, 24 Mar 2012 16:25:34 EDT

Low stroke rates in two registries tracking outcomes for the two leading transcatheter valves are raising hopes that the cerebrovascular events that concerned people in the pivotal PARTNER trial may not necessarily represent the real-world occurrence of this problem going forward.

Everolimus DES: Stent-thrombosis advantage vs bare-metal stents in meta-analysis

Fri, 23 Mar 2012 18:45:02 EDT

Stents like the widely used Xience V showed a lower rate at one year and at other time points compared with bare-metal stents and some other drug-eluting stents in 50�000-patient meta-analysis.

Cardiologists are happy(ish), married non-tweeters, survey reveals

Thu, 22 Mar 2012 17:00:00 EDT

Cardiologists, for the most part, drive Japanese cars, believe in a higher power, and are moderately savvy when it comes to social media. Those are just some of the cardiology pearls from a recent "lifestyle survey" of physicians.

Poor prognosis for big between-arm BP differences in primary care

Thu, 22 Mar 2012 14:30:29 EDT

The first research to look specifically at how interarm differences in systolic blood pressure in a primary-care setting relate to future outcomes has found that those with a double-digit difference have a threefold increased risk of death over 10 years.

Latest Canadian AF guidelines encourage new oral anticoagulants

Wed, 21 Mar 2012 16:30:07 EDT

The Canadian Cardiovascular Society has updated its guidelines on atrial fibrillation to reflect some major new findings that have been reported during the past year or so.

Another study questions epinephrine for out-of-hospital cardiac arrest

Tue, 20 Mar 2012 16:30:00 EDT

Any short-term gains from giving the drug come with a high cost later, suggest adjusted analyses of a massive national CPR registry.

Renal patients with ACS don't benefit from antiplatelets

Tue, 20 Mar 2012 11:30:36 EDT

In the first-ever meta-analysis to mine antiplatelet trials for specific data on kidney-disease patients, researchers find that there is little evidence of benefit for agents such as clopidogrel in renal patients with acute coronary syndrome, but there is a risk of harm from major bleeding. Those at risk for or with stable coronary disease do appear to gain from antiplatelets, however, in the form of fewer MIs.

Nonphysicians pinpoint those at high CVD risk in rural India

Mon, 19 Mar 2012 16:00:00 EDT

Employing nonphysician healthcare workers to go into villages in India, spot those at high risk of CVD, and recommend appropriate therapies holds promise as a way of tackling the CVD epidemic affecting the country, say the authors of a new study.

What's going to be hot at ACC 2012

Mon, 19 Mar 2012 14:00:51 EDT

There are 18 late-breaking clinical trials, many addressing unresolved issues with already-approved products or procedures. Outside the main tent, the program offers debates, live and taped cases, a new Q&A series with "legends" in cardiology, plus a novel gambit for attracting attendees to the exposition: a "thought leaders' theater" located in the exhibit hall.