theHeart.org - Clinical cardiology

Medicaid access to smoking cessation falls short

Thu, 05 Nov 2009 17:30:46 EST

A national survey shows that although the majority of state Medicaid programs offer coverage for some form of tobacco-dependence treatment, most fall far short of a stated mandate to provide unrestricted access to approved therapies.

Low-cholesterol/cancer studies should "dispel lingering doubts" of causal link

Thu, 05 Nov 2009 14:15:24 EST

Two new papers should help put to rest concerns that low serum cholesterol levels may increase cancer risk.

Not all metabolic syndrome is created equal: Framingham Offspring analysis

Thu, 05 Nov 2009 11:45:03 EST

The syndrome (defined by ATP III criteria) can predict increased cardiovascular and mortality risk or not, depending on which three of five risk factors contributed to the diagnosis, a cohort study suggests; its investigators caution that their observations are only preliminary.

Better survival in hospitalized flu patients on statins

Wed, 04 Nov 2009 17:30:28 EST

Statin users hospitalized for influenza experienced a 54% lower risk of death compared with patients not taking statins.

Adding fuel to the J-curve fire; debate is reignited

Wed, 04 Nov 2009 14:30:56 EST

More discussion about the J-curve in hypertension is published this week; one expert believes the undue attention being paid to this subject might discourage doctors from treating high blood pressure aggressively.

No CV risk reduction with B vitamins posttransplant

Wed, 04 Nov 2009 13:15:27 EST

In keeping with all the other evidence showing no effects of homocysteine-lowering with B vitamins, the FAVORIT study now confirms that this lack of benefit is also seen in renal-transplant recipients.

Another in-hospital CV risk marker: 24-hour shifts with overnight on-call duty

Wed, 04 Nov 2009 09:45:43 EST

Long work shifts with nighttime on-call duty, with the inevitable interruptions of sleep, are associated with ECG, blood-pressure, and biochemical changes associated with increased cardiovascular risk, suggests a randomized crossover study that hints at a sustained effect on the risk markers if the 24-hour shifts happen too frequently.

US updates advice on perioperative beta-blocker use in noncardiac surgery

Tue, 03 Nov 2009 14:30:32 EST

A US update on the perioperative use of beta blockers for noncardiac surgery is, says the lead author, "similar" to recent European guidance on this issue.

CMS set to cut Medicare physician fees for cardiovascular imaging

Tue, 03 Nov 2009 11:45:09 EST

The 2010 Medicare Physician Fee Schedule final rule released by the CMS makes major cuts to several cardiovascular imaging services.

Combined home/GP hypertension control program successful in Pakistan

Mon, 02 Nov 2009 17:00:00 EST

A synergistic approach of educating general practitioners about hypertension control together with a program to send lay workers into people's homes to educate them about the management of high blood pressure has proven successful in low- to middle-income households in Pakistan.

Sex differences in changing MI prevalence, mortality challenge conventional wisdom

Thu, 29 Oct 2009 10:30:28 EDT

Two well-known observational registries highlight such changes in women and men over a decade or more: Do women younger than 55 still have an advantage over men in the same age group?

Underutilization of ICDs in CABG patients is worst in women and elderly, Halifax study shows

Wed, 28 Oct 2009 16:45:37 EDT

Only 101 of 1169 post-bypass-surgery patients eligible for an ICD got one over a 13-year period in Nova Scotia.

Contrary to common belief, women feel same heart-attack symptoms as men

Tue, 27 Oct 2009 14:30:23 EDT

Women and men have the same rates of chest pain and other classic symptoms during ACS, although women are more likely to experience some other symptoms such as jaw and neck pain.

Blood products should be used conservatively in heart-surgery patients, trial shows

Tue, 27 Oct 2009 12:15:25 EDT

Administration of blood products to stable patients post-cardiac surgery increases their risk of death, renal failure, and sepsis, according to new research.

ACCORD update: "One size fits all" may not be best glucose-lowering strategy

Tue, 27 Oct 2009 10:00:02 EDT

While post hoc analyses of ACCORD data suggest there are subgroups of diabetic patients who may not benefit from an aggressive glucose-lowering approach, similar analyses with ADVANCE data did not identify subgroup differences.

Distribution of body fat important in VTE

Mon, 26 Oct 2009 16:00:00 EDT

The distribution of body fat, as well as the amount, is important when it comes to the risk of venous thromboembolism, Danish researchers have discovered.

NRMI data raise more questions about PCI in nonsurgery centers

Mon, 26 Oct 2009 13:00:23 EDT

A new analysis of national registry data suggests that the superior outcomes of NSTEMI patients in hospitals with open-heart-surgery capabilities vs those without it are due to their size, procedure volume, and adherence to medication guidelines.

Less exposure to cardiovascular risk factors with intensive diabetes intervention: Look AHEAD

Mon, 26 Oct 2009 10:00:00 EDT

Intensive lifestyle intervention in the management of diabetes produces sustained weight loss and improvements in fitness, as well as improvements in glycemic control, systolic blood pressure, and HDL-cholesterol levels.

NT-proBNP "remarkable predictor" of incident atrial fibrillation

Fri, 23 Oct 2009 16:30:37 EDT

The fact that elevated baseline NT-proBNP levels predict a diagnosis of AF even 16 years later suggests that peptide elevations precede the onset of arrhythmia, according to the researchers.

New model connects low-dose radiation to CVD risk

Fri, 23 Oct 2009 15:30:21 EDT

Data from Japanese atomic-bomb survivors and people exposed to radiation in their jobs show that even low doses of ionizing radiation may contribute to cardiovascular disease risk. British researchers have created a complex mathematical model to better understand the relationship between radiation exposure and heart disease.

Look at absolute event rates when interpreting trial results

Fri, 23 Oct 2009 13:30:19 EDT

The low event rate in the RECORD trial of rosiglitazone has led some to question the validity of the results.

GLP-1 analog liraglutide promising in obesity

Thu, 22 Oct 2009 18:30:00 EDT

A drug originally developed to treat diabetes may have promise as an obesity therapy, a new study shows. Those taking liraglutide, a GLP-1 analog, lost more weight than those on an established obesity medication, orlistat.

Simple cooling methods improve neurologic outcomes after cardiac arrest, new review confirms

Thu, 22 Oct 2009 11:00:03 EDT

A new literature review confirms that conventional cooling methods work safely to improve survival and reduce brain damage after cardiac arrest.

New analyses from ECASS 3 support use of tPA up to 4.5 hours after stroke

Thu, 22 Oct 2009 08:30:55 EDT

Investigators show benefits of thrombolysis after stroke across a variety of subgroups; although not all end points reached statistical significance, trends favored treatment with tPA. The message, though, remains to treat as soon as possible, they say.

Iloprost prevents contrast-induced nephropathy in high-risk patients undergoing coronary intervention

Wed, 21 Oct 2009 13:00:34 EDT

Intravenously administered iloprost, a prostacyclin analog, may help prevent contrast-induced nephropathy in patients with renal dysfunction undergoing coronary procedures, a new pilot study suggests.

Cardiovascular disease increases risk of hip fracture

Tue, 20 Oct 2009 16:00:00 EDT

Swedish researchers have confirmed a link between stroke and subsequent hip fracture in older people and identified for the first time that a diagnosis of heart failure also increases the risk for this fracture. They also identify a large genetic component to this association, via their use of a twin registry.

Just one-third of heart-failure patients receive aldosterone antagonists

Tue, 20 Oct 2009 16:00:00 EDT

Just one-third of hospitalized HF patients who meet the criteria for an aldosterone antagonist receive the drugs upon discharge. On the plus side, few patients with contraindications are prescribed the medication.

Omega-3s no help to SSRI-treated CHD patients

Tue, 20 Oct 2009 16:00:00 EDT

The researchers suggest further study is still needed, as it is unclear whether higher doses of omega-3 fatty acids or setraline, longer treatment, or a different ratio of EPA to DHA would produce favorable results.

Data from 1.23 million patients confirms warfarin increases mortality in trauma patients

Tue, 20 Oct 2009 13:45:55 EDT

Warfarin use is rising in both older and younger patients. How much does the anticoagulant contribute to the risk of traumatic injuries?

Thiazolidinediones have a role for appropriate diabetic patients

Tue, 20 Oct 2009 12:45:38 EDT

After 10 years of clinical use of TZDs, "we are still at the beginning," and randomized controlled trials shed light on their use in appropriate diabetic patients, speakers at a diabetes symposium reported.

ACE inhibitors of benefit in ischemic heart disease patients with preserved LV function

Mon, 19 Oct 2009 17:00:00 EDT

Patients with ischemic heart disease and preserved LV function on standard therapy will gain additional benefit from taking ACE inhibitors, a new review concludes. The same cannot be said for ARBs, a drug class for which the evidence is much weaker, but these are a good substitute in those who cannot tolerate ACE inhibitors, the authors say.

Expanded indication for telmisartan

Mon, 19 Oct 2009 13:30:16 EDT

The drug can now be used to reduce the risk of MI, stroke, or death from cardiovascular causes in patients 55 years of age or older who are intolerant to ACE inhibitors but at high risk for cardiovascular events.

Transfusion in acute HF: No extra mortality risk

Mon, 19 Oct 2009 11:00:10 EDT

Blood transfusions for anemia in acute decompensated heart failure don't exacerbate outcomes, as may happen in some ACS cases, suggests a one-year experience of hospitals in Israel. On the contrary�.�.�.�

Zero CAC score not 100% reassuring in those presenting to ER with chest pain

Fri, 16 Oct 2009 12:45:08 EDT

In those presenting to the ER with chest pain, a prior zero calcium score cannot completely rule out a coronary obstruction, a new analysis of the MESA study has shown. This is likely due to the presence of soft plaques not detected by calcium screening, the researchers say.

No link seen between heart failure and coffee intake

Fri, 16 Oct 2009 10:15:02 EDT

With few studies in the literature specifically looking at the issue, a prospective, population-based study in Sweden has found no significant rise or fall in risk of heart-failure hospitalization or death at increasing levels of coffee intake.

New COI disclosure form for all ICMJE journals

Wed, 14 Oct 2009 15:15:57 EDT

The International Committee of Medical Journal Editors has adopted a new uniform disclosure form for reporting conflicts of interest.

Expert council focuses on left main PCI: Guideline changes suggested

Wed, 14 Oct 2009 14:45:22 EDT

The group argues that the data are substantive enough for left main PCI to be a class IIb indication or even a class IIa indication in selected patients without coexisting multivessel disease. In contrast, the current ACC/AHA guidelines make left main PCI a class III indication unless patients are ineligible for CABG surgery.

A fish tale with merit: Omega-3 PUFAs underrated for heart failure

Wed, 14 Oct 2009 12:30:27 EDT

Are the data not shouting loud enough, or is cardiology hard of herring? Omega-3 fatty acids may have only a modest treatment effect in heart failure, but they've performed swimmingly in randomized and observational studies considering how few new HF drugs have been reeled in lately.

Hospital efficiency gauged by resource use vs outcomes

Tue, 13 Oct 2009 16:00:00 EDT

An analysis of Medicare data from heart-failure patients at six California hospitals challenges the notion advanced by some studies that hospital efficiency can be measured by looking back at resource use on behalf of patients who ultimately died.

Glucocorticoids seen to double risk of atrial arrhythmias

Mon, 12 Oct 2009 16:00:00 EDT

In a case-control study from Denmark, the risk of atrial fibrillation or flutter was significantly increased with current but not previous use of glucocorticoids for chronic obstructive pulmonary disease, rheumatoid arthritis, and other conditions.

Vernakalant converts AF to sinus rhythm postsurgery

Fri, 09 Oct 2009 17:15:03 EDT

The drug, however, is still not yet approved by the Food and Drug Administration.

Target HbA1c levels still the subject of much debate, but tailored therapy should be the aim

Fri, 09 Oct 2009 16:45:25 EDT

Diabetologists are trying to tease out the best message to convey when it comes to target HbA_1c levels for primary-care physicians and other nonspecialists who might be treating patients with type 2 diabetes.

EULAR: CV risk management in inflammatory arthritis

Fri, 09 Oct 2009 11:45:12 EDT

The European League Against Rheumatism has issued 10 recommendations for cardiovascular risk management in patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis.

FDA clears colesevelam for FH in kids

Fri, 09 Oct 2009 11:00:39 EDT

The FDA has approved an expanded indication for colesevelam tablets and a new powder for oral suspension as an adjunct to diet and exercise to reduce LDL-C levels in boys and postmenarchal girls aged 10 to 17 years with heterozygous familial hypercholesterolemia.

Coronary thrombosis�the culprit is not just plaque rupture

Thu, 08 Oct 2009 17:45:48 EDT

Clots derived from a different source—erosions of the arterial wall—may be an important cause of MI and sudden death, particularly in younger women, who may need a different approach to treatment, new research suggests.

New joint statement streamlines definition of metabolic syndrome

Thu, 08 Oct 2009 16:45:46 EDT

The statement from the International Diabetes Federation, the National Heart, Lung, and Blood Institute, and the American Heart Association, among others, formalizes the definition of the metabolic disorder with the hope of eliminating some of the confusion regarding how to identify patients with the syndrome.

New review confirms homocysteine lowering does not prevent CVD events

Thu, 08 Oct 2009 15:30:45 EDT

The latest review to look at the effects of homocysteine lowering with vitamin-B supplementation has come to much the same conclusions as most other studies and analyses in this field.

Lupus anticoagulant a major risk factor for stroke and MI in young women

Wed, 07 Oct 2009 10:00:40 EDT

Results of the RATIO study suggest lupus anticoagulant, but not anticardiolipin or antiprothrombin antibodies, is associated with increased stroke risk and to a lesser extent MI.

Mercury/blood-pressure link should guide fish choices

Tue, 06 Oct 2009 16:45:03 EDT

An association seen between mercury levels and blood pressure, even after considering omega-3s and selenium, has researchers warning about the need to weigh the risks and benefits of fish consumption and to steer clear of bigger predators.

Counseling and education fail to reduce prehospital delays in ACS

Tue, 06 Oct 2009 16:00:00 EDT

Even among patients with documented ischemic heart disease, an intensive program of education and counseling about the importance of seeking treatment quickly does not lead to reductions in prehospital delays or increased ambulance use among those experiencing the signs and symptoms of an ACS, a new study shows.

China death toll due to hypertension worse than predicted

Tue, 06 Oct 2009 14:15:24 EDT

The first prospective study using real data to inform the number of people suffering from and dying due to high blood pressure in China finds the problem is much worse than previously thought. A number of initiatives are planned to try to tackle this crisis.

Thiazolidinediones once again linked to fracture risk

Tue, 06 Oct 2009 12:30:18 EDT

Risk appeared to be similar in men and women, with exposure to either rosiglitazone or pioglitazone, and across a range of fracture sites. The longer the duration of exposure to the drugs, the greater the risk.

Acute heart-failure prediction model blends clinical gestalt with natriuretic peptides

Mon, 05 Oct 2009 17:00:00 EDT

Its developers say the prediction model for guiding management of patients presenting with dyspnea can make a difference when clinicians aren't sure about the diagnosis based on clinical signs. An editorial takes issue.

Philips recalls thousands of AEDs

Mon, 05 Oct 2009 14:00:59 EDT

The automatic external defibrillators were distributed by Philips Medical and Laerdal Medical with model numbers M3860A, M3861A, M3840A, and M3841A.

Stroke reduction with dronedarone shown in post hoc analysis

Fri, 02 Oct 2009 17:15:19 EDT

Investigators say that although the analysis raises the possibility that a drug with antiarrhythmic activity could reduce the risk of stroke, dronedarone is not a replacement for oral anticoagulant therapy or a treatment for stroke prevention.

New heparin standards reduce potency of drug 10%

Fri, 02 Oct 2009 12:30:34 EDT

The Food and Drug Administration is asking clinicians to be aware of the change, particularly in settings where an immediate anticoagulant effect is clinically important.

New "principles" on authorship and COI from PhRMA get mixed response

Fri, 02 Oct 2009 12:00:10 EDT

The "Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results" echo recent standards set by medical journal editors, but some observers say the document, which has no penalty component, lacks real teeth.

REVERSE, MADIT-CRT make case for extending CRT to mild heart failure: Should guidelines change?

Thu, 01 Oct 2009 10:30:49 EDT

Now in print after having been presented at meetings, the REVERSE randomized trial's European-cohort two-year results are consistent with the recently published, much larger MADIT-CRT trial in showing both clinical and LV structural benefits from resynchronization therapy in patients with NYHA class 1-2 heart failure.

Doctor-led "hospital-at-home" care subs for hospitalization in acute heart failure

Tue, 29 Sep 2009 12:00:05 EDT

They lived just as long, but in a small randomized trial, patients with acute decompensated heart failure who received hospital-quality care in their homes as an alternative to hospital admission after presentation to the emergency department benefited in ways missed by those managed as inpatients in the traditional manner.

Diabetes: An independent risk factor for AF

Tue, 29 Sep 2009 00:00:23 EDT

Atrial fibrillation was more likely to develop in diabetics than in nondiabetics in a new observational study, and the link was particularly strong in women.

Early statin therapy in ACS: What's the level of evidence?

Mon, 28 Sep 2009 17:00:00 EDT

The use of high-dose statin therapy early in the course of acute coronary syndrome currently has the highest possible (class IA) recommendation in US guidelines, but a group of experts argues that this is inaccurate based on current evidence. However, they stress, they are not saying statins should not be used in this indication.

CHARISMA Genomics Substudy links loss-of-function allele and bleeding

Mon, 28 Sep 2009 14:15:11 EDT

Patients who are homozygous for the CYP2C19*2 allele are at increased risk of ischemia but less likely to bleed. Routine genotyping for the variant still isn't recommended.

Sitagliptin linked to acute pancreatitis, FDA warns

Mon, 28 Sep 2009 13:00:51 EDT

The FDA is revising prescribing information for sitagliptin and sitagliptin/metformin after cases of acute pancreatitis, some severe, surfaced in postmarketing reports.

Skin lesions from heparin more common than thought

Mon, 28 Sep 2009 12:00:00 EDT

A new prospective study has found the incidence of heparin-induced skin lesions to be around 7.5%. Women, the obese, and those on heparin therapy for longest are most at risk.

Hormonal therapies for prostate cancer increase risk of heart disease

Fri, 25 Sep 2009 16:30:12 EDT

A huge study of Swedish data shows an increased risk of all types of cardiovascular disease in men taking hormonal therapies for prostate cancer.

BNP-boosting gene variant hints at possible screening, cardioprotective roles

Fri, 25 Sep 2009 10:45:02 EDT

A single-nucleotide polymorphism associated with chronically raised natriuretic-peptide levels is common enough to potentially influence interpretation of BNP and NT-proBNP assays under some circumstances, researchers say; there is increasing evidence that the gene variant may enhance survival in some patient groups.

COGENT: No CV events but significant GI benefits of PPI omeprazole

Thu, 24 Sep 2009 16:30:07 EDT

The randomized controlled trial results should put a stop to alarmist headlines about PPIs blunting efficacy of antiplatelet drugs, experts say. By withholding PPIs, physicians are doing more harm than good, the results suggest.

New Canadian lipid guidelines will recommend CRP testing for certain patients

Thu, 24 Sep 2009 13:45:07 EDT

New Canadian guidelines for the diagnosis and treatment of dyslipidemia and the prevention of cardiovascular disease will recommend the testing of hs-CRP for certain patients, most notably those at intermediate risk. However, the lead author stresses that the majority of patients will not require a CRP test and that recommending and promoting a healthy lifestyle must be the first port-of-call for doctors.

Should patients go directly to a PCI-capable hospital? Two studies, different results

Wed, 23 Sep 2009 10:45:51 EDT

One trial showed that despite a mean treatment delay of 67 minutes, STEMI patients undergoing primary PCI taken first to an emergency department before transfer had equivalent rates of major adverse cardiac events when compared with those who presented directly to a PCI facility. A smaller study showed that taking patients directly to the cardiac center resulted in significantly better survival when compared with patients who were transported to an emergency department.

Senators question Dr Martin Leon's financial links to industry

Tue, 22 Sep 2009 17:15:30 EDT

UPDATED // The letter, from Sens Herb Kohl and Charles Grassley, states that Leon did not fully disclose much of the money he has received from outside companies.

Enoxaparin cheaper than UFH in STEMI patients undergoing thrombolysis?

Tue, 22 Sep 2009 17:15:18 EDT

A new analysis of the EXTRACT-TIMI 25 trial concludes that enoxaparin is slightly cheaper in the long term than unfractionated heparin for STEMI patients undergoing thrombolysis. But there are questions as to why 30-day data and not one-year results were used to model long-term cost-effectiveness.

Should left main PCI be a class IIa indication?

Tue, 22 Sep 2009 13:15:44 EDT

TCT 2009 kicked off with a discussion on revascularization strategies for left main PCI. Interventionalist Dr Paul Teirstein argues the data are sufficient for left main PCI to be a class IIa indication, upgrading it from the current class III recommendation, but surgeon Dr David Taggart says that CABG is still the preferred revascularization option in the majority of left main patients.

Flu vaccine may protect against MI

Mon, 21 Sep 2009 18:30:00 EDT

A protective effect was seen in patients with established cardiovascular disease. Whether vaccination is protective in people with no vascular disease is less clear, a new review suggests.

Further testing and increased costs only for those with high CAC scores: EISNER study

Mon, 21 Sep 2009 17:00:00 EDT

Patients who undergo coronary artery calcium scans are unlikely to undergo further testing or invasive procedures if the CAC scores are low. The results suggest that CAC might play a role in more selective testing patterns in asymptomatic individuals at risk for cardiovascular disease, say researchers.

Smoking bans cut heart attacks by up to a quarter

Mon, 21 Sep 2009 17:00:00 EDT

A nationwide smoking ban in the US would prevent up to 150�000 new MIs every year, the authors of a new meta-analysis estimate. They show that similar bans in parts of the US and in other countries have reduced the incidence of MI by almost 20% and that the longer the ban is in place, the greater the benefits seem to be.

Added to diuretics, low-dose dopamine renoprotective in small acute-HF trial

Mon, 21 Sep 2009 12:30:00 EDT

Better late than never in the age of evidence-based medicine, a randomized test of an established strategy might have confirmed the value of adding dopamine to loop diuretics to allow the latter at reduced, less kidney-damaging dosages.

Teachable software may help diagnose endocarditis, study shows

Fri, 18 Sep 2009 16:30:57 EDT

In a proof-of-concept study, researchers developed an artificial neural network with high sensitivity in diagnosing endocarditis related to implanted cardiac rhythm devices.

How to shave 10 years off your life: Have high cholesterol, be hypertensive, and smoke

Fri, 18 Sep 2009 15:30:13 EDT

Smoking, together with high cholesterol and blood pressure, can knock 10 years off life expectancy in middle-aged men, new UK research shows. If excessive weight and glucose intolerance are added in, the difference can be as much as 15 years, they add.

Cutting salt intake in US could save $50 billion a year

Thu, 17 Sep 2009 11:00:49 EDT

A new economic analysis concludes that regulations to reduce sodium content in processed foods and/or voluntary reductions in salt by companies could save up to $50 billion a year in healthcare costs in the US.

Physician, teach thyself: IMPROVE-HF initiative boosts use of evidence-based outpatient care

Wed, 16 Sep 2009 17:45:55 EDT

The two-year prospective registry-based study of a performance-improvement initiative's effectiveness saw significant jumps, >70% in some cases, in the appropriate use of six out of seven measured evidence-based treatments for patients with chronic heart failure.

Newly initiated statin therapy after ACS reduces plaque burden within six weeks

Tue, 15 Sep 2009 16:45:07 EDT

Initiating statin therapy following an acute coronary syndrome resulted in a significant reduction in coronary atheroma volume after just six weeks, showing that the lipid-lowering drugs act quickly on atherosclerotic plaques.

New ASCOT analysis: Beta blockers not beneficial in hypertensives with tachycardia

Tue, 15 Sep 2009 14:15:57 EDT

Pulse rate should not be the determinant of which drugs are used in hypertension, conclude the authors of a new subgroup analysis of the ASCOT trial.

Conflicts of interest affect best practices in both industry-funded and non-industry-funded trials

Tue, 15 Sep 2009 12:00:19 EDT

Clinicians and researchers need to be more aware before signing on to studies about what potential conflicts might arise with the sponsor and set the ground rules for such areas as access to data, manuscript preparation, and right to publish.

Omeprazole, but not pantoprazole, inhibits clopidogrel's platelet response

Tue, 15 Sep 2009 11:15:53 EDT

The use of omeprazole significantly reduced the antiplatelet activity of clopidogrel, even with a high maintenance dose of the drug, and other PPIs, such as pantoprazole, should be preferred in clopidogrel-treated patients, according to investigators.

Cardiovascular health of Americans is "at a crossroad"

Mon, 14 Sep 2009 16:00:00 EDT

The number of Americans who have a low cardiovascular risk-factor profile is decreasing, indicating that after two decades of improvement, progress appears to be reversing. The overriding driver of this phenomenon is excessive weight, say the researchers, which in turn contributes to hypertension and diabetes, itself a major contributor to heart disease.

Sponsorship of med-school textbooks in Denmark exposes vulnerable minds to commercial bias

Mon, 14 Sep 2009 11:45:00 EDT

Results of a new survey showed that a surprising 15% of textbooks had one or more drug or device sponsors and, in two cases, those sponsors had tried to influence the content of the textbooks.

Spin not uncommon in negative RCTs, study shows

Mon, 14 Sep 2009 11:30:00 EDT

French researchers who systematically quantified the prevalence of spin across 72 negative randomized controlled trials say half of the studies put a positive spin on the negative findings in the conclusion sections of the papers.

Darusentan in resistant hypertension: Data published

Sun, 13 Sep 2009 18:30:00 EDT

Further studies will be required to fully determine the role of the investigational agent darusentan in resistant hypertension, say the authors of a phase 3 study with the drug.

US cardiologists in short supply; problem could get worse

Fri, 11 Sep 2009 13:15:22 EDT

The US is short roughly 1600 general cardiologists and 2000 interventional cardiologists. The problem is expected to get worse unless the shortage is addressed, according to an ACC task force.

Homocysteine lowering cuts mortality in early-onset CAD patients

Fri, 11 Sep 2009 12:00:04 EDT

A new Israeli study finds that treatment with folic acid/B vitamins long term did significantly reduce mortality, but only in those with elevated homocysteine levels at baseline.

Ghost authorship on the wane, but guest authorship still common

Fri, 11 Sep 2009 11:00:38 EDT

UPDATED // Compared with a 1996 survey by JAMA editors, a 2008 survey indicates that the practice of having ghost writers pen papers, then not appear as authors, is down to 8%, from 12% in 1996. The practice of inviting a prominent name to appear in the list of authors, without requiring that person to contribute to the research, has held steady at roughly 20%.

Ivabradine BEAUTIFUL in subset of patients with angina and heart rates >70 bpm

Thu, 10 Sep 2009 16:00:11 EDT

Ivabradine may reduce major cardiovascular events in patients with stable CAD and LV dysfunction who present with limiting angina, BEAUTIFUL investigators say in a post hoc analysis.

Unresolved depression doubles risk of mortality in post-MI patients

Thu, 10 Sep 2009 15:00:28 EDT

The latest findings from the SADHART study show that new-onset depression is just as deadly as recurrent depression in patients who have suffered an MI.

Novel insulin-resistance variant identified

Thu, 10 Sep 2009 14:00:29 EDT

A new genetic variant associated with type 2 diabetes has been identified; crucially, this appears to be implicated in insulin resistance rather than having an effect on beta-cell activity in the pancreas.

Taser shocks said to pose little CV risk

Wed, 09 Sep 2009 17:30:14 EDT

Their heart rates jumped by about 11 bpm and blood pressures rose, but volunteers who received multiple shocks didn't otherwise show abnormal heart rhythms or changes in QRS or corrected-QT intervals.

Quality and completeness of medical literature questioned in two new studies

Wed, 09 Sep 2009 17:00:23 EDT

Two new studies cast some negative light on the quality and completeness of medical literature, with one showing that less than half of registered studies are published in medical journals, and the other showing major discrepancies between the registered and reported clinical outcomes.

New ESC guidelines on infective endocarditis

Wed, 09 Sep 2009 09:45:03 EDT

The ESC issues new recommendations on the prevention, diagnosis, and treatment of infective endocarditis—"an old but changing disease." The guidance with respect to antibiotic prophylaxis is similar to US advice, experts say.

Elderly patients in JUPITER benefit from statin therapy

Tue, 08 Sep 2009 16:30:54 EDT

The analysis showed that adults >70 years of age had a smaller reduction in relative risk in cardiovascular events compared with those younger than 70 years old but larger absolute reductions, resulting in a lower number needed to treat, particularly for more serious adverse events, according to investigators.

ARB/ACE-inhibitor combo not recommended in CHF

Tue, 08 Sep 2009 15:45:55 EDT

An individual patient-data meta-analysis of the studies to date of angiotensin-receptor blockers and ACE inhibitors in heart failure might help identify those candidates who could benefit from this drug combo, say Swiss researchers. But in the meantime, it should be avoided.