theHeart.org - Heart failure

CORONA analysis reopens door for statins in heart failure

Tue, 03 Nov 2009 10:45:33 EST

Statins for heart failure? After they failed to show much effect in two large randomized trials? Yes—maybe; at least in patients with ischemic heart failure who start the drugs early enough, suggests a post hoc analysis based on one of the trials.

Benefits of targeted lead placement with CRT devices supported by long-term mortality data

Thu, 29 Oct 2009 15:00:55 EDT

An additional year of data from the INCREMENTAL study showed that echo-targeted LV lead positioning increased the likelihood of a response to device therapy by about 40% over standard lead placement. But does that difference translate into better long-term outcomes for the patient?

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.

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.

HCM transmitted by sperm donation: A case report

Thu, 22 Oct 2009 15:45:36 EDT

The donor, who was later shown to be affected by a novel beta-myosin heavy-chain mutation that causes HCM, is responsible for at least nine children known to be genetically affected with HCM.

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.

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�.�.�.�

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.

Racial background woefully underreported in CV trials

Thu, 15 Oct 2009 13:15:10 EDT

Two-thirds of the 156 trials considered by the AHA in preparing a recent guideline failed to even record the ethnic backgrounds of participants, a new study has found. The researchers call for the reporting of race/ethnicity to be mandatory in all clinical trials, and they suggest medical journals should enforce this policy.

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.

Hopes build for natriuretic-peptide risk stratification before noncardiac surgery

Tue, 13 Oct 2009 10:00:10 EDT

Could a preoperative blood assay take the place of imaging studies or other more costly assessments of cardiovascular risk? A meta-analysis suggests yes. A massive randomized trial is looking into it now.

IRIS confirms: No survival gains from early post-MI primary-prevention ICDs

Wed, 07 Oct 2009 17:00:00 EDT

Defibrillators implanted within a month of acute MI may prevent sudden cardiac deaths, but they don't reduce overall mortality, according to a trial that supports current guidelines based primarily on the smaller 2004 trial DINAMIT.

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.

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.

New biomarker, galectin-3, shows risk-stratification potential in chronic heart failure

Mon, 28 Sep 2009 15:00:18 EDT

The proposed biomarker, which seems to apparently play a role in the progression of cardiomyopathy and heart failure, predicted mortality or HF hospitalization in a post hoc analysis from the already published COACH randomized trial.

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.

Changing PARTNER: Program tweaks overshadow updates from transcatheter-valve studies

Wed, 23 Sep 2009 09:15:00 EDT

A packed session of interventionalists eager to hear more about long-term safety and efficacy were caught off-guard by news that a new co-primary end point has been added to cohort B.

Mixed start to planned MARVEL trial of post-MI autologous skeletal-myoblast therapy

Tue, 22 Sep 2009 14:00:42 EDT

A pilot analysis suggests the cell therapy can improve functional capacity, but amiodarone may be needed to prevent ventricular arrhythmias; its investigators say they plan to switch gears on the remainder of the study.

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.

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.

CAD hospitalizations decline, but HF admissions increase

Wed, 16 Sep 2009 15:15:04 EDT

FAST enough? Intrathoracic monitor bests weight gain in predicting worsening heart failure

Tue, 15 Sep 2009 14:30:51 EDT

Can an intrathoracic fluid-status monitor, added to an already-indicated ICD or CRT-D device in patients with heart failure, serve as the decompensation early-warning system now provided—unreliably but as recommended in the guidelines—by the bathroom scale?

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.

Who should get CRT? Resynchronization benefits seen in heart failure with LVEF >35%

Mon, 14 Sep 2009 17:15:00 EDT

Heart-failure patients with ejection fractions >35% aren't necessarily excluded from the clinical and reverse-remodeling benefits of cardiac resynchronization therapy, suggests yet another study questioning the limits of CRT's current eligibility criteria.

ICDs in women with heart failure? Won't work, suggests meta-analysis

Mon, 14 Sep 2009 16:00:00 EDT

Implantable defibrillators don't cut all-cause mortality in women with systolic heart failure, proclaim five major clinical trials speaking in unison. An editorial writer cries "foul" on the frequent assumption in clinical practice that outcomes data from randomized trials conducted primarily in men should also apply to women.

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.

B-CONVINCED: Maintain beta blockers during acute heart-failure management

Mon, 14 Sep 2009 10:30:00 EDT

Short-term outcomes are the same whether beta blockers are continued or withheld at hospitalization for acute decompensated heart failure, and there are good reasons to continue them, according to researchers.

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.

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%.

Dronedarone in atrial fib trades efficacy for safety in meta-analysis

Fri, 11 Sep 2009 10:15:53 EDT

The finding, based on eight randomized trials, supports the view that dronedarone is less effective than amiodarone at preventing the arrhythmia's recurrence but doesn't have the older drug's serious toxicities, as suggested by the DIONYSOS trial.

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.