Tombosis risk news, trials, articles & opinions | theheart.org

COMFORTABLE-AMI: Bioerodable polymer DES trumps bare metal in STEMI

Wed, 16 May 2012 10:50:23 EDT

The trial is the first randomized controlled trial to show a safety advantage of a DES, investigators say.

COMPARE II: Nobori biolimus stent matches everolimus stents in all-comers

Wed, 16 May 2012 10:15:12 EDT

While equal to the market-leading Xience/Promus stents in terms of efficacy and safety, the Nobori failed to show an edge where many hope stents with bioerodable polymers will have their niche—in reducing stent thrombosis.

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.

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.

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.

Taking STEMI patients to PCI hospitals saves time and lives

Fri, 11 May 2012 12:45:16 EDT

A new study has found that patients taken directly to a PCI hospital were reperfused an average of 31 minutes faster than patients first taken to a hospital without PCI capability, which was associated with a possible mortality reduction.

Riata revelations: ICD lead failure rates, mechanisms take HRS center stage

Fri, 11 May 2012 10:30:34 EDT

Next chapter in the Riata recall story: how often do the leads fail, and why? In one of many Riata-related presentations at the Heart Rhythm Society meeting, the rate was about 2% per patient year. Why is less easily determined.

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.

Bypass moderate coronary lesions? Taking sides in the debate

Fri, 04 May 2012 11:30:07 EDT

When is it worth bypassing moderate coronary lesions? In the pathophysiology of CAD progression, as in politics, whether right or left seems to make a difference.

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.

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.

DES or bare-metal stents for primary PCI? New meta-analysis provokes debate

Thu, 26 Apr 2012 13:30:38 EDT

UPDATED // Long-term outcomes with first-generation drug-eluting stents in primary PCI for STEMI show that they have benefits over and above bare-metal stents, say the authors of a new meta-analysis. But an accompanying editorialist is not so sure.

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.

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.

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.

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.

XAMOS: Rivaroxaban in real-world orthopedic prophylaxis

Thu, 19 Apr 2012 13:45:30 EDT

The trial is said to confirm the benefits shown in the RECORD phase 3 trial program.

ESC issues position paper on new anticoagulants

Wed, 18 Apr 2012 16:15:30 EDT

The ESC's Working Group on Thrombosis is enthusiastic about the new drugs in AF, but it is not so impressed with their use in ACS.

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.

FDA adds VTE risk to drospirenone BCP labels

Tue, 10 Apr 2012 17:15:49 EDT

Despite inconsistent epidemiologic studies, the FDA has concluded that drospirenone-containing oral contraceptives may be linked to a higher risk of venous thromboembolism.

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.

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.

Oral anticoagulants in the real world: Bleeding rates and medical costs compared

Mon, 02 Apr 2012 11:45:35 EDT

Two separate experiences with dabigatran from different US centers showing very different results, and new cost-effectiveness analyses with the new drugs were reported in a poster session at last week's ACC meeting.

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.

Rivaroxaban gets NICE nod in UK for AF

Mon, 02 Apr 2012 09:30:31 EDT

In its final draft guidance, the UK National Institute for Clinical Excellence has recommended rivaroxaban as an option for the prevention of stroke and systemic embolism in people with atrial fibrillation.

New analysis extends dabigatran MI signal to other thrombin inhibitors

Fri, 30 Mar 2012 11:00:00 EDT

A new meta-analysis of trials of dabigatran and its almost-forgotten, long-lost cousin, ximelagatran, shows that there is a signal of increased MI with use of direct thrombin inhibitors. The novel findings were dissected and digested at the ACC Scientific Sessions earlier this week.

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.

RAPID GENE: Point-of-care genetic test singles out clopidogrel nonresponders

Thu, 29 Mar 2012 12:00:42 EDT

Patients in the RAPID GENE test, randomized to undergo point-of-care gene testing, then given prasugrel instead of clopidogrel if found to be carriers of the CYP2C19*2 allele, were significantly less likely to demonstrate high on-treatment platelet reactivity seven days post-PCI.

Figure-8-shaped vena cava filter shows promise

Wed, 28 Mar 2012 10:00:35 EDT

The Crux vena cava filter was 98% successful in the RETRIEVE clinical trial, and its designers hope it will avoid the problems that have plagued other vena cave filters in recent years.

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.

New oral anticoagulants in AF: What to do in clinical practice

Tue, 27 Mar 2012 15:45:51 EDT

In a talk entitled "Putting it all together: What should we do now?" Prof John Camm attempted to make some recommendations on how the new drugs should be incorporated into clinical practice.

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?

EINSTEIN PE: Rivaroxaban equals standard therapy, halves major bleeding

Mon, 26 Mar 2012 15:00:17 EDT

The new oral factor Xa inhibitor rivaroxaban proved equivalent to standard care of LMWH plus vitamin-K antagonist for the treatment of acute pulmonary embolism in the EINSTEIN PE study reported today. The new drug also halved major bleeds, in particular the troublesome intracranial hemorrhage, said the investigator. Commentators said they eagerly await cost-effectiveness data.

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.

PARTNER A: Even mild paravalvular leaks linked with higher mortality at two years

Mon, 26 Mar 2012 09:00:00 EDT

UPDATED // A phenomenon virtually unheard of in the surgical valve-replacement era, paravalvular leaks were linked with higher mortality, although overall mortality rates were no different between surgery- and TAVR-treated patients. Investigators are calling paravalvular regurgitation a new "target" that could potentially further improve TAVI results.

MI in pregnancy "a different entity"

Mon, 26 Mar 2012 07:30:14 EDT

MI in pregnancy or in the postpartum period creates a host of issues that are different from a conventional heart attack, data from a new survey of such cases show.

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.

BRIDGE ACS: Quality initiative leads to more evidence-based ACS care

Sun, 25 Mar 2012 09:00:00 EDT

BRIDGE-ACS evaluated how a coordinated education strategy could improve the Brazilian hospitals' adherence to evidence-based medicine for acute coronary syndromes.

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.

Patients with high calcium score more likely to lose weight, take statins

Sat, 24 Mar 2012 16:30:00 EDT

Researchers showed patients the calcium in their coronary arteries using scans to find out whether actually seeing coronary disease would motivate more patients to take statins or lose weight.

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.

GIFT exome analysis unearths two new genes related to platelet function

Sat, 24 Mar 2012 15:20:38 EDT

A different kind of genetic analysis, whole exome sequencing, of some of the participants in the GRAVITAS trial has led to the discovery of two new genes believed to be critical to platelet function. This novel approach holds much promise in general for the assessment of response to drugs, says the researcher.

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.

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.