Topolog : News and views from Eric J. Topol

Fish oils to prevent CHD . . . it's now official

info@theheart.org (theheart.org) — Wed, 08 May 2013 17:00:00 EDT

The GISSI group's impressive, collaborative study just published in NEJM puts to bed any lingering theory stipulating a positive effect of fish oils to prevent heart disease in patients who have not had an MI and do not have HF.

Chelation therapy in TACT: Daring to challenge dogma (and suspend disbelief)

info@theheart.org (theheart.org) — Tue, 26 Mar 2013 16:00:00 EDT

It seemed like a crazy notion in 2003--when the NIH invested $31 million to fund the research--but the consistent and notable reduction of a spectrum of clinical end points indicates that maybe something important--and controversial--is happening.

Lp(a) and aortic stenosis: How genomics points the way

info@theheart.org (theheart.org) — Tue, 19 Feb 2013 11:35:00 EST

The recent discovery of an association between an Lp(a) gene variant and aortic stenosis once again brings genomics into the limelight. How do we act on findings in genomics? What are the implications of this study?

New oximetry app may promote home monitoring, cut cost, empower patients

info@theheart.org (theheart.org) — Mon, 21 Jan 2013 17:20:00 EST

Although not yet approved for medical use, the oximetry app from Masimo is an interesting tool with promise to empower patients and be another step towards the creative destruction of medicine.

What treatment for Dr Topol's 91-year-old mother-in-law post-TIA?

info@theheart.org (theheart.org) — Mon, 26 Nov 2012 00:00:00 EST

This challenging case illustrates how digital medicine speeds up diagnosis through the simple identification of atrial ectopic beats (iPhone ECG) and the ability to confirm AF (a 14-day iRhythm period).

Digital data paves the way to transparency in medicine

info@theheart.org (theheart.org) — Thu, 11 Oct 2012 10:45:00 EDT

As much as some cardiologists might dislike the idea (and even resist it), two new studies indicate that digital data--and the patient's access to it--are contributing to a new era in healthcare in which transparency contributes to better outcomes.

Genomic testing to take on unnecessary coronary angiography?

info@theheart.org (theheart.org) — Tue, 21 Aug 2012 11:45:00 EDT

It's no secret that a high percentage of the two million coronary angiographies performed in the US each year are unnecessary. How do we stop the waste and the needless radiation exposure?

There is something strange about apixaban

info@theheart.org (theheart.org) — Tue, 26 Jun 2012 13:45:00 EDT

When ARISTOTLE was published, results for apixaban were hailed as the best seen in a large randomized trial vs warfarin, better even than the trials using dabigatran or rivaroxaban in patients with AF. So why is the FDA reluctant to approve the drug?

Downgrading the importance of HDL cholesterol

info@theheart.org (theheart.org) — Mon, 21 May 2012 11:05:00 EDT

A large genetic analysis just published in the Lancet concludes that there is no relationship between levels of HDL cholesterol and risk for myocardial infarction. Should we be surprised?

Taking point-of-care genetic testing closer to mainstream

info@theheart.org (theheart.org) — Wed, 11 Apr 2012 09:27:00 EDT

The first rapid point-of-care genotyping randomized clinical trial in cardiology--although small--demonstrated striking results and is another indication of the future role of genetic testing in cardiovascular practice.

Statins and diabetes: A hard look at the data

info@theheart.org (theheart.org) — Thu, 01 Mar 2012 17:25:00 EST

The data are clear: in primary prevention, when comparing the benefit in preventing heart attack, stroke, and death vs the risk of diabetes, the trade-off is very slim--and the dangers, very real.

Talking about a (healthcare) revolution: The digital age ushers in precision medicine

info@theheart.org (theheart.org) — Wed, 25 Jan 2012 11:25:00 EST

The digital age is revolutionizing the healthcare paradigm by replacing an archaic and wasteful population-based model with precision medicine.

An important miscue in clopidogrel pharmacogenomics

info@theheart.org (theheart.org) — Tue, 27 Dec 2011 16:00:00 EST

Dr Matthew Price joins Dr Eric Topol to counter the paper published by Dr Holmes and colleagues, which questions clopidogrel platelet-function testing and genotyping and their relationship with clinical outcomes.

Big-time progress in cardiovascular genomics

info@theheart.org (theheart.org) — Tue, 11 Oct 2011 13:05:00 EDT

Two important recent studies--pertaining to Sporadic Thoracic Aortic Aneurysms and Dissections (STAAD) and hypertension--point to remarkable progress in the realm of genomic research.

Novel anticoagulants: Is this the best we can do?

info@theheart.org (theheart.org) — Mon, 12 Sep 2011 11:45:00 EDT

Despite being a positive and significant trial, ARISTOTLE demonstrated the benefit of apixaban compared with warfarin in only 29 patients out of 1000. What about the remaining 971 people?

What purpose does the IMT measurement serve?

info@theheart.org (theheart.org) — Tue, 09 Aug 2011 16:00:00 EDT

As the measurement of intima-media thickness gathers traction, it's time to ponder whether this test is really worthwhile.

AliveCor app transforms your iPhone into an ECG: Watch my demo!

info@theheart.org (theheart.org) — Wed, 22 Jun 2011 10:15:00 EDT

Revolutionary new technology--developed by Dr David Albert and pending FDA approval--brings heart monitoring closer to home and onto your iPhone. See how easy it is to use, and watch as I take the device for a test drive.

Why has dabigatran uptake been disappointing?

info@theheart.org (theheart.org) — Thu, 09 Jun 2011 09:30:00 EDT

With strong evidence to support the use of the drug, what explains its relatively poor uptake? What are your reasons for not prescribing dabigatran?

Recognizing the legendary accomplishments of Dr Arthur Moss

info@theheart.org (theheart.org) — Thu, 19 May 2011 11:10:00 EDT

A master clinician, teacher, and researcher, Dr Moss's numerous accomplishments--worthy of wide recognition--have helped advance cardiology for over 50 years.

Medical errors: Still made in one out of four hospitalized patients

info@theheart.org (theheart.org) — Tue, 19 Apr 2011 13:50:00 EDT

The April edition of Health Affairs tackles the issue of error in medical practice, which is estimated to cause the death 100 000 patients and cost $17 billion annually, despite a decade of quality initiatives. How can we stop medical error?

Colleagues, do we need to order 20 million echocardiograms a year?

info@theheart.org (theheart.org) — Wed, 16 Mar 2011 11:25:00 EDT

As the economic crisis continues, we cardiologists should be reigning in costs and helping to reduce spiraling healthcare expenses. Do you need that echocardiogram?

Creating cardiac diseases in a dish using pluripotent stem cells

info@theheart.org (theheart.org) — Mon, 21 Feb 2011 12:24:00 EST

Fascinating research using induced pluripotent stem cells has effectively allowed researchers to create "diseases in a dish." The medical implications are exciting and far-reaching: What are your thoughts?

Extraordinary use of nuclear scintigraphy

info@theheart.org (theheart.org) — Fri, 07 Jan 2011 13:29:00 EST

Ten million nuclear heart scans are performed per year: why are we exposing our patients unnecessarily to such a high dose of radiation?

Symplicity: A key to treating severe resistant hypertension

info@theheart.org (theheart.org) — Fri, 03 Dec 2010 11:20:00 EST

Impressive results from the Symplicity HTN-2 trial, which sought to treat severe resistant hypertension with renal nerve denervation, point to a new mainstay of therapy and pose a number of stimulating questions.

67 stents, 28 coronary angiograms, and a crippled healthcare system

info@theheart.org (theheart.org) — Mon, 01 Nov 2010 14:20:00 EDT

A recent case report in JACC of Cardiology of a 56-year-old patient with 67 stents and a history of 28 coronary angiograms is symbolic of a healthcare system that is barreling out of control fueled by outrageous costs and unbridled use of procedures.

PARTNER triumph takes TAVI to the next level

info@theheart.org (theheart.org) — Thu, 23 Sep 2010 08:35:00 EDT

In the history of cardiovascular trials, it's rare to see an improvement in rates of survival as remarkable as those shown in the PARTNER trial, which showed a 45% reduction in death in patients randomized to transcatheter aortic-valve implantation. . .

Robotic surgery is going mainstream: Watch for healthcare costs to skyrocket

info@theheart.org (theheart.org) — Wed, 25 Aug 2010 09:35:00 EDT

In their paper, Drs Barbash and Glied pose a fundamental question: why adopt new technologies that have not been validated by randomized clinical trials, appear to offer no advantage to patient outcomes, and are more expensive than existing procedures?

Complex trait genomics, or why common gene variants don't fully explain disease

info@theheart.org (theheart.org) — Mon, 26 Jul 2010 16:00:00 EDT

A landmark new study by Dr Robert A Hegele's team explores common and rare variants for hypertriglyceridemia and shows that a combination of multiple rare variants of common genes can help to explain heritability of disease.

Clopidogrel, genotyping, coronary stenting, and guidelines

info@theheart.org (theheart.org) — Thu, 08 Jul 2010 14:15:00 EDT

When we know that simple testing can tell us a lot about patient risk and there is a substantial data set to support testing, why do policy makers continue to ignore the importance of individualized medicine?

The revolving hospital door for HF and sensory-implant guides to cut hospitalization risk

info@theheart.org (theheart.org) — Wed, 02 Jun 2010 17:30:00 EDT

Are we making progress in the care of patients hospitalized for HF? How can we lower hospital readmission rates in HF? Do you think new sensory devices will improve care?

First clinical assessment incorporating a personal genome

info@theheart.org (theheart.org) — Tue, 04 May 2010 10:10:00 EDT

In its May 1, 2010 issue, the Lancet published the first fully clinically annotated whole-genome sequence, from a 40-year-old healthy Stanford professor who had sequenced himself last August.

Frugal innovation: Challenging sleepy "practice as usual"

info@theheart.org (theheart.org) — Mon, 19 Apr 2010 14:45:00 EDT

The Economist argues that emerging economies are the engines of innovation that could leave the rest of the world priced out of the market. With soaring healthcare costs, tightened budgets, and a dramatic rise in "medical tourism", what can we learn?

NAVIGATING lessons: Design smaller trials with more biological plausibility

info@theheart.org (theheart.org) — Fri, 19 Mar 2010 15:30:00 EDT

This massive trial will have little influence on clinical practice but should serve as a beacon for better design and execution in future trials. What do you conclude from NAVIGATOR?

Should we loosen up on ventricular rate control?

info@theheart.org (theheart.org) — Tue, 16 Mar 2010 11:20:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Calling for individualized medicine from ACC 2010

info@theheart.org (theheart.org) — Fri, 26 Mar 2010 10:55:00 EDT

The recurring theme of "less is more"--as shown by the results of numerous trials at ACC 2010--points to two possibilities: either our current therapies are stretched to capacity, or we need to further develop individualized medicine.

Mitral-clip in EVEREST II: A step forward

info@theheart.org (theheart.org) — Mon, 15 Mar 2010 23:30:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Mobile pocket echo device: Revolutionizing medicine

info@theheart.org (theheart.org) — Fri, 05 Feb 2010 12:40:00 EST

It's the size of a cell phone, portable, and with inherent wireless potential and has wide-ranging--revolutionary--possibilities that stretch beyond CV care. Click to watch my demo!

Lipoprotein(a): a causal factor for coronary disease

info@theheart.org (theheart.org) — Thu, 07 Jan 2010 10:30:00 EST

This striking and impressive study of the genomics of CAD raises several practical questions

PACE: A trial that challenges dogma

info@theheart.org (theheart.org) — Tue, 24 Nov 2009 13:50:00 EST

This well designed trial sought to find out whether placing a right ventricular lead at the apex--as per standard pacing procedure--leads to adverse cardiac remodeling and hence could promote heart failure and cardiac death.

Twitter: A place in the medical world?

info@theheart.org (theheart.org) — Wed, 16 Dec 2009 10:30:00 EST

It appears to be more than a passing fad. Can micro-messaging serve a practical purpose in our world of healthcare and research?

Ezetimibe in ARBITER 6-HALTS: What lessons can we learn?

info@theheart.org (theheart.org) — Mon, 16 Nov 2009 17:00:00 EST

Another trial has failed to show efficacy for ezetimibe. What can we learn from this unfortunate saga?

Dabigatran: Crossing a remarkable threshold

info@theheart.org (theheart.org) — Wed, 14 Oct 2009 11:00:00 EDT

The exciting results of the RE-LY trial appear to mark the beginning of a new era in anticoagulation for atrial fibrillation. Will dabigatran be the drug to replace warfarin, at last? How do you think these findings will improve patient care?

Antiplatelet therapy: A step forward with individualized medicine

info@theheart.org (theheart.org) — Tue, 22 Sep 2009 10:30:00 EDT

The Scripps clinic and health system is announcing at TCT this week routine genotyping of all patients undergoing stenting after concluding that this data is vital in selecting antiplatelet therapy.

Cash for clunkers, cash for lowering obesity rates

info@theheart.org (theheart.org) — Mon, 24 Aug 2009 13:50:00 EDT

The raging popularity of the cash for car clunkers program gives rise to an even more striking potential for cash incentives to deal with the world's biggest problem: obesity.

Preventing rehospitalization for heart failure

info@theheart.org (theheart.org) — Tue, 28 Jul 2009 13:25:00 EDT

Recent figures indicate that 27% of heart-failure patients are readmitted to the hospital within 30 days of discharge. Can new wireless sensors pave the way to better monitoring, reduced hospitalization, increased quality of life, and substantial savings?

Low-dose aspirin for primary prevention

info@theheart.org (theheart.org) — Wed, 17 Jun 2009 14:03:00 EDT

A new meta-analysis questions the use of low-dose aspirin for the prevention of cardiovascular events. Given its current wide use, these findings are important and have far-reaching consequences. What are your thoughts?

New wireless sensors and technologies for CV medicine

info@theheart.org (theheart.org) — Thu, 07 May 2009 11:30:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Watchman device: A step towards preempting the need for anticoagulation in patients with atrial fibrillation

info@theheart.org (theheart.org) — Fri, 17 Apr 2009 10:00:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

STICH: Surprising results?

info@theheart.org (theheart.org) — Sun, 29 Mar 2009 13:30:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

SYNTAX: No change to clinical practice so what is the value of the trial?

info@theheart.org (theheart.org) — Thu, 12 Mar 2009 09:24:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Clopidogrel Pharmacogenomics

info@theheart.org (theheart.org) — Tue, 13 Jan 2009 19:55:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Reflections on 25 years of cardiology meetings: Where do we go for "live" scientific exchange?

info@theheart.org (theheart.org) — Wed, 03 Dec 2008 09:42:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

JUPITER: How will it change your practice?

info@theheart.org (theheart.org) — Sun, 09 Nov 2008 15:50:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Pfizer, Prasugrel and New Cardiovascular Drugs

info@theheart.org (theheart.org) — Thu, 02 Oct 2008 12:52:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Putting SYNTAX In Context

info@theheart.org (theheart.org) — Tue, 02 Sep 2008 12:48:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Statin Induced Myopathy

info@theheart.org (theheart.org) — Tue, 29 Jul 2008 15:19:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

CT Angiography: What is the Proper Role and Place?

info@theheart.org (theheart.org) — Tue, 01 Jul 2008 12:35:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Lessons From Tim Russert

info@theheart.org (theheart.org) — Mon, 16 Jun 2008 12:21:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

POISED to Challenge Dogma: Peri-Op Beta Blockade

info@theheart.org (theheart.org) — Wed, 04 Jun 2008 11:36:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Genetic Beta-Blockade

info@theheart.org (theheart.org) — Wed, 07 May 2008 17:23:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

From ACC 2008: Home Automated External Defibrillator Trial (HAT); how does government select what trials to fund?

info@theheart.org (theheart.org) — Fri, 04 Apr 2008 10:59:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Genomics and Prediction of Cardiovascular Events

info@theheart.org (theheart.org) — Tue, 25 Mar 2008 17:38:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Diabetes and Blood Sugar: The Art of De-Personalized Medicine

info@theheart.org (theheart.org) — Tue, 19 Feb 2008 13:46:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Temple of the LDL Cholesterol

info@theheart.org (theheart.org) — Fri, 18 Jan 2008 09:44:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Defibrillation Stagnation

info@theheart.org (theheart.org) — Thu, 20 Dec 2007 12:06:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

too many cardiology journals??

info@theheart.org (theheart.org) — Mon, 26 Nov 2007 13:21:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

TRITON

info@theheart.org (theheart.org) — Mon, 05 Nov 2007 14:34:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

DLS vs DES

info@theheart.org (theheart.org) — Mon, 05 Nov 2007 14:33:00 EST

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.

Welcome to AHA 2007

info@theheart.org (theheart.org) — Fri, 02 Nov 2007 12:57:00 EDT

Cardiologist, Dr Eric Topol, Editor-in-chief, theheart.org and Director, Scripps Translational Science Institute, translates clinical research in cardiology to daily practice.