theheart.org - Acute Coronary Syndromes

US judge upholds FDA approval of generic enoxaparin

Thu, 09 Feb 2012 16:30:13 EST

Sanofi-Aventis had sued the agency in 2010, saying it had failed to follow its own rules and had not appropriately established that a generic drug made by a rival company included the same active ingredient as Lovenox.

Like father, like son: Y-chromosome variant may explain CAD

Wed, 08 Feb 2012 18:30:00 EST

New genetic work has unveiled an association between some lineages of the relatively empty male Y chromosome and coronary artery disease. The hypothesis, while "intriguing," requires more research to confirm, says one expert.

SWITCH III: Bivalirudin is as safe as heparin after fondaparinux in PCI patients

Tue, 07 Feb 2012 12:30:10 EST

Recent studies have shown that ACS patients on fondaparinux prior to PCI should switch to another anticoagulant prior to the procedure to avoid thrombus. The SWITCH III trial compares bivalirudin and unfractionated heparin in a small group of these patients.

TRA 2�P: Vorapaxar meets end point but ups bleeding

Tue, 07 Feb 2012 12:20:03 EST

In its second phase 3 trial, Merck's novel antiplatelet agent reduced ischemic events but increased bleeding, including ICH. Results looked more promising in patients without a history of stroke.

CTO, even in non-infarct-related artery, bodes ill in NSTEMI patients

Tue, 07 Feb 2012 09:45:51 EST

Swedish researchers examined SCAAR to determine the prognostic significance of a chronic total occlusion in an artery other than the infarct-related one of non-ST-elevation-MI patients.

MI-shock proposal is cold comfort: Hypothermia might boost survival

Mon, 06 Feb 2012 16:00:00 EST

Some data suggest therapeutic hypothermia might reduce the currently high mortality from cardiogenic shock; let's do the necessary clinical studies to see whether it might be true, urges a published viewpoint.

"Irrational" choices stall adoption of new antiplatelets

Mon, 06 Feb 2012 09:15:50 EST

Dr David Cohen points out some of physicians' potential "psychological" barriers to more rapid adoption of new antiplatelet agents, even though they may be the best choice for their patients.

CMS draft of proposed coverage for TAVI

Fri, 03 Feb 2012 09:30:30 EST

The CMS has issued a draft of the conditions under which it will provide coverage for transcatheter aortic-valve replacements, as the technology begins to be rolled out in the US.

The flap over flavonoids

Thu, 02 Feb 2012 15:15:40 EST

The field of flavonoids and polyphenols continues to attract a massive amount of interest, from researchers and the public alike. But can health really be improved by eating chocolate and drinking red wine?

Heart attack deaths plummet in three EU nations

Thu, 26 Jan 2012 12:15:26 EST

New statistics from Denmark, England, and Poland show a roughly 50% drop in deaths due to acute AMI in recent decades.

Cardiologists flagging woeful patient care say they paid with their jobs

Wed, 25 Jan 2012 15:30:00 EST

An echocardiographer and cardiac surgeon who say their jobs were axed in retaliation after they lodged numerous complaints of substandard patient care at a county hospital in Santa Clara are suing some of their former bosses, including two other cardiologists. The plaintiffs also claim they suffered severe harassment as a result of expressing their concerns. The defendants' attorney says the case "is hotly disputed."

Pay for SGR repeal with war savings, say medical groups

Tue, 24 Jan 2012 15:45:34 EST

A letter to Rep Dave Camp from 110 medical societies admits that war savings from military pullbacks are a "budget gimmick" but says they could retire SGR debt, another budget gimmick.

PLATO: PPI analysis "raises flag" but should not change practice

Tue, 24 Jan 2012 13:00:47 EST

A new analysis of the PLATO study has found that use of a proton-pump inhibitor was independently associated with a higher rate of cardiovascular events but that this was apparent in both the ticagrelor and clopidogrel arms. The finding is likely due to confounding and should not precipitate any change in advice on this subject, says the lead author.

Carotid images don't boost quit rates or cut CV risk factors in smokers

Mon, 23 Jan 2012 17:00:00 EST

A new randomized controlled trial is the latest addition to a contentious field of research trying to establish whether "seeing is believing" when it comes to motivating cardiovascular risk reduction.

Lower mortality rates at two years with transradial PCI, Italian registry shows

Thu, 19 Jan 2012 16:45:25 EST

In a propensity-score-matching analysis, the mortality rate at two years was 8.8% among patients treated via the radial artery and 11.4% in the femoral-PCI patients, a statistically significance difference. Transradial PCI was also associated with a significantly reduced need for vascular surgery and blood transfusions.

Pillow talk: First AHA advice on sex and CVD

Thu, 19 Jan 2012 16:00:00 EST

The first-ever guidance on sexual activity and cardiovascular disease from the AHA encourages doctors, patients, and their partners to discuss the subject during consultations. The majority of those with heart disease can safely engage in sex, which is important to quality of life, it concludes.

FFR shows benefit in FAME II; enrollment halted

Wed, 18 Jan 2012 12:00:29 EST

An interim analysis of the FAME II study shows a significant benefit of fractional-flow-reserve-guided stenting plus optimal medical therapy over and above optimal medical therapy alone; as a result the data safety monitoring board has said no further patients should be randomized to medical therapy alone.

BRIDGE study published: Cangrelor suited for important antiplatelet niche

Tue, 17 Jan 2012 16:00:00 EST

The intravenous antiplatelet with a very short half-life is the ideal candidate for bridging patients on clopidogrel or other thienopyridines to surgery, the authors say.

Resveratrol scientists react to Das fraud scandal: "Research will continue"

Fri, 13 Jan 2012 17:20:01 EST

As the controversy over the research fraud allegations against Dr Dipak Das enters its third day, researchers told heartwire what the news means for the field of resveratrol research and, more pressingly, an upcoming scientific meeting.

FDA: CardioGen-82 problems site-specific

Fri, 13 Jan 2012 10:15:04 EST

The generators, used in cardiac nuclear scans, were recalled by the manufacturer last summer, and the FDA previously found fault with manufacturing processes. Now the FDA says the excessive radiation cases appear to have occurred only at specific clinical sites and were unrelated to any manufacturing deficiencies.

Red-wine researcher charged with photo-editing fraud

Fri, 13 Jan 2012 09:30:31 EST

A University of Connecticut investigation found Dr Dipak K Das guilty of falsifying and fabricating images that appeared in published research.

Serum potassium targets in acute MI need rethink, analysis suggests

Tue, 10 Jan 2012 16:00:00 EST

Recommendations to routinely raise serum potassium levels when ventricular arrhythmias are a concern may be based on outmoded data, according to authors of one of the largest analyses of its kind.

GWTG improves AMI care in Asian Americans

Tue, 10 Jan 2012 16:00:00 EST

The new data suggest that among participating hospitals in the GWTG program, equitable quality care for many performance measures can be attained across racial and ethnic groups, including Asian Americans, say researchers.

New guidelines suggest blood glucose testing for all inpatients

Tue, 10 Jan 2012 09:30:37 EST

New clinical-practice guidelines from the Endocrine Society say all patients should have a glucose test on admission to the hospital and describe optimal management of hyperglycemia in patients who do not require intensive care.

Aortic stenosis grading system misses rare, high-risk group

Mon, 09 Jan 2012 17:00:00 EST

A new study has examined the clinical outcomes of asymptomatic aortic-stenosis patients classified by valve area plus flow-gradient patterns instead of the older, inherently inconsistent system based on separate area, gradient, and flow measurements.

Bereavement triggers MI, new study finds

Mon, 09 Jan 2012 16:00:00 EST

Bereaved people are 21 times more likely to suffer an MI the day after the death of a significant other, and this heightened risk remains for as long as a month afterward, new research finds. Healthcare providers, the bereaved themselves, and their family and friends need to recognize this heightened risk, say the authors.

Rivaroxaban filed for ACS in US and EU

Wed, 04 Jan 2012 09:30:58 EST

The factor Xa inhibitor rivaroxaban has been filed for approval for the additional indication of secondary prevention in acute coronary syndrome in both the US and EU.

US leads in shorter hospital stays, early readmission after STEMI

Tue, 03 Jan 2012 16:00:00 EST

Patients with ST-segment-elevation MI were more likely to be hospitalized again within a month if they had been treated in the US, and American patients had the shortest initial hospitalization, in a retrospective study of data from an international trial. The work identifies national differences in this measure of care—30-day-readmission—and it should help guide future investigations, the authors say.

Analysis slams use of clopidogrel loss-of-function gene test; proponents fire back

Thu, 29 Dec 2011 15:30:00 EST

A new meta-analysis and especially an accompanying editorial argue against current use of CYP2C19 genotyping to define risk of subsequent CV events in patients considered for clopidogrel. Proponents of the test defend its use and describe what they see as flaws in the study.

Troponins at admission and three hours allow MI diagnosis or rule-out

Wed, 28 Dec 2011 18:30:00 EST

Troponin levels measured using a sensitive or highly sensitive assay can help with early MI rule-out, suggests a study that makes a case supporting the possible approval of the high-sensitivity assay in the US.

MR beats out SPECT in CE-MARC crossover trial

Fri, 23 Dec 2011 18:30:00 EST

UPDATED // The diagnostic accuracy of SPECT imaging for assessment of myocardial ischemia is variable and exposes patients to ionizing radiation, so evidence that magnetic resonance can be at least as accurate might make it an attractive alternative.

Congress postpones Medicare pay cut

Fri, 23 Dec 2011 09:30:15 EST

UPDATED // After the Senate had overwhelmingly approved the plan and a tumultuous few days among House Republicans, this morning Congress voted to put off a steep cut in Medicare physician reimbursements that was to take effect on January 1, 2012.

First data to show antihypertensive therapy prolongs life

Tue, 20 Dec 2011 16:00:25 EST

The first-ever long-term data from a high-blood-pressure trial, the Systolic Hypertension in the Elderly Program, reveals that people taking the antihypertensives lived longer free from cardiovascular disease and died less often from CV causes. The results should help encourage patients to comply with medication and doctors to prescribe it, say the researchers.

Combining wireless sensors and genomics for CVD prevention?

Mon, 19 Dec 2011 10:00:31 EST

Monitoring an individual's risk for MI in the future would ideally first take into account his or her genome sequence or other biomarkers and then might use an implanted nanosensor smaller than a grain of sand. In an excerpt from his new book, The Creative Destruction of Medicine, theheart.org's editor in chief offers a glimpse of what that might look like.

AHA Statistics: New year, same trends

Thu, 15 Dec 2011 16:00:12 EST

The new annual update on the state of America's heart health is out and provides some encouraging news about outcomes while underscoring the severity of the country's problems with obesity and poor fitness.

PCI at centers without on-site surgery backed by meta-analysis

Tue, 13 Dec 2011 16:00:00 EST

A new meta-analysis of over a million patients sheds more light on the benefits of allowing centers with no bypass-surgery capability to perform PCI, a practice that remains controversial.

New evidence addresses ADHD meds and adult CVD risk

Tue, 13 Dec 2011 09:30:56 EST

A large observational study provides reassuring news on the safety of medications for attention-deficit hyperactivity disorder in middle-aged adults, researchers say.

Survey says: Most cardiologists support elective PCI sans on-site CABG�.�.�.�with caveats

Tue, 13 Dec 2011 08:00:00 EST

Is elective angioplasty without surgical backup on-site safe and effective enough for the US? Where would you send a family member? Sparks flew on both sides of the debate, as captured in a survey conducted jointly by theheart.org and US News & World Report.

Chewing khat increases risk in cardiac patients

Mon, 12 Dec 2011 16:00:00 EST

Researchers in the Middle East are warning doctors about the practice of chewing khat leaves, previously described as a "smokeless gun," which they have shown results in worse outcomes among ACS patients. Far from being benign, this plant contains constituents similar to amphetamines, but neither physicians nor users understand the risks, they say.

"Striking" variation in PCI/CABG across Ontario hospitals

Mon, 12 Dec 2011 12:00:00 EST

A large study in Ontario has identified a threefold variation in the ratio of PCI to CABG, depending on which hospital a patient attends. The widest range was seen among those with multivessel disease, and the results indicate that proper, unbiased discussion with each patient is needed to determine the best course of treatment for each individual, say the authors and accompanying editorialists.