theheart.org - Brain/Kidney/Peripheral

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.

Biomarker may distinguish ICH from ischemic stroke

Thu, 09 Feb 2012 15:15:53 EST

The test might eventually be applied at the point of care to help triage patients for treatment.

More bleeding, thromboembolic events with dabigatran in AF ablation

Wed, 08 Feb 2012 16:45:00 EST

Dabigatran was stopped the morning of the procedure; its long half-life combined with the use of unfractionated heparin during the procedure likely explains the increased risk of bleeding.

For stroke risk, look for novel lipid/lipoprotein biomarkers

Wed, 08 Feb 2012 11:15:16 EST

Women with triglyceride levels in the highest quartile had a significant 56% increased risk of stroke compared with women in the lowest quartile. Similarly, for women with highest quartile of VLDL particle size and IDL particle number, there was a significant 59% and 46% increased risk of ischemic stroke compared with women in the lowest quartile.

Wake-up stroke patients may still benefit from thrombolysis

Tue, 07 Feb 2012 15:00:01 EST

A new study shows tPA was safe for patients who woke up with stroke symptoms, a population not normally treated since they could exceed the 4.5-hour window.

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.

ICDs charged with sex discrimination: Women get fewer shocks

Mon, 06 Feb 2012 17:00:00 EST

Differences in appropriate-therapy and device-related complication rates in a prospective study question (once again) whether women and men should have the same ICD-eligibility criteria.

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.

KEEP: Focus on CKD patients with highest SBP

Mon, 06 Feb 2012 12:30:06 EST

A new, contemporary study in real-world patients with chronic kidney disease finds that those with systolic BPs of 140 mm Hg and higher are at the greatest risk of developing end-stage renal disease. Hence the current "goal" in CKD patients of 130 mm Hg should be revised upward, say the authors, making the target easier to achieve and allowing physicians to focus on other aspects of care.

No recurrent stroke prevention seen with clopidogrel plus aspirin

Fri, 03 Feb 2012 17:15:57 EST

A new study shows that the combination of clopidogrel and aspirin increases risk of hemorrhage and mortality, including nonvascular mortality, vs aspirin alone.

Heart failure linked to loss of brain gray matter

Fri, 03 Feb 2012 16:15:21 EST

Heart failure is associated with a decline in mental function and loss of gray matter in the brain, which may make it more difficult for patients to follow instructions regarding their medication, a new Australian study has found.

Aspirin as effective as warfarin in heart failure: WARCEF

Fri, 03 Feb 2012 14:55:27 EST

Although there was an edge for warfarin for those treated for four or more years, there is "no compelling" reason to anticoagulate these patients, researchers say.

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.

Cardiac telemetry identifies AF in cryptogenic stroke

Thu, 02 Feb 2012 16:00:00 EST

Outpatient monitoring for 21 days detected atrial fibrillation in 17% of patients, and this could change management.

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?

Severe, rapid memory loss could herald stroke

Thu, 02 Feb 2012 14:15:18 EST

A new study finds that victims of fatal stroke had sharp memory declines before the event.

US "roadmap" for TAVI rollout published

Wed, 01 Feb 2012 15:00:32 EST

A new US expert-consensus document on transcatheter aortic-valve implantation aims to smooth the rollout of this new technology stateside.

Restenosis similar with carotid stenting or surgery: CREST

Wed, 01 Feb 2012 13:30:07 EST

At two years, carotid restenosis is infrequent and appears similar whether patients were treated with carotid stenting or endarterectomy.

Stroke risk linked to infections in children

Wed, 01 Feb 2012 09:00:00 EST

A new study finds the risk is highest closer to infection, then tapers off.

Shifty and dangerous: Worsening diastolic dysfunction ups mortality

Tue, 31 Jan 2012 16:45:13 EST

Actually, it was just as strong a mortality predictor as worsening systolic function in a retrospective series of patients followed with echocardiography.

New data will shed light on cancer risk from imaging

Tue, 31 Jan 2012 13:00:29 EST

Ongoing epidemiological studies in children who have undergone CT scans should help provide a better understanding of radiation-associated cancer risks from cardiac imaging over the next few years.

PARTNER CAP data show transapical outcomes improve with practice

Tue, 31 Jan 2012 10:15:37 EST

Only 104 of the 799 high-risk patients in the PARTNER A trial of the Sapien transcatheter valve were treated with the transapical approach, so it can be considered to be only the preliminary experience with this technique. Now data from 822 patients in the continued-access protocol are available.

Don't routinely replace spent ICDs: Proposal

Fri, 27 Jan 2012 17:00:00 EST

It may have little to offer and it might not be what the patient wants, argues a perspective in the New England Journal of Medicine.

More data needed on carotid atherosclerosis, CMS advisers agree

Fri, 27 Jan 2012 12:30:43 EST

The Centers for Medicare & Medicaid Services' Medicare Evidence Development & Coverage Advisory Committee met to once again discuss the latest available evidence on different treatments of carotid atherosclerosis, and the only clear message was these questions remain a moving target.

Riata Summit insights: Vigilance key to following functional but "recalled" ICD leads

Fri, 27 Jan 2012 10:00:32 EST

UPDATED // Most attending the recent Riata ICD lead summit felt that fluoroscopic screening of Riata recipients was a reasonable thing to do, at odds with some recommendations; remote monitoring has its limits here, say VA data.

Proximal balloon superior to distal protection in carotid artery stenting

Thu, 26 Jan 2012 17:45:14 EST

Proximal balloon-occlusion devices do not cross the lesion before it is stented, which helps to significantly reduce embolic load in the brain during the carotid procedure, according to researchers.

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."

Vytorin US label updated with SHARP results

Wed, 25 Jan 2012 12:05:17 EST

But the FDA has not allowed an official indication for chronic-kidney-disease patients, which has concerned investigators who conducted the trial.

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.

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.

Gifts, pep talks have some success post-PCI and in hypertension

Mon, 23 Jan 2012 16:00:00 EST

Some of the first research showing that positive affect interventions—including phone calls to bolster self-affirming thoughts and small gifts—generate some success in post-PCI and hypertensive patients has been published. An editorialist describes the work as "innovative" and calls for many more studies of this kind.

EMA investigating CV problems with fingolimod

Fri, 20 Jan 2012 12:30:39 EST

Physicians are being advised to intensify cardiovascular monitoring after the first dose of the new oral agent for multiple sclerosis.

Mortality climbs with rising PA pressure in heart failure: Community-based study

Wed, 18 Jan 2012 09:45:46 EST

The finding in a broad community-based HF population confirms and extends what is recognized in the hospital setting.

Contemporary look at VTE after joint surgery

Tue, 17 Jan 2012 16:00:00 EST

One in 100 patients who have knee-replacement surgery and one in 200 who undergo hip replacement will have a venous thromboembolic event in the hospital, despite receiving modern anticoagulant prophylaxis, a new review shows. These numbers will help inform patients and clinicians, say the authors, but an editorialist notes that to get a better picture, it will be necessary to look at a longer postsurgery time frame.

Thoracic endoprosthesis gets traumatic transection approval

Mon, 16 Jan 2012 11:30:00 EST

The FDA has expanded approval for the Gore TAG Thoracic Endoprosthesis to include treatment of "life-threatening tears or ruptures of the aorta."

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.

Pulmonary hypertension in kids differs from adult PAH

Tue, 10 Jan 2012 18:30:00 EST

A new registry of children with pulmonary hypertension is helping to differentiate the pediatric population with this disease from the adult one and should aid in better diagnosis and treatment of this condition in kids, say the authors.

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.

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.

UK's NICE wants more data on rivaroxaban in AF

Mon, 09 Jan 2012 10:50:00 EST

The UK drugs cost-efficacy watchdog, NICE, has asked for more data from Bayer before it will sanction use of rivaroxaban for stroke prevention in atrial-fibrillation patients.

RESPECT PFO/stroke trial completes enrollment

Wed, 04 Jan 2012 17:00:32 EST

After eight years of sluggish patient accrual, the RESPECT trial looking at the Amplatzer device for the prevention of cryptogenic stroke has finally collected enough events for the trial to be stopped.

Public Citizen requests recall of the Wingspan stent

Wed, 04 Jan 2012 16:15:25 EST

A consumer-advocacy group argues that the Wingspan Stent System provides less benefit and causes more harm than aggressive medical treatment alone.

BRCA1 cancer gene affects cardiac function

Wed, 04 Jan 2012 14:00:00 EST

Canadian researchers have discovered that the BRCA1 gene is implicated in cardiac function, at least in mice. The findings may also have implications for cancer sufferers who have mutations in this gene: they may be at increased risk of heart disease and more likely to suffer cardiotoxicity from chemotherapy.

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.

Enoxaparin prophylaxis doesn't cut mortality in acute-care setting

Fri, 30 Dec 2011 09:00:02 EST

Antithrombotic prophylaxis remains important in this group for other reasons, but don't expect it to necessarily prevent death, according to researchers.

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.

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.

Increasing heart rate over time linked with heart disease mortality

Tue, 20 Dec 2011 16:00:00 EST

Despite the adverse effects of an increase in resting heart rate over time, individuals who lowered their resting heart rate did not have a lower risk of ischemic heart disease, a finding that suggests the association is not linear.

ALTITUDE halted: Adverse events when aliskiren added to ACE, ARB therapy

Tue, 20 Dec 2011 13:20:02 EST

Data and safety monitors for ALTITUDE noted that patients in the trial taking aliskiren instead of placebo on top of ACE or ARB therapy experienced an increased incidence of nonfatal stroke, renal complications, hyperkalemia, and hypotension.

Overeating, salt, the real culprits in stroke risk

Tue, 20 Dec 2011 10:15:41 EST

The quality and quantity of a person's diet are more important determinants of stroke risk than the foods and nutrients consumed.

Improving BP in middle age pays off later

Mon, 19 Dec 2011 17:30:20 EST

Most studies of lifetime risk of cardiovascular disease that have focused on BP look at one index point, so researchers have examined multiple pooled studies to see how changes in BP over time during middle age affect lifetime risk.

FDA puts new warnings on dronedarone

Mon, 19 Dec 2011 17:00:31 EST

CORRECTED // The FDA is warning atrial-fibrillation patients taking dronedarone about the risks of the drug in patients with permanent AF.

RECOVER II confirms benefit of dabigatran in treatment of VTE

Mon, 19 Dec 2011 16:45:08 EST

The new study adds another 2500 patients tested with dabigatran in the setting of VTE, confirming the results observed in the first RECOVER study.

Support for edoxaban for VTE prevention

Mon, 19 Dec 2011 13:00:17 EST

The benefit of edoxaban over enoxaparin for the prevention of VTE following hip and knee surgery did not appear to come at a cost, according to investigators, as there was no statistically significant increased risk in bleeding in the overall cohort or in any subgroups.

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.

AF following TAVI associated with higher risk of stroke

Wed, 14 Dec 2011 16:00:00 EST

A small study indicates that even a very short episode of AF following TAVI might be associated with an increased risk of stroke. The findings have implications for antithrombotic therapy after TAVI, say the authors and accompanying editorialists.

Catheter-directed thrombolysis in iliofemoral DVT reduces risk of postthrombotic syndrome

Tue, 13 Dec 2011 15:15:32 EST

Catheter-directed thrombolysis significantly reduced the risk of postthrombotic syndrome at 24 months and increased venous patency after six months, compared with standard therapy in patients with a high proximal deep vein thrombosis, according to the results of a new study. There were 20 bleeding events associated with thrombolysis, although investigators expect these event rates to decline.

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.

Aspirin a safe, low-cost option for preventing recurrent VTE after anticoagulation stopped

Mon, 12 Dec 2011 09:30:45 EST

Investigators say the reduction in recurrent VTE risk, which was achieved without an increased risk of bleeding, makes aspirin an attractive treatment option for the extended prevention of recurrent VTE once oral anticoagulation is stopped.