theheart.org - Thrombosis

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.

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.

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.

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.

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?

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.

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.

Women do better after TAVI, hints small study

Mon, 30 Jan 2012 16:00:00 EST

The first foray into possible gender differences in presentation and outcome among patients undergoing TAVI for severe aortic stenosis hints that women may fare better than men after this procedure.

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.

Heart disease risk begins with middle-age risk factors

Wed, 25 Jan 2012 17:00:00 EST

Risk-factor-reduction efforts are usually based on short-term risk scores, but most Americans at low risk for cardiovascular disease over the next 10 years are actually at much higher risk for heart problems over the rest of their lives.

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.

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.

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.

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.

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.

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.

US bleeding ADRs higher with dabigatran than warfarin

Thu, 12 Jan 2012 15:40:19 EST

There is particular concern over use of dabigatran in the elderly, in whom there has been a high number of bleeds, including intracranial hemorrhages, reported to the FDA.

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.

Venous thrombosis, pulmonary embolism raise mortality risk

Tue, 10 Jan 2012 17:00:00 EST

First-time venous thrombosis or pulmonary embolism dramatically increases the long-term mortality rate in individuals with and without malignancy, according to a recent study.

New DES best older stents for deaths, restenosis in latest SCAAR data

Tue, 10 Jan 2012 15:00:18 EST

The latest data from the Swedish registry that launched the international furor over stent thrombosis with drug-eluting stents is now providing reassuring data about the safety and efficacy of the latest generation of the devices.

Aspirin in primary prevention: New meta-analysis finds bleeding outweighs benefits for most

Tue, 10 Jan 2012 14:00:46 EST

But there may be a case for aspirin treatment in certain individuals at high risk of heart disease or with a family history of cancer.

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.

Dabigatran: New data on MI and ischemic events

Mon, 09 Jan 2012 16:00:00 EST

The question of MI risk with dabigatran is in the spotlight once again, with two new papers on the subject published within the last few days.

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.

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.

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.

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.

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.

Rivaroxaban approved in Europe for AF and DVT treatment

Mon, 19 Dec 2011 10:45:19 EST

The factor Xa oral anticoagulant rivaroxaban has been approved in the European Union for the prevention of nonvalvular AF-related stroke and systemic embolism and for the treatment of DVT.

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.

FDA approves AtriCure AF ablation system

Fri, 16 Dec 2011 15:15:00 EST

The FDA has approved the AtriCure Synergy Ablation System for the treatment of AF in patients undergoing open concomitant CABG surgery and/or valve replacement or repair.

Riata ICD lead "alert" is now a class I recall

Fri, 16 Dec 2011 09:30:00 EST

The US FDA has designated a recent physician advisory letter relating to St Jude Medical's Riata family of ICD leads as a class I recall, the most serious. The letter, issued last month, warned doctors that more leads than it first thought were affected by a problem related to insulation failure.

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.

New anticoagulants do not interact with HIT antibodies in heparin-compromised patients

Thu, 15 Dec 2011 15:00:14 EST

Based on a proof-of-concept laboratory study, investigators are suggesting that heparin-induced thrombocytopenia patients can be treated with the newer anticoagulants, without any of the consequences observed with heparin.

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.

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.

Less than 10% of retrievable IVC filters removed, even though indication no longer present

Tue, 13 Dec 2011 07:45:45 EST

At one large US trauma center, less than 10% of inferior vena cava filters are removed from patients, despite the fact that the initial indication for the filter is no longer present. In addition, 18% of filters could not be removed for various reasons, making this an underrecognized problem, say researchers.

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.

Bleeding risk scores provide mixed results, especially in intermediate-risk patients

Mon, 12 Dec 2011 15:00:13 EST

Overall, the bleeding risk scores were able to identify patients at high risk for bleeding but had limited ability to identify patients at intermediate risk, report investigators.

"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.

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.