MedWorm: Cardiology

Medical education in Brazil

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

We report a case that illustrates how mental stress radionuclide imaging has the potential to be used in the assessment of myocardial ischemia non-detected by conventional methods in patients with suspicion of ischemic thoracic pain. (Source: Arquivos Brasileiros de Cardiologia)

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22q11.2 duplication and congenital heart defects

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

Radionuclide imaging of myocardium with mental stress in the investigation of thoracic pain

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

Late spontaneous regression of obstructive tumor in the mitral valve

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

O rabdomioma cardíaco raramente é encontrado na valva mitral, porém, embora de grande dimensão (15x14 mm), causando até obstrução a esse nível nos primeiros meses de vida, observou-se a involução total e espontânea do mesmo, iniciada com 68 meses, e tornando-se progressivamente menor até completar 14 anos de idade.Cardiac rhabdomyoma is uncommonly found in the mitral valve. However, in the case reported, although the tumor was large (15x14 mm) and even caused obstruction at this level in the first months of life, its complete and spontaneous regression was observed as from 68 months of age, with progressive reduction until the patient was 14 years old. (Source: Arquivos Brasileiros de Cardiologia)

Postpartum torsades de pointes and long QT syndrome

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

This article reports the case of a puerperal patient admitted with diagnosis of urinary tract infection and heart failure. This condition evolved with torsades de pointes ventricular arrhythmias, then, hypokalemia, and use of Ciprofloxacin. Ventricular arrhythmias did not present any improvement after potassium and magnesium replacement, but after implantation of temporary pacemaker, this condition showed signs of improvement. The patient was discharged with QTc at 490 ms, taking Propranolol. (Source: Arquivos Brasileiros de Cardiologia)

Case 6/2009: 13 years old youngsters with major atrial and ventricular septal defects

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

A terapia de ressincronização cardíaca (TRC) tem sido uma opção efetiva nos pacientes com insuficiência cardíaca avançada. No entanto 20% a 30% dos pacientes não apresentam benefícios nessa terapêutica. Critérios clínicos, eletrocardiográficos e ecocardiográficos têm sido estudados na tentativa de selecionar os pacientes que serão beneficiados com a ressincronização cardíaca, mas o ecocardiograma tem papel importante tanto na seleção quanto na avaliação e otimização dessa terapêutica. O objetivo desta revisão é descrever os principais parâmetros ecocardiográficos utilizados na avaliação da terapia de ressincronização cardíaca. (Source: Arquivos Brasileiros de Cardiologia)

Arterial hypertension and physical activity

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

Echocardiography in cardiac resynchronization therapy

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

Experimental myocardium infarction in rats: analysis of the model

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

Uma das estratégias mais utilizadas para o estudo das alterações fisiopatológicas decorrentes da oclusão coronariana é o uso do modelo do infarto experimental no rato. Entre outros fatores, esse fato é decorrência da similaridade com as alterações fisiopatológicas que ocorrem após o infarto, em humanos. Devemos considerar, entretanto, que esse modelo possui características que podem dificultar tanto o uso como a interpretação de eventuais resultados. Assim, essa revisão tem como objetivo discutir as principais características do modelo do infarto experimental no rato, abordando a técnica da oclusão coronariana, as consequências e os métodos de avaliação morfológica e funcional do infarto e suas implicações clínicas. (Source: Arquivos Brasileiros de Cardiologia)

Late enhancement and myocardial perfusion in hypertrophic cardiomyopathy (comparison betw een groups)

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: The thickest ventricular segments are the septal ones. The hypertrophic regions are associated to a greater extension of late enhancement. There was a positive correlation between the areas of ventricular hypertrophy and altered myocardial perfusion and these findings were more evident in the obstructive group. (Source: Arquivos Brasileiros de Cardiologia)

Cardiorespiratory and perceptual responses to walking and running at the same speed

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

FUNDAMENTO: É possível que diferentes formas de locomoção, quando executadas a uma mesma velocidade, influenciem de forma distinta as respostas fisiológicas e perceptivas ao esforço. OBJETIVO: Comparar as respostas cardiorrespiratórias e de percepção subjetiva ao esforço, ao caminhar e ao correr nas mesmas velocidades, determinadas a partir da velocidade de transição caminhada-corrida (VTCC) MÉTODOS: A partir de uma amostra inicial de 453 sujeitos em serviço militar obrigatório, foram selecionados 12 homens adultos jovens e criteriosamente homogeneizados quanto ao sexo, idade, características antropométricas, condição aeróbica e experiência em exercícios na esteira rolante. Em sessões preliminares, foi determina individualmente a VTCC. Posteriormente, em três dias d...

Peri-operative evaluation by holter in elderly patients submitted to prostatectomy

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: Ambulatory monitoring is not regarded as an appropriate procedure for the screening of myocardial ischemia, due to the characteristics and technical limitations of the method, especially in populations with a low prevalence of coronary disease. In this cross-sectional and observational study, we concluded that the Holter recordings provided additional information which could not be obtained by conventional electrocardiogram. (Source: Arquivos Brasileiros de Cardiologia)

Exercise prevents cardiometabolic alterations induced by chronic use of glucocorticoids

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: The aerobic exercise training have a protective effect against the cardiometabolic alterations induced by the chronic use of glucocorticoids. (Source: Arquivos Brasileiros de Cardiologia)

Vaccination against the influenza virus and mortality due to cardiovascular diseases in the city of Sao Paulo

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: The vaccination against the Influenza virus was associated with a significant decrease in the mortality due to IHD. (Source: Arquivos Brasileiros de Cardiologia)

Prevalence of high blood pressure levels and associated factors among adults in Southern Brazil

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSIONS: One third of the assessed adults presented high blood pressure levels, similar to most of the Brazilian findings. Factors that can be prevented, such as overweight, obesity and self-reported diabetes were associated with high blood pressure levels. (Source: Arquivos Brasileiros de Cardiologia)

Electrocardiography in the diagnosis of ventricular hypertrophy in patients with chronic renal disease

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: ECG is a useful, efficient, and highly reproducible method for the diagnosis of LVH in HD patients. In this population, the Cornell-product proved to be the most reliable criterion for the detection of LVH. (Source: Arquivos Brasileiros de Cardiologia)

Systolic function of patients with myocardial infarction undergoing autologous bone marrow transplantation

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: Autologous mononuclear bone marrow cell transplantation did not improve the echocardiographic parameters of systolic function. (Source: Arquivos Brasileiros de Cardiologia)

Study of vascular reactivity in HIV patients whether or not receiving protease inhibitor

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: HIV-positive patients receiving PI presented endothelium-independent dysfunction when compared to HIV-positive patients not receiving PI and to the control group. (Source: Arquivos Brasileiros de Cardiologia)

Evaluation of the degree of vascular inflammation in patients with metabolic syndrome

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: We concluded that the CRP was the inflammatory marker with the highest expression regarding the studied variables, with smoking, albuminuria, previous personal history of cardiopathy, BMI, abdominal perimeter and hyperglycemia being the ones with the highest statistical significance. Interleukin-6 did not present a correlation with any of the studied variables. (Source: Arquivos Brasileiros de Cardiologia)

Coronary artery disease and experiences of losses

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

FUNDAMENTO: Na literatura, a depressão aparece associada a doenças cardiovasculares. A partir da experiência clínica, observou-se a categoria vivência de perdas associada à instalação e ao desenvolvimento da coronariopatia. A vivência de perdas, desencadeada por evento(s) significativo(s) apontado(s) pelo paciente, implica em processo de luto, remetendo-o aos fatores psicossociais predisponentes ao adoecer. OBJETIVO: Investigar vivência de perdas por meio da avaliação do estado de luto e de depressão, e verificar a relação entre ambos, em pacientes internados com doença arterial coronariana. MÉTODOS: Avaliaram-se 44 pacientes internados, com os diagnósticos de infarto agudo do miocárdio ou angina, de 33 a 65 anos, 50% homens e 50% mulheres. Foram utilizados dois instrume...

Dante Pazzanese risk score for non-st-segment elevation acute coronary syndrome

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: A risk score of easy application in the emergency service was developed to predict death or (re)infarction within 30 days in a brazilian population with non-ST-segment elevation acute coronary syndrome. (Source: Arquivos Brasileiros de Cardiologia)

Videothoracoscopy for isolated atrial fibrillation ablation through bipolar radiofrequency

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: The video-assisted surgery for the treatment of atrial fibrillation is reproducible and safe. There is a heart failure symptom evolution improvement after the surgery. (Source: Arquivos Brasileiros de Cardiologia)

Frequency of left ventricular diastolic dysfunction by mitral doppler in healthy elderly individuals

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

CONCLUSION: A large proportion of individuals aged 60 to 80 years present normal diastolic function at the Doppler-echocardiographic assessment of the mitral flow. Healthy elderly individuals with impaired LV relaxation filling have a larger aortic root diameter and longer PR interval. (Source: Arquivos Brasileiros de Cardiologia)

Body Mass Index has a Good Correlation with a Proatherosclerotic Profile in Children and Adolescents

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

(Source: Arquivos Brasileiros de Cardiologia)

Considerations on perioperative silent ischemia in patients undergoing transurethral resection of the prostat

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

(Source: Arquivos Brasileiros de Cardiologia)

64th Brazilian Congress of Cardiology is the largest in SBC's history

Arquivos Brasileiros de Cardiologia — Fri, 20 Nov 2009 13:54:09 +0100

(Source: Arquivos Brasileiros de Cardiologia)

Combined imaging recommended for suspected CAD

MedWire News - Cardiology — Fri, 20 Nov 2009 13:53:50 +0100

Risk stratification of patients with suspected coronary artery disease can be improved by addition of multi-slice computed tomography coronary angiography to calcium scoring, study results in the European Heart Journal show. (Source: MedWire News - Cardiology)

House passes bill to repeal 21.2 percent rate cut for physicians, SGR formula

Cardiovascular Business News — Fri, 20 Nov 2009 12:25:06 +0100

The U.S. House of Representatives voted Thursday to pass H.R. 3961, the Medicare Physician Payment Act, 243-183, altering the way Medicare pays physicians and preventing a scheduled 21.2 percent rate decrease set to take effect on Jan. 1, 2010. (Source: Cardiovascular Business News)

COLD-FX(R) Maker Broadens Its Scientific Direction: Launches Pilot Trial Of New Formulation LIP-01 Geared To Lowering Cholesterol And Lipids

Cholesterol News From Medical News Today — Fri, 20 Nov 2009 10:00:00 +0100

Afexa Life Sciences Inc. ("Afexa" or the "Company") (TSX:FXA) maker of COLD-FX announced the launch of a pilot clinical trial of a new formulation, LIP-01 that has shown promise in reducing blood lipids - including cholesterol. Cholesterol can stick to the walls of arteries, causing atherosclerosis or "hardening of the arteries." This, in turn, can ultimately lead to a heart attack or stroke. (Source: Cholesterol News From Medical News Today)

VerifyNow(R) System Highlighted In POPular Study Comparing Platelet Reactivity Tests

Cardiovascular / Cardiology News From Medical News Today — Fri, 20 Nov 2009 10:00:00 +0100

Accumetrics, Inc., developer of the VerifyNow System, the first point-of-care method for measuring platelet reactivity, announces that its market-leading VerifyNow P2Y12 Test was one of multiple methods evaluated in the POPular study, which was presented during a Late Breaking Clinical Trials session at the American Heart Association's annual Scientific Sessions. (Source: Cardiovascular / Cardiology News From Medical News Today)

Results Presented From First Study Reviewing Convergent Approach To Treating Atrial Fibrillation At American Heart Association Scientific Sessions

Cardiovascular / Cardiology News From Medical News Today — Fri, 20 Nov 2009 10:00:00 +0100

nContact Surgical, Inc. ("nContact"), a leader in the investigation of devices for minimally-invasive treatment for heart conditions, announced that data from a poster was presented at the American Heart Association Scientific Sessions in Orlando. The study demonstrated that the convergent approach, which combines surgical and electrophysiological expertise, appears to be a good strategy to achieve short term success in patients with long standing persistent atrial fibrillation (AF). (Source: Cardiovascular / Cardiology News From Medical News Today)

Prevalence Of High LDL, Or 'Bad' Cholesterol Levels Decreases In U.S.

Cholesterol News From Medical News Today — Fri, 20 Nov 2009 09:00:00 +0100

Between 1999 and 2006, the prevalence of adults in the U.S. with high levels of LDL cholesterol, the "bad" cholesterol, decreased by about one-third, according to a study in the November 18 issue of JAMA. But a high percentage of adults still are not being screened or treated for high cholesterol levels. (Source: Cholesterol News From Medical News Today)

Miller School Researchers Present Findings At AHA Scientific Sessions

Cardiovascular / Cardiology News From Medical News Today — Fri, 20 Nov 2009 09:00:00 +0100

A multidisciplinary team of clinical and basic science researchers in the Vascular Biology Institute at the University of Miami Miller School of Medicine has discovered a possible molecular signature of coronary artery disease in bone marrow stem cells. The dramatic findings were presented on November 16 at the American Heart Association's Scientific Sessions in Orlando. Coronary artery disease remains the number one killer in the United States and much of the Western world. (Source: Cardiovascular / Cardiology News From Medical News Today)

Clinical Data, Inc. Initiates Phase III Trial Of Stedivaze For Cardiac Stress Testing

Cardiovascular / Cardiology News From Medical News Today — Fri, 20 Nov 2009 09:00:00 +0100

Clinical Data, Inc. (NASDAQ: CLDA) announced that it has enrolled the first patient in its initial Phase III trial of Stedivaze™, a potential best-in-class vasodilator for use in cardiac stress testing. The study will evaluate the safety and efficacy of Stedivaze (apadenoson) for use as a pharmacologic stress agent in myocardial perfusion imaging (MPI), a method for detecting defects in the blood supply to the heart. (Source: Cardiovascular / Cardiology News From Medical News Today)

Telephone-Delivered Care For Treating Depression After Coronary Artery Bypass Graft Surgery Appears To Improve Outcomes

Cardiovascular / Cardiology News From Medical News Today — Fri, 20 Nov 2009 09:00:00 +0100

Patients who received telephone-delivered collaborative care for treatment of depression after coronary artery bypass graft surgery reported greater improvement in measures of quality of life, physical functioning and mood than patients who received usual care, according to a study in the November 18 issue of JAMA. The study is being released early online because of its presentation at an American Heart Association scientific conference. (Source: Cardiovascular / Cardiology News From Medical News Today)

Journal Scan: Advanced Heart Failure Treated With Continuous-Flow Left Ventricular Assist Device (N Engl J Med 2009;Nov 17:[Epub ahead of print].)

Cardiosource — Fri, 20 Nov 2009 08:52:31 +0100

The HeartMate II study was a randomized trial that enrolled patients with advanced heart failure who were ineligible for cardiac transplantation, in a 2:1 ratio, to undergo implantation of a continuous-flow device (n = 134) or the currently approved pulsatile-flow device (n = 66). The primary compos. . . (Source: Cardiosource)

Managing Mixed Dyslipidemia in Special Populations

Preventive Cardiology — Fri, 20 Nov 2009 00:00:00 +0100

Controlling low-density lipoprotein cholesterol is one of the major focuses of cardiovascular care. However, the twin global pandemics of obesity and diabetes are promoting an increased prevalence of associated cardiometabolic risk factors. These factors include mixed dyslipidemia, which is prevalent among several important subgroups of the overall population. Cardiovascular risk increases as women reach and extend beyond menopause, partly reflective of dyslipidemia. In addition, women with polycystic ovary syndrome display a cluster of risk factors reminiscent of the metabolic syndrome. Certain ethnic groups are also at increased risk for type 2 diabetes or the metabolic syndrome. Dyslipidemia contributes significantly to overall cardiovascular risk in the elderly, and the frequency of ch...

Dietary sodium advice prevents rehospitalization in HF

MedWire News - Cardiology — Fri, 20 Nov 2009 00:00:00 +0100

Heart failure patients with preserved systolic function who are advised to restrict dietary sodium intake after discharge from hospital have a reduced risk for death and readmission, study results demonstrate. (Source: MedWire News - Cardiology)

Sleep Apnea Raises BP for Kidney Transplant Patients (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 21:00:00 +0100

Sleep apnea is common among kidney transplant patients, and those with the sleep disorder have higher systolic blood pressure despite taking more antihypertensive medications, a new study found. (Source: MedPage Today Cardiovascular)

AHA: Obesity and Smoking Major Risk Factors for VTE (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 20:59:26 +0100

ORLANDO (MedPage Today) -- Overweight smokers have the greatest risk of a venous thrombotic event, according to a review of data from the Copenhagen City Heart Study reported here. (Source: MedPage Today Cardiovascular)

AHA: Weight-Loss Surgery Ups Cardiac Function in Kids (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 20:03:00 +0100

ORLANDO (MedPage Today) -- Bariatric surgery led to sustained improvements in left ventricular mass and diastolic function in morbidly obese teenagers, a researcher reported here. (Source: MedPage Today Cardiovascular)

HHS revise Medicare fee-for-service error rates

Cardiovascular Business News — Thu, 19 Nov 2009 19:26:17 +0100

The Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have significantly revised its calculations of Medicare fee-for-service error rates in 2009. (Source: Cardiovascular Business News)

AHA: Air Pollution Link to Thrombosis Fades Away (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 19:18:32 +0100

ORLANDO (MedPage Today) -- Researchers said they were unable to replicate a link between ambient particulate matter air pollution and venous thromboembolism in women using estrogens. (Source: MedPage Today Cardiovascular)

ALLHAT investigators report 10-year follow-up and stand by diuretics as first step antihypertensive treatment

theHeart.org — Thu, 19 Nov 2009 19:00:01 +0100

New 10-year mortality and morbidity data confirm the original trial conclusions, they say, that while amlodipine and lisinopril are not superior to chlorthalidone on any outcome, chlorthalidone is superior to these agents on one or more secondary end points. Full agreement with this conclusion in the community, though, is still hard to come by. (Source: theHeart.org)

AHA: Drilling Down in JUPITER Confirms Benefit for Women (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 17:11:20 +0100

ORLANDO (MedPage Today) -- A subset analysis of data from the JUPITER trial indicates that apparently healthy women treated with rosuvastatin (Crestor) reduced their relative risk of major cardiovascular events by 46%, slightly higher than the 42% reduction seen in men. (Source: MedPage Today Cardiovascular)

AHA: Diuretics Measure Up to Newer BP Drugs (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 17:08:07 +0100

ORLANDO (MedPage Today) -- Over the long term, diuretics fight hypertension as well as newer, more expensive blood pressure medications, researchers said here. (Source: MedPage Today Cardiovascular)

Goal-directed Haemodynamic Therapy and Gastrointestinal Complications in Major Surgery: A Meta-Analysis of Randomized Controlled Trials

Medscape Cardiology Headlines — Thu, 19 Nov 2009 17:00:00 +0100

Investigators performed a meta-analysis to examine the effects of goal-directed hemodynamic therapy on postoperative gastrointestinal and hepatic complications. British Journal of Anaesthesia (Source: Medscape Cardiology Headlines)

AHA: Obesity Okay with Some People (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 16:37:55 +0100

ORLANDO (MedPage Today) -- Nearly one obese person in 10 feels no need to lose weight or prevent further weight gain, researchers found. (Source: MedPage Today Cardiovascular)

AHA: Cardiac Care No Better with Report Cards (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 16:27:51 +0100

ORLANDO (MedPage Today) -- Issuing public report cards on various aspects of hospitals' delivery of cardiovascular care did not improve overall care, a Canadian study showed. (Source: MedPage Today Cardiovascular)

The prognostic role of echocardiographic indices in chronic heart failure: right ventricle revisited

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

(Source: European Journal of Heart Failure)

Clinical trials update from the European Society of Cardiology Meeting 2009: AAA, RELY, PROTECT, ACTIVE-I, European CRT survey, German pre-SCD II registry, and MADIT-CRT

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

This article provides information and a commentary on trials relevant to the pathophysiology, prevention, and treatment of heart failure presented at the annual meeting of the European Society of Cardiology held in Barcelona in 2009. The AAA study does not support the routine use of aspirin for the prevention of vascular events in patients with asymptomatic atherosclerosis. RELY suggests that dabigatran may be more effective than warfarin for the prevention of stroke in patients with atrial fibrillation. Rolofylline was not superior to placebo in improving outcomes in patients with acute heart failure enrolled in the PROTECT study, but dyspnoea was improved. Data from ACTIVE-I suggest that irbesartan does not provide additional therapeutic benefit in patients with atrial fibrillation who a...

'Hospital at home' care model as an effective alternative in the management of decompensated chronic heart failure

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion Hospital at home care allows an important reduction in the costs during the index episode compared with hospital care, whilst maintaining similar outcomes with respect to cardiovascular mortality and morbidity and quality of life at 1 year follow-up. (Source: European Journal of Heart Failure)

Depressive symptoms and outcomes in patients with heart failure: data from the COACH study

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion In patients with HF, depression is independently associated with poor outcomes. These findings highlight the need for continued exploration of whether improvements in depression lead to better cardiovascular outcomes. The study was registered at clinical trial (www.trialregister.nl): NCT 98675639. (Source: European Journal of Heart Failure)

Effect of simvastatin vs. rosuvastatin on adiponectin and haemoglobin A1c levels in patients with non-ischaemic chronic heart failure

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion These findings suggest that hydrophilic rosuvastatin but not lipophilic simvastatin increases adiponectin and decreases HbA1c levels in patients with NICHF. (Source: European Journal of Heart Failure)

The obesity paradox in stable chronic heart failure does not persist after matching for indicators of disease severity and confounders

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion The obesity paradox does not appear to persist in a matched setting with respect to indicators of disease severity and other confounders. NT-proBNP remains an independent prognostic indicator of adverse outcome irrespective of obesity status. (Source: European Journal of Heart Failure)

The impact of concurrent heart failure on prognosis in patients with chronic obstructive pulmonary disease

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion Heart failure is a strong independent predictor of all-cause mortality in patients with a diagnosis of COPD. (Source: European Journal of Heart Failure)

Cardiac mortality in {beta}-thalassemia major: resting but not dobutamine stress echocardiography predicts mortality among initially cardiac disease-free patients in a prospective 12-year study

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

(Source: European Journal of Heart Failure)

Right atrial size and deformation in patients with dilated cardiomyopathy undergoing cardiac resynchronization therapy

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion Right atrial area index was increased and RA myocardial deformation was impaired in patients with DCM who were non-responders to CRT. (Source: European Journal of Heart Failure)

Increased plasma retinol binding protein 4 levels in patients with inflammatory cardiomyopathy

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion Elevated RBP 4 plasma concentrations, induced by IL-8, might be one mechanism leading to a higher incidence of diabetes in patients with DCMi. (Source: European Journal of Heart Failure)

Red cell distribution width: an inexpensive and powerful prognostic marker in heart failure

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion Red cell distribution width is a readily available test in the HF-population with similar independent prognostic power to NT-proBNP across the first to third quartiles. Prognostic models in HF should include RDW and further investigation is necessary to determine the pathological mechanism of the relationship. (Source: European Journal of Heart Failure)

Red cell distribution width has incremental prognostic value to B-type natriuretic peptide in acute heart failure

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

(Source: European Journal of Heart Failure)

Implementation of device therapy (cardiac resynchronization therapy and implantable cardioverter defibrillator) for patients with heart failure in Europe: changes from 2004 to 2008

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:20 +0100

Conclusion Implantation rates of devices for HF, in particular ICD and CRT-D, have increased significantly between 2004 and 2008 in Europe, but there remain major differences between countries. (Source: European Journal of Heart Failure)

Heart failure in patients hospitalized with acute coronary syndromes: observations from the Gulf Registry of Acute Coronary Events (Gulf RACE)

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:19 +0100

Conclusion Heart failure complicates a substantial proportion of ACS admissions in the Arab Middle East and is associated with higher in-hospital death. Younger patients with ACS have a higher relative increase in mortality related to HF. (Source: European Journal of Heart Failure)

Normal systolic blood pressure and risk of heart failure in US male physicians

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:19 +0100

Conclusion Our findings suggest a linear relationship between normotensive SBP and HF risk. Strategies to prevent HF, such as lifestyle modification, should be emphasized across all blood pressure ranges. (Source: European Journal of Heart Failure)

Impaired cellular contractile function in thiamine-deficient rat cardiomyocytes

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:19 +0100

(Source: European Journal of Heart Failure)

Food-restriction in obese dyslipidaemic diabetic mice partially restores basal contractility but not contractile reserve

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:19 +0100

Conclusion Food-restriction in obese diabetic mice leads to improved cardiac performance by diminishing cardiac load and by ameliorating the intrinsic contractile properties of the cardiac muscle. However, cardiac reserve under dobutamine stimulation did not increase. (Source: European Journal of Heart Failure)

Acute coronary syndromes, heart failure, and diabetes in the Gulf Registry of Acute Coronary Events

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:19 +0100

(Source: European Journal of Heart Failure)

The Nobel Prize for medicine for telomere biology and relevance to heart failure research

European Journal of Heart Failure — Thu, 19 Nov 2009 16:06:19 +0100

(Source: European Journal of Heart Failure)

Oral anticoagulants REDEEMed? Daily dabigatran "safe" with dual antiplatelets after MI

theHeart.org — Thu, 19 Nov 2009 16:00:11 +0100

A dose-finding study saw what were characterized as low bleeding rates associated with triple-drug antithrombotic therapy that included the oral anticoagulant dabigatran in patients with a recent ACS event and other cardiovascular risk factors. (Source: theHeart.org)

CMS' reimbursements for PET MPI to increase

Cardiovascular Business News — Thu, 19 Nov 2009 15:42:29 +0100

The Centers for Medicaid & Medicare Services (CMS) will increase the reimbursement for PET myocardial perfusion imaging (MPI) by 24 percent in 2010. (Source: Cardiovascular Business News)

AHA: Newer Anticoagulants Beat Heparin for PCI (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 15:14:11 +0100

ORLANDO (MedPage Today) -- Acute myocardial infarction patients pretreated with anticoagulants before percutaneous coronary interventions appear to fare better with fondaparinux or enoxaparin than unfractionated heparin, researchers reported. (Source: MedPage Today Cardiovascular)

EFFECT: Public reporting of hospital performance improves quality of care?

theHeart.org — Thu, 19 Nov 2009 15:00:55 +0100

Publicly released report cards based on hospital performance did not result in a measurably greater systemwide improvement in two composite AMI or CHF process-of-care indicators in a Canadian study. But they did appear to stimulate some important changes in delivery of care that could have led to some better outcomes. (Source: theHeart.org)

AHA: While on statins, better to also raise HDL and not just lower LDL levels

Cardiovascular Business News — Thu, 19 Nov 2009 14:44:52 +0100

Orlando, Fla.—The use of statins to reduce LDL-C is more effective with the subsequent addition of extended-release niacin (Niaspan; Abbott), which lowers LDL plus increases HDL, compared with the subsequent administration of ezetimibe (Zetia; Merck) in reducing the progression of atherosclerosis, according to the ARBITER 6-HALTS trial presented Monday at the American Heart Association (AHA) conference. (Source: Cardiovascular Business News)

Study Supports Use Of MTWA Test As Predictor Of Sudden Cardiac Death

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 14:00:00 +0100

Cambridge Heart, Inc. (OTCBB-CAMH), announced that results of the PREVENT-SCD trial, presented at the American Heart Association Scientific Sessions in Orlando, Florida, reinforce the value of the Microvolt T-wave Alternans (MTWA) test in identifying patients at risk of sudden cardiac death (SCD). (Source: Cardiovascular / Cardiology News From Medical News Today)

HEAAL: High-dose beats low-dose losartan in HF

MedWire News - Cardiology — Thu, 19 Nov 2009 13:56:05 +0100

Patients treated with a high, 150-mg daily dose of the angiotensin-receptor blocker losartan had a significantly reduced risk for death or hospitalization for heart failure compared with patients taking a 50-mg daily dose of the drug, the HEAAL investigators report. (Source: MedWire News - Cardiology)

Inside This Issue

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:19 +0100

1993 Joseph D. Mishkin, Sherry J. Saxonhouse, Gregory W. Woo, Thomas A. Burkart, William M. Miles, Jamie B. Conti, Richard S. Schofield, Samuel F. Sears, Juan M. Aranda, Jr (Source: Journal of the American College of Cardiology)

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:18 +0100

Kirsten E. Fleischmann, MD, MPH, FACC, Chair Joshua A. Beckman, MD, FACC (Source: Journal of the American College of Cardiology)

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:17 +0100

Lee A. Fleisher, MD, FACC, FAHA, Chair Joshua A. Beckman, MD, FACC (Source: Journal of the American College of Cardiology)

Coronary Artery Aneurysm Formation Within New-Generation Bare-Metal Stents: Not Just Due to Drug Elution!

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:17 +0100

A 57-year-old woman with chronic stable angina underwent uncomplicated stenting in the left anterior descending artery (LAD) and right coronary artery (RCA) (A) with excellent results in the target vessel. Coronary angiogram repeated for atypical chest pain 6 months later demonstrated coronary artery aneurysm (CAA) (arrowheads) within the segments stented with a bare-metal stent (BMS) in both arteries (B), confirmed on intravascular ultrasound examination (C). Arrows show the extent of the aneurysm as seen on the intravascular ultrasound images. The RCA segment stented with the everolimus-eluting stent Xience (Abbott Laboratories, Abbott Park, Illinois) was free of aneurysm. History did not suggest any predisposition to aneurysm formation, and systemic arteritis was excluded. The patient w...

Anemia in Adults With Congenital Heart Disease Relates to Adverse Outcome

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:17 +0100

Objectives: To assess the relation of anemia in noncyanotic adults with congenital heart disease (ACHD) to functional capacity and mortality.Background: Anemia is common in acquired heart failure and affects prognosis. The presence of anemia and its relation to outcome in ACHD remain unknown.Methods: Data were collected on consecutive noncyanotic ACHD patients attending our tertiary center between 2001 and 2006 in whom hemoglobin concentration was measured. Anemia was defined as hemoglobin concentration (Source: Journal of the American College of Cardiology)

A Meta-Analysis of the Mechanism of Blood Pressure Change With Aging

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:16 +0100

Conclusions: These findings challenge the current consensus view that a shift in timing of wave reflection significantly contributes to the changes in the BP waveform with aging. We should re-evaluate the mechanisms of BP elevation in aging. (Source: Journal of the American College of Cardiology)

Sleep Apnea and Atrial Fibrillation: The Autonomic Link⁎

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:16 +0100

The intuitive and postulated links () between the established association of obstructive sleep apnea with atrial fibrillation (AF) are hypertension, diastolic dysfunction, and the resultant long-term atrial remodeling (). However, studies suggest that the relationship between sleep apnea and AF is independent of hypertension, cardiac function, or body mass index. Further, untreated sleep apnea doubles the risk of AF recurrence within 12 months of cardioversion independent of other risk factors (). Thus, is the relationship between sleep apnea and AF an epiphenomenon, or is it truly causative and the linking mechanism is simply not yet explained? (Source: Journal of the American College of Cardiology)

The Role of Ganglionated Plexi in Apnea-Related Atrial Fibrillation

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:16 +0100

Conclusions: This experimental model of apnea shows a reproducible incidence of AF. After neural ablation of the RPA GP or autonomic blockade, AF inducibility was significantly inhibited. (Source: Journal of the American College of Cardiology)

The RYR2-Encoded Ryanodine Receptor/Calcium Release Channel in Patients Diagnosed Previously With Either Catecholaminergic Polymorphic Ventricular Tachycardia or Genotype Negative, Exercise-Induced Long QT Syndrome: A Comprehensive Open Reading Frame Mutational Analysis

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:15 +0100

This study was undertaken to determine the spectrum and prevalence of mutations in the RYR2-encoded cardiac ryanodine receptor in cases with exertional syncope and normal corrected QT interval (QTc).Background: Mutations in RYR2 cause type 1 catecholaminergic polymorphic ventricular tachycardia (CPVT1), a cardiac channelopathy with increased propensity for lethal ventricular dysrhythmias. Most RYR2 mutational analyses target 3 canonical domains encoded by (Source: Journal of the American College of Cardiology)

Genotype–Phenotype Relationship in the Long QT Syndrome: Brimming With Knowledge but Thirsting for a Therapeutic Solution⁎

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:15 +0100

Since it was first reported 50 years ago, the long QT syndrome (LQTS) is now recognized as a genetic disease caused by mutations of ion channel genes encoding a cardiac channel essential for the control of ventricular repolarization (). The LQTS is not only the most common and extensively researched genetic cardiac arrhythmia (), it has also attracted premier scientists and scholars in single-cell electrophysiology and molecular genetics. In turn, they have produced seminal discoveries that shaped our understanding of the syndrome. The mutated genes in LQTS patients cause delayed repolarization and, in turn, prolong the QT interval on the surface electrocardiogram; these abnormalities are associated with torsade de pointes and/or ventricular fibrillation, resulting in the clinical manifest...

Genotype-Phenotype Aspects of Type 2 Long QT Syndrome

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:12 +0100

Conclusions: The KCNH2 missense mutations located in the transmembrane S5-loop-S6 region are associated with the greatest risk. (Source: Journal of the American College of Cardiology)

Atrial Fibrillation After Major Thoracic Surgery: New Insights Into Underlying Mechanisms⁎

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:12 +0100

Atrial fibrillation (AF) is a common complication in patients undergoing major thoracic surgery (). It is most frequently observed acutely after valve surgery and/or coronary artery bypass graft surgery (CABG), but it can also manifest after lung and heart transplantation procedures (). Although mechanisms underlying this unique form of AF have not been adequately elucidated, it is likely that these involve a combination of pericardial inflammation, myocardial ischemia, catecholamine surge, autonomic imbalance, interstitial fluid mobilization, tissue rejection, and so forth (). It is interesting to note that AF is observed significantly less often after cardiac transplantation than after valve surgery and/or CABG (). This relative protection from AF after cardiac transplantation has been a...

A Comparison of Atrial Arrhythmias After Heart or Double-Lung Transplantation at a Single Center: Insights Into the Mechanism of Post-Operative Atrial Fibrillation

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:12 +0100

Conclusions: In heart transplant recipients, AF is uncommon and occurs in the setting of myocardial dysfunction and graft rejection. In contrast, AF is more common after lung transplantation despite the absence of graft rejection and cardiac dysfunction. Pulmonary vein isolation alone cannot explain the discrepancy in AF incidence between heart transplant recipients and double-lung transplant recipients. Cardiac autonomic denervation may have a protective effect for heart transplant patients in the post-operative setting. (Source: Journal of the American College of Cardiology)

Transesophageal Echocardiography Before Atrial Fibrillation Ablation: Looking Before Cooking⁎

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:12 +0100

In many electrophysiology laboratories, atrial fibrillation (AF) is becoming the most common heart rhythm disorder being treated with catheter ablation. Reasons for this include the large numbers of patients with AF, the poor quality of life commonly associated with AF, the limitations of drug therapy, advances in ablation tools and methods, and the increasing number of electrophysiologists trained in the technique. Catheter ablation is now recognized as a legitimate option for patients with symptomatic AF who have failed antiarrhythmic drug therapy (). (Source: Journal of the American College of Cardiology)

Role of the CHADS2 Score in the Evaluation of Thromboembolic Risk in Patients With Atrial Fibrillation Undergoing Transesophageal Echocardiography Before Pulmonary Vein Isolation

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:11 +0100

Objectives: The goals of this study were to determine: 1) if low-risk patients assessed by a CHADS2 score, a clinical scoring system quantifying a risk of stroke in patients with atrial fibrillation (AF), require a routine screening transesophageal echocardiogram (TEE) before pulmonary vein isolation (PVI); and 2) the relationship of a CHADS2 score with left atrial (LA)/left atrial appendage (LAA) spontaneous echo contrast, sludge, and thrombus.Background: There is no clear consensus of whether a screening TEE before catheter ablation of AF should be performed in every patient.Methods: Initial TEEs for pre-PVI of 1,058 AF patients (age 57 ± 11 years, 80% men) were reviewed and compared with a CHADS2 score.Results: CHADS2 scores of 0, 1, 2, 3, 4, 5, and 6 were present in 47%, 33%, 14%, 5%,...

Atrial Fibrillation at Baseline and During Follow-Up in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:11 +0100

Objectives: The ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) determined that treatment with amlodipine, lisinopril, or doxazosin was not superior to thiazide-like diuretic (chlorthalidone) in preventing coronary heart disease (CHD) or other cardiovascular events. This subanalysis examines baseline prevalence and in-trial incidence of new-onset atrial fibrillation (AF) or atrial flutter (AFL) and their influence on clinical outcomes.Background: Limited information is available on whether atrial fibrillation incidence is affected differentially by different classes of antihypertensive medications or treatment with statins.Methods: AF/AFL was identified from baseline and follow-up electrocardiograms performed biannually. Analyses were performed to ident...

Transtelephonic Versus Remote Monitoring of Cardiovascular Implantable Electronic Devices: Is One Approach to Be Preferred?⁎

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:11 +0100

Intracardiac pacemaker implantation was first described a half century ago; the same authors first reported on transtelephonic monitoring (TTM) of such devices a dozen years later (). Follow-up of the pacemaker patient was recognized as critical, particularly in view of the uncertain reliability associated with leads and generators. Tracking device longevity and function have remained an important problem (), compounded by the development of more widespread indications for pacemakers (), increasingly complex devices, and mounting advisories that attest to an ever-present threat of premature device failure (). Ironically, the population at risk of device malfunction has expanded due to medical and technological advances resulting in greater patient and pacemaker longevity. Device follow-up ...

Clinical Benefits of Remote Versus Transtelephonic Monitoring of Implanted Pacemakers

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:11 +0100

Conclusions: The strategic use of remote pacemaker interrogation follow-up detects actionable events that are potentially important more quickly and more frequently than transtelephonic rhythm strip recordings. The use of transtelephonic rhythm strips for pacemaker follow-up is of little value except for battery status determinations. (PREFER [Pacemaker Remote Follow-up Evaluation and Review]; NCT00294645) (Source: Journal of the American College of Cardiology)

Women Have a Lower Prevalence of Structural Heart Disease as a Precursor to Sudden Cardiac Arrest: The Ore-SUDS (Oregon Sudden Unexpected Death Study)

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:10 +0100

Conclusions: Women were significantly less likely than men to have a diagnosis of structural heart disease (LV dysfunction or coronary artery disease) before SCA. These findings suggest that fewer women may be eligible for prophylactic implantable cardioverter-defibrillator placement based on current guidelines and therefore may not have equal opportunity for prevention. Enhancement of SCA risk stratification may have even higher importance for women. (Source: Journal of the American College of Cardiology)

Implantable Cardioverter-Defibrillator Therapy After Acute Myocardial Infarction: The Results Are Not Shocking

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:10 +0100

The risk of sudden death is highest early after myocardial infarction (MI) and progressively declines over the ensuing 6 to 12 months. Nevertheless, several randomized clinical trials have failed to show a survival benefit for implantable cardioverter-defibrillators when implanted early after MI in high-risk patients. The etiology of this acute MI–sudden cardiac death paradox is unclear, but may be related to the changing nature of the substrate over the several month period after acute MI. Further investigation is needed to delineate the actual causes of death in the early post-MI period and which interventions can be implemented to reduce the increased rate of sudden death that is observed. (Source: Journal of the American College of Cardiology)

Appropriate Evaluation and Treatment of Heart Failure Patients After Implantable Cardioverter-Defibrillator Discharge: Time to Go Beyond the Initial Shock

Journal of the American College of Cardiology — Thu, 19 Nov 2009 13:52:10 +0100

Multiple clinical trials support the use of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure (HF). Unfortunately, several complicating issues have arisen from the universal use of ICDs in HF patients. An estimated 20% to 35% of HF patients who receive an ICD for primary prevention will experience an appropriate shock within 1 to 3 years of implant, and one-third of patients will experience an inappropriate shock. An ICD shock is associated with a 2- to 5-fold increase in mortality, with the most common cause being progressive HF. The median time from initial ICD shock to death ranges from 168 to 294 days depending on HF etiology and the appropriateness of the ICD therapy. Despite this prognosis, current guidelines do not p...

AHA: Low Bleeding Rates Observed in Dabigatran Dose-Ranging Trial (CME/CE)

MedPage Today Cardiovascular — Thu, 19 Nov 2009 13:30:19 +0100

ORLANDO (MedPage Today) -- The oral anticoagulant dabigatran did not appear to markedly increase major bleeding rates among post-MI patients who were already being treated with aspirin and clopidogrel (Plavix), researchers said here. (Source: MedPage Today Cardiovascular)

PanGenex Expands Clinical Trial Sites After Promising Pre-Clinical Data About Lower Coronary Arterial Calcium Scores In Cardiac Patients

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 13:00:00 +0100

PanGenex Corporation (Pink Sheets: PGCX) ("PanGenex" or "the Company") announced that due to promising pre-clinical results from its clinical trial at the Cardiovascular Institute of the South (http://www.cardio.com/site1.php), the Company will extend its trial to two additional sites. (Source: Cardiovascular / Cardiology News From Medical News Today)

Report: Most patients satisfied with U.S. inpatient hospital care

Cardiovascular Business News — Thu, 19 Nov 2009 12:54:36 +0100

Patient ratings of overall inpatient care in U.S. hospitals increased by 1.5 percent last year, with an increase in patients who said they would recommend the care to others, based on the findings of a report published by healthcare consulting firm Press Ganey. (Source: Cardiovascular Business News)

Can alcohol be good for you?

BHF National News — Thu, 19 Nov 2009 12:01:00 +0100

We say there are limits to the health benefits of alcohol for the heart (Source: BHF National News)

People With Type D Personalities Experience More Health Problems

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 11:00:00 +0100

People who experience a lot of negative emotions and do not express these experience more health problems, says Dutch researcher Aline Pelle. She discovered that heart failure patients with a negative outlook reported their complaints to a physician or nurse far less often. The personality of the partner can also exert a considerable influence on these patients. Aline Pelle investigated patients with a so-called type D personality. (Source: Cardiovascular / Cardiology News From Medical News Today)

Results From Two Phase II Trials Add To Understanding Of Ticagrelor (BRILINTA(TM)) And How It Works In The Body

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 11:00:00 +0100

AstraZeneca (NYSE: AZN) announced the results of the phase II studies, ONSET/OFFSET and RESPOND for ticagrelor (BRILINTA(TM)) at the annual American Heart Association (AHA) Scientific Sessions in Orlando, FL,(1,2) with ONSET/OFFSET study results being simultaneously published in the medical journal Circulation.(3) The ONSET/OFFSET data showed that treatment with ticagrelor (BRILINTA(TM)) achieved a more rapid onset of antiplatelet effect (41% IPA vs. (Source: Cardiovascular / Cardiology News From Medical News Today)

Levels Of Bad Cholesterol Falling In US, But Still Too Many Unscreened And Untreated

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 10:00:00 +0100

A new study published this week found that the proportion of American adults with high levels of low-density lipoprotein (LDL or "bad") cholesterol fell by around one third between 1999 and 2006, but concluded that too many are still not being screened or treated for the condition. (Source: Cardiovascular / Cardiology News From Medical News Today)

Crestor® Reduced Risk Of Cardiovascular Events In Women By Nearly Half In New Analysis Of Jupiter Study

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 10:00:00 +0100

A new analysis of 6,801 women in the JUPITER study showed CRESTOR® (rosuvastatin calcium) 20 mg significantly reduced cardiovascular (CV) events (defined as the combined risk of myocardial infarction, stroke, arterial revascularization, hospitalization for unstable angina, or death from CV causes) by nearly half (46 percent; p=0.002 vs. (Source: Cardiovascular / Cardiology News From Medical News Today)

Aldagen Announces Clinical Data For ALD-201 For Ischemic Heart Failure Presented At AHA

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 10:00:00 +0100

Aldagen, Inc. announced that results from a Phase 1 clinical trial of ALD-201, a cell therapy being developed as a treatment for ischemic heart failure, were presented at AHA. In the study, ALD-201 was found to be well-tolerated and to improve myocardial perfusion. The data were presented at the American Heart Association Scientific Sessions 2009 by Emerson C. (Source: Cardiovascular / Cardiology News From Medical News Today)

Hospital Report Cards Do Not Appear To Result In Significant Improvements

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 10:00:00 +0100

An analysis of quality of cardiac care following the public release of data on measures of care at hospitals in Ontario, Canada, did not result in significant systemwide improvement in hospitals' performance on most quality of care indicators, according to a study to be published in the December 2 issue of JAMA. The study is being released early online because of its presentation at an American Heart Association scientific conference. (Source: Cardiovascular / Cardiology News From Medical News Today)

Did FDA ignore COGENT to slap warning on clopidogrel/PPI interaction?

Cardiovascular Business News — Thu, 19 Nov 2009 09:53:53 +0100

The FDA is requiring a labeling change to Sanofi-Aventis and Bristol-Myers Squibb’s blockbuster anti-bloodclotting drug clopidogrel (Plavix) to indicate that it should not be used with AstraZeneca’s proton pump inhibitor (PPI) omeprazole (Prilosec/Prilosec OTC) and some other acid-reducing drugs. (Source: Cardiovascular Business News)

Medtronic receives FDA warning letter over cardiac rhythm facility

Cardiovascular Business News — Thu, 19 Nov 2009 09:27:27 +0100

The FDA has sent Medtronic a warning letter, regarding the inspection of the company’s cardiac rhythm disease management facility in Mounds View, Minn., which was completed in August. (Source: Cardiovascular Business News)

ED Drug Improves Heart's Pumping Action In Young Patients With Single-Ventricle Disease

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 09:00:00 +0100

Heart function significantly improved in children and young adults with single-ventricle congenital heart disease who have had the Fontan operation following treatment with sildenafil, a drug used to treat erectile dysfunction and pulmonary hypertension, say researchers from The Children's Hospital of Philadelphia. Single-ventricle defects are a collection of cardiac malformations that impair the heart's ability to pump blood. (Source: Cardiovascular / Cardiology News From Medical News Today)

Vitamin B Niacin Offers No Additional Benefit To Statin Therapy In Seniors Already Diagnosed With Coronary Artery Disease

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 09:00:00 +0100

The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows. (Source: Cardiovascular / Cardiology News From Medical News Today)

Pluristem Therapeutics Announces Three Month Follow-Up Data From The First Patient To Receive PLX-PAD

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 09:00:00 +0100

Pluristem Therapeutics Inc. (NasdaqCM:PSTI) (DAX:PJT) announced that safety and potential efficacy parameters were demonstrated by the three month follow up data from the first patient ever to receive its placenta derived cell therapy product, PLX-PAD. The patient is participating in a Phase I dose-escalating clinical trial in Europe with PLX-PAD, the company's leading product candidate for the treatment of critical limb ischemia (CLI), the end-stage of peripheral artery disease (PAD). (Source: Cardiovascular / Cardiology News From Medical News Today)

NIH Awards $8.5 Million For Research On Pharmaceuticals For Children

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 09:00:00 +0100

Studying drugs in pediatric populations is challenging because drugs often affect children differently than they do adults. The scarcity of pediatric studies limits the ability of doctors and scientists to predict drug dosing, safety and efficacy in children. To address this gap, the National Institutes of Health has announced 18 grants to help determine outcome measures and increase the likelihood of success of future trials of treatments for children. (Source: Cardiovascular / Cardiology News From Medical News Today)

Journal Scan: 2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update) (J Am Coll Cardiol 2009;Nov 18:[Epub ahead of print].)

Cardiosource — Thu, 19 Nov 2009 08:54:45 +0100

(Source: Cardiosource)

Highlights Of NHLBI-Supported Research Presented At American Heart Association's Scientific Sessions

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 08:00:00 +0100

New education strategies for better controlling hypertension and research suggesting a possible link between short-term and long-term exposure to air pollution and increased risk of constricted blood vessels are among the research highlights from studies supported by the National Heart, Lung, and Blood Institute (NHLBI) at the American Heart Association's 2009 Scientific Sessions in Orlando held Nov. 14-18. (Source: Cardiovascular / Cardiology News From Medical News Today)

Lifelong Exercise Keeps Seniors Young at Heart

MedicineNet High Blood Pressure General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Lifelong Exercise Keeps Seniors Young at HeartCategory: Health NewsCreated: 11/18/2009 4:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet High Blood Pressure General)

Diuretics Still Best Treatment for High Blood Pressure

MedicineNet High Blood Pressure General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Diuretics Still Best Treatment for High Blood PressureCategory: Health NewsCreated: 11/18/2009 2:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet High Blood Pressure General)

No Increased Pregnancy Risk for MS Patients

MedicineNet High Blood Pressure General — Thu, 19 Nov 2009 07:00:00 +0100

Title: No Increased Pregnancy Risk for MS PatientsCategory: Health NewsCreated: 11/19/2009 10:42:00 AMLast Editorial Review: 11/19/2009 10:42:22 AM (Source: MedicineNet High Blood Pressure General)

Dual Heart Tests Best for Young Athletes

MedicineNet High Blood Pressure General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Dual Heart Tests Best for Young AthletesCategory: Health NewsCreated: 11/19/2009 10:47:00 AMLast Editorial Review: 11/19/2009 10:47:49 AM (Source: MedicineNet High Blood Pressure General)

Lifelong Exercise Keeps Seniors Young at Heart

MedicineNet Heart General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Lifelong Exercise Keeps Seniors Young at HeartCategory: Health NewsCreated: 11/18/2009 4:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet Heart General)

Diuretics Still Best Treatment for High Blood Pressure

MedicineNet Heart General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Diuretics Still Best Treatment for High Blood PressureCategory: Health NewsCreated: 11/18/2009 2:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet Heart General)

Newer Blood Thinners May Outperform Old Standbys

MedicineNet Heart General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Newer Blood Thinners May Outperform Old StandbysCategory: Health NewsCreated: 11/18/2009 2:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet Heart General)

Study Shows Hospital Report Cards Unlikely to Spur Improvement

MedicineNet Heart General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Study Shows Hospital Report Cards Unlikely to Spur ImprovementCategory: Health NewsCreated: 11/18/2009 12:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet Heart General)

Alcohol May Reduce Men's Heart Risk

MedicineNet Heart General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Alcohol May Reduce Men's Heart RiskCategory: Health NewsCreated: 11/19/2009 10:28:00 AMLast Editorial Review: 11/19/2009 10:28:47 AM (Source: MedicineNet Heart General)

Diuretics Still Best Treatment for High Blood Pressure

MedicineNet Cholesterol General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Diuretics Still Best Treatment for High Blood PressureCategory: Health NewsCreated: 11/18/2009 2:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet Cholesterol General)

Newer Blood Thinners May Outperform Old Standbys

MedicineNet Cholesterol General — Thu, 19 Nov 2009 07:00:00 +0100

Title: Newer Blood Thinners May Outperform Old StandbysCategory: Health NewsCreated: 11/18/2009 2:10:00 PMLast Editorial Review: 11/19/2009 (Source: MedicineNet Cholesterol General)

FDA, Cardiovascular Systems recall sheath introducer due to stretching, fractures

Cardiovascular Business News — Thu, 19 Nov 2009 02:51:57 +0100

The FDA and Cardiovascular Systems have issued a nationwide recall of all lots of the ViperSheath sheath introducer, on behalf of Thomas Medical due to reports about stretching or fracture of the sheath during use. (Source: Cardiovascular Business News)

A Soccer Scholarship

Preventive Cardiology — Thu, 19 Nov 2009 00:00:00 +0100

(Source: Preventive Cardiology)

Journal Scan: Ferric Carboxymaltose in Patients With Heart Failure and Iron Deficiency (N Engl J Med 2009;Nov 17:[Epub ahead of print].)

Cardiosource — Thu, 19 Nov 2009 00:00:00 +0100

The FAIR-HF trial investigators enrolled 459 patients with New York Heart Association (NYHA) functional class II or III heart failure, a left ventricular ejection fraction ≤40% (for patients with NYHA class II) or ≤45% (for NYHA class III), iron deficiency (ferritin level (Source: Cardiosource)

AF-associated stroke ‘a distinct pathophysiologic and clinical entity’

MedWire News - Cardiology — Thu, 19 Nov 2009 00:00:00 +0100

Strokes associated with atrial fibrillation account for around one-third of the total and tend to be particularly severe, disabling, and likely to recur, research suggests. (Source: MedWire News - Cardiology)

RE-DEEM: Dabigatran causes no safety concerns in phase II ACS trial

MedWire News - Cardiology — Thu, 19 Nov 2009 00:00:00 +0100

When added to dual anti-platelet therapy, the orally administered direct thrombin inhibitor, dabigatran etexilate, results in a “low and acceptable bleeding rate” compared with placebo in patients who have suffered an acute myocardial infarction, according to data presentedat the American Heart Association 2009 Scientific Sessions in, Orlando, Florida, USA. (Source: MedWire News - Cardiology)

CT-STAT: CTA faster and cheaper than standard protocol for CAD diagnosis

MedWire News - Cardiology — Thu, 19 Nov 2009 00:00:00 +0100

A protocol using initial computed tomography angiography is effective and both faster and cheaper than standard-of-care evaluation in the diagnosis of coronary artery disease among low-to-intermediate risk patients with chest pain, show results of the CT-STAT trial. (Source: MedWire News - Cardiology)

Chlorthalidone preferred over amlodipine, lisinopril as initial anti-hypertensive therapy in long-term ALLHAT follow-up

MedWire News - Cardiology — Thu, 19 Nov 2009 00:00:00 +0100

Ten-year follow-up of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack trial confirmed the results from the 5-year trial demonstrating that an older drug, chlorthalidone, was as effective as drugs considered newer at the time the trial was initiated (ie, the calcium-channel blocker amlodipine, the ACE inhibitor lisinopril, and the alpha blocker doxazosin. (Source: MedWire News - Cardiology)

Pfizer submits new paediatric data for atorvastatin to European Medicines Agency

NeLM - Cardiovascular Medicine — Thu, 19 Nov 2009 00:00:00 +0100

Source: BioSpace Area: News Pfizer Inc has announced that it has submitted paediatric data for atorvastatin to the European Medicines Agency (EMEA) and also developed a new chewable form of the drug, including a paediatric-appropriate 5 mg dose, which is part of this submission. (Source: NeLM - Cardiovascular Medicine)

Focused update 2009 of ACC/AHA guidelines for management of ST-elevation myocardial infarction and percutaneous coronary intervention

NeLM - Cardiovascular Medicine — Thu, 19 Nov 2009 00:00:00 +0100

Source: Circulation Area: News In an effort to respond promptly to new evidence, the American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Task Force on Practice Guidelines has created a "focused update" process to revise the existing guideline recommendations that are affected by evolving data or opinion. These updated guideline recommendations reflect a consensus of expert opinion after a review primarily of late-breaking clinical trials identified as being important to the relevant patient population, as well as a review of other new data deemed to have an impact on patient care. A focused update on guidelines for the management of patients with ST-elevation myocardial infarction (updating 2004 guideline and 2007 focused update) and guidelines on percutaneous ...

Investigational oral antiplatelet agent ticagrelor (Brilinta®) filed for approval in US

NeLM - Cardiovascular Medicine — Thu, 19 Nov 2009 00:00:00 +0100

Source: PharmaTimes Area: News AstraZeneca has submitted a New Drug Application with the FDA for its investigational oral antiplatelet therapy ticagrelor (Brilinta®) for the reduction of major adverse cardiac events in patients with acute coronary syndrome. The filing includes data from the 18,624-patient PLATO study, the phase III head-to-head trial comparing ticagrelor plus aspirin with clopidogrel plus aspirin (see NeLM link). Ticagrelor is the first in a new class of drugs, the CPTPs (cyclo-pentyl-triazolo-pyrimidines) and is chemically distinct from the thienopyridines. It was filed for approval with regulators in Europe in October 2009. (Source: NeLM - Cardiovascular Medicine)

Initial medical rather than interventional management more cost-effective for most diabetic patients with stable CHD

NeLM - Cardiovascular Medicine — Thu, 19 Nov 2009 00:00:00 +0100

Source: Circulation Area: News The most cost-effective initial treatment for diabetic patients with stable coronary heart disease (CHD) depends on the seriousness of their CHD: intensive medical management appears more cost-effective than percutaneous coronary intervention (PCI) in less seriously affected patients, however those with more severe disease should probably proceed straight to CABG (coronary artery bypass grafting). These conclusions come from pre-specified secondary outcome and economic analyses of the BARI-2D trial (Bypass Angioplasty Revascularization Investigation 2 Diabetes), published early online in Circulation. The primary results from BARI-2D were published earlier this year (see link to NEJM study) and showed no significant difference in 5-year mortality b...

CVN: High LDL Levels

Cardiosource — Thu, 19 Nov 2009 00:00:00 +0100

High LDL Levels in U.S. Population Drop Significantly (Source: Cardiosource)

Variability in Postpacing Intervals Predicts Global Ventricular Activation Pattern during Tachycardia

Pacing and Clinical Electrophysiology : PACE — Thu, 19 Nov 2009 00:00:00 +0100

Conclusions: Our data suggest that the global ventricular activation pattern during VT can be rapidly and accurately defined by assessing the PPIV. This technique allows for a rapid confirmation of the tachycardia activation and significantly facilitates mapping and ablation. (PACE 2009; 1[ndash]6) (Source: Pacing and Clinical Electrophysiology : PACE)

Results From Phase 2b Study On Atrial Fibrillation Agent Reviewed At American Heart Association

Cardiovascular / Cardiology News From Medical News Today — Thu, 19 Nov 2009 00:00:00 +0100

ARYx Therapeutics, Inc. (NASDAQ:ARYX), a biopharmaceutical company, announced that a review of the results of the Phase 2b clinical trial, PASCAL, testing the efficacy and safety of ARYx's compound for the treatment of atrial fibrillation, budiodarone, was presented today at the American Heart Association meeting in Orlando, Florida. (Source: Cardiovascular / Cardiology News From Medical News Today)

BeneFIX 250 IU, 500 IU, 1000 IU, 2000 IU powder and solvent for solution for injection (nonacog alfa) - Revised SPC

NeLM - Cardiovascular Medicine — Thu, 19 Nov 2009 00:00:00 +0100

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC includes changes to: Section 4.4 (Special warnings and precautions for Use) - blurred vision Section 4.8 (Undesirable Effects) - blurred vision (rare) (Source: NeLM - Cardiovascular Medicine)

Hydrogen Sulfide Opens the K ATP Channel on Rat Atrial and Ventricular Myocytes

Cardiology — Wed, 18 Nov 2009 23:00:00 +0100

Cardiology 2010;115:120-126 (DOI:10.1159/000260073) (Source: Cardiology)

Alcohol Cuts CHD Risk in Men (CME/CE)

MedPage Today Cardiovascular — Wed, 18 Nov 2009 23:00:00 +0100

Consumption of alcohol in almost any quantity is associated with a nearly one-third reduction in the incidence of coronary heart disease (CHD) (MedPage Today) -- at least in men, a large Spanish study confirmed. (Source: MedPage Today Cardiovascular)

Pfizer Submits New Pediatric Data For Lipitor(R) (Atorvastatin) To The European Medicines Agency (EMEA)

Cholesterol News From Medical News Today — Wed, 18 Nov 2009 23:00:00 +0100

Pfizer Inc (NYSE:PFE) announced it has submitted pediatric data for Lipitor® (atorvastatin) to the European Medicines Agency (EMEA). Pfizer has also developed a new chewable form of Lipitor, including a pediatric-appropriate 5 mg dose, which is part of this submission. (Source: Cholesterol News From Medical News Today)

AHA: Prasugrel Incorporated into New STEMI Guidelines (CME/CE)

MedPage Today Cardiovascular — Wed, 18 Nov 2009 22:13:34 +0100

ORLANDO (MedPage Today) -- A 60-milligram loading dose of prasugrel (Effient) is now a recommended alternative to clopidogrel for patients with ST-elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention, according to updated guidelines. (Source: MedPage Today Cardiovascular)

AHA: Load up on ARBs for fewer heart failure hospital admissions

Cardiovascular Business News — Wed, 18 Nov 2009 21:46:29 +0100

Orlando, Fla.—Using a higher dose of the angiotensin-receptor blocker (ARB) losartan reduces death or hospital admission for heart failure, based on the findings of the HEAAL study, presented Tuesday at the American Heart Association conference. (Source: Cardiovascular Business News)

Senate set to unveil healthcare bill

Cardiovascular Business News — Wed, 18 Nov 2009 21:36:42 +0100

Healthcare legislation expected to reach the Senate floor this weekend is projected to cost $848 billion and reduce the federal budget deficit by $130 billion over 10 years, according to the Congressional Budget Office (CBO). (Source: Cardiovascular Business News)

AHA: Messages to Wrap Up and Take Home from AHA 2009

MedPage Today Cardiovascular — Wed, 18 Nov 2009 21:00:00 +0100

ORLANDO (MedPage Today) -- In this American Heart Association InFocus™ wrap-up, the two people who spearheaded the selection of presentations -- Mariell Jessup, MD, chair of the program committee, and Elliott M. Antman, MD, vice-chair -- review the most relevant clinical findings. (Source: MedPage Today Cardiovascular)

BARI 2D cost-effectiveness analysis favors medication over PCI for less severe CVD in diabetic patients

theHeart.org — Wed, 18 Nov 2009 20:45:07 +0100

New data from the BARI 2D trial comparing medical therapy vs revascularization in diabetics shows higher up-front costs of revascularization are only partially offset by long-term savings. (Source: theHeart.org)

NEJM: Bundling payments could reduce healthcare spending

Cardiovascular Business News — Wed, 18 Nov 2009 20:43:58 +0100

The most promising option for curbing healthcare spending is changing the way doctors and hospitals are paid to provide care, but implementing such a system must overcome significant obstacles to be successful, according to an analysis by the nonprofit research organization RAND that was published Nov. 11 in the New England Journal of Medicine. (Source: Cardiovascular Business News)

Ticagrelor effects unraveled in new phase 2 trials

theHeart.org — Wed, 18 Nov 2009 20:00:52 +0100

New and unique phase 2 data add to the growing body of evidence explaining the pharmacologic effects of the new antiplatelet agent ticagrelor. (Source: theHeart.org)