HeartWire

Heart failure

Gender-matched heart transplants lead to better survival

Nov 20, 2008 17:30 EST

Drawing on data from over 18 000 transplant recipients, researchers say their findings support a policy of matching donor hearts to recipients, "if all else is equal." (American Heart Association 2008 Scientific Sessions.)

Murmurs

Dr Adrian Kantrowitz, inventor, transplant surgeon, dies

3 COMMENTS - Nov 19, 2008 15:30 EST

In more than 60 years of surgical practice, Kantrowitz is credited with performing the first heart transplant in the US, the second worldwide, as well as inventing the LVAD, IABP, and an early version of the implantable defibrillator.

Arrhythmia/EP

ATHENA secondary results: Dronedarone for AF may cut hospital admissions regardless of cause

1 COMMENT - Nov 19, 2008 10:45 EST

In the large randomized trial that compared the drug with placebo, even patients who never achieved sinus rhythm on the drug had a reduced risk of hospitalization. (American Heart Association 2008 Scientific Sessions.)

Thrombosis Risk

Bevacizumab significantly increases venous thromboembolism

Nov 18, 2008 16:00 EST

The risk of venous thromboembolism was increased by 33%, compared with controls, concludes a new meta-analysis of 15 cancer trials. (Nalluri SR et al. JAMA 2008; 300:277-2285.)

Acute Coronary Syndrome

ACC/AHA publishes new performance measures for STEMI patients

Nov 18, 2008 13:30 EST

Differing from guidelines, the new performance measures identify aspects of care with evidence so strong, such as prescribing a statin upon discharge or delivering reperfusion in a timely manner, that every patient should be receiving the same treatment. In other words, "If you're not doing things a certain way, then you're not providing the best care," says one expert. (Masoudi FA et al. Krumholz HM et al. J Am Coll Cardiol, Circulation; published online before print November 10, 2008.)

Clinical cardiology

ECGs add little when it comes to prognosis in those with chest pain

1 COMMENT - Nov 18, 2008 12:45 EST

ECGs or exercise ECGs have little incremental value over and above clinical assessment for prognosis in patients with suspected angina, a new study has found. Hence, such tests should not be used to rule out future events in these patients, researchers say. (Sekhri N et al. BMJ; published online before print November 13, 2008.)

Interventional/Surgery

OCT imaging suggests low rates of uncovered/malapposed struts following DES for AMI

Nov 18, 2008 11:30 EST

An OCT study conducted in a subset of HORIZONS-AMI patients suggests that exposed and malapposed stent struts in the setting of AMI are more common with drug-eluting stents than with bare-metal stents but still relatively rare. (American Heart Association 2008 Scientific Sessions.)

Heart failure

Negative thinking predicts depression in heart-failure patients

Nov 17, 2008 18:00 EST

Negative thinking may play a major role in the development of depression in patients with heart failure, new research suggests. (American Heart Association 2008 Scientific Sessions.)

Heart failure

Depression, not SSRIs, linked to increased mortality in heart-failure patients

Nov 17, 2008 15:00 EST

Contrary to recent research suggesting antidepressant use increases mortality in heart-disease patients, a new study suggests that, at least when it comes to selective serotonin-reuptake inhibitors, this is not the case. (O'Connor CM et al. Arch Intern Med 2008; 168:2232-2237.)

Prevention

Cardiovascular effects of air pollution, even in the comfort of home

Nov 14, 2008 16:45 EST

Researchers who fitted study subjects with "air-pollution vests" to continuously monitor exposure to both indoor and outdoor air pollutants say that people are probably exposed to much higher levels of pollutants than community monitoring stations typically indicate and that this exposure affects both endothelial function and systolic blood pressure. (American Heart Association 2008 Scientific Sessions.)

Clinical cardiology

Music, like laughter, benefits heart health

1 COMMENT - Nov 14, 2008 09:15 EST

Listening to enjoyable music may be good for cardiovascular health in the same way that laughter is beneficial, new research suggests. (American Heart Association 2008 Scientific Sessions.)

Dr Richard W Nesto

Lipid/Metabolic

APPROACH: Rosiglitazone doesn't affect atherosclerosis progression in diabetics with CV disease

19 COMMENTS - Nov 13, 2008 15:00 EST

The thiazolidinedione, given for 18 months, didn't appear to reverse or slow disease progression compared with the same duration of treatment with a sulfonylurea, according to the IVUS-based study. Investigators point to hints that that rosiglitazone may have slowed atherosclerosis in such patients with longer-established diabetes. (American Heart Association 2008 Scientific Sessions.)

Murmurs

heartwire journalist wins American Heart Association writing award

4 COMMENTS - Nov 13, 2008 14:00 EST

Arrhythmia/EP

THINRS: Home INR monitoring as effective as clinic-based care

4 COMMENTS - Nov 13, 2008 13:30 EST

A randomized comparison shows weekly home monitoring is safe but did not reduce stroke, major bleeds, or death vs monthly clinic INR testing, as had been suggested by previous studies. (American Heart Association 2008 Scientific Sessions.)

Interventional/Surgery

Patients believe elective PCI prevents MI and saves lives, but who's to blame?

8 COMMENTS - Nov 12, 2008 16:15 EST

Two-thirds of patients surveyed after undergoing elective PCI for angina relief said they believed the procedure would save their lives; still more believed they'd avoid a future MI. Experts say patients may not be digesting information appropriately, but doctors are also at fault. Indeed, the majority of patients also said they were not offered any therapy other than PCI. (American Heart Association 2008 Scientific Sessions.)

Heart failure

HF-ACTION: Early and sustained quality-of-life improvements with structured exercise program

Nov 12, 2008 15:30 EST

Heart-failure patients participating in an exercise-training program improved their quality of life, with the improvement occurring early and sustained for three years, new HF-ACTION data show. Investigators say the results are consistent with the overall clinical findings and support the use of exercise training in this patient population. (American Heart Association 2008 Scientific Sessions.)

Prevention

FIT HEART: Novel family-based intervention a good idea, but better methods needed

Nov 12, 2008 15:00 EST

A new study in which the family members of patients hospitalized for cardiovascular disease were given CVD risk screening and lifestyle advice has shown that it is useful to take advantage of such "motivational moments." But the results could be improved upon, illustrating that it is difficult to change behavior in the "toxic environment" of the US, said the discussant. She stressed that better interventions—such as adopting the Mediterranean diet—are urgently needed. (Mosca L et al. Circ Cardiovasc Qual Outcomes; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

Interventional/Surgery

New meta-analysis of beta blockers in noncardiac surgery: Time to abandon their use, or not?

2 COMMENTS - Nov 12, 2008 14:00 EST

The use of beta blockers perioperatively to prevent cardiovascular events in patients undergoing noncardiac surgery is not justified by current evidence, according to the authors of a new meta-analysis. An update to the guidelines on this issue is under way, says one member of the writing committee, who incidentally does not agree with this overall conclusion. (Bangalore S et al. Lancet; published online before print November 12, 2008. American Heart Association 2008 Scientific Sessions.)

Heart failure

I-PRESERVE: Strike three for RAAS inhibition in preserved-LVEF heart failure

7 COMMENTS - Nov 12, 2008 10:45 EST

Four years of treatment with irbesartan, usually on top of other drugs that affect the renin-angiotensin-aldosterone system, didn't improve outcomes in patients with the common but poorly understood form of heart failure. The trial follows previous negative studies of an ACE inhibitor and a different angiotensin-receptor blocker, respectively, in similar populations. (American Heart Association 2008 Scientific Sessions.)

Lipid/Metabolic

Higher nonfasting triglycerides associated with increased ischemic stroke risk

1 COMMENT - Nov 12, 2008 09:00 EST

A new observational study finds an association between higher levels of nonfasting triglycerides and increasing risk for ischemic stroke. (Freiberg JJ et al. JAMA 2008; 300:2142-2152. American Heart Association 2008 Scientific Sessions.)

Heart failure

MR-proADM better prognostic tool than BNP, but not everybody convinced of biomarker's merit

Nov 11, 2008 16:15 EST

A novel biomarker of vascular status is a better predictor of mortality at three months than brain natriuretic peptide among acute heart-failure patients presenting at the emergency department with shortness of breath. One expert, however, said it doesn't matter if the high-risk patients are separated from very high-risk patients—they should all be receiving optimal medical therapy. (American Heart Association 2008 Scientific Sessions.)

Heart failure

Interferon hope for chronic viral cardiomyopathy

4 COMMENTS - Nov 11, 2008 15:15 EST

A phase 2 trial has shown that interferon beta-1b—a drug currently used to treat multiple sclerosis—may be effective in chronic viral cardiomyopathy. But a phase 3 trial is needed for definitive proof of concept, say the study investigators and discussant. (American Heart Association 2008 Scientific Sessions.)

Heart failure

HF-ACTION misses, but experts say results support intensive exercise in HF patients

5 COMMENTS - Nov 11, 2008 14:30 EST

Investigators failed to show a difference in the primary end point of all-cause mortality and all-cause hospitalizations, but a secondary analysis that took into account prognostic factors did show significant reductions in hard clinical events. One expert believes it should strengthen exercise guidelines. (American Heart Association 2008 Scientific Sessions.)

Hypertension

Hibiscus tea reduces blood pressure

7 COMMENTS - Nov 11, 2008 13:30 EST

Results of a small randomized trial show that hibiscus tea given three times daily reduced systolic blood pressure by about 7 mm Hg in prehypertensive and mildly hypertensive subjects. (American Heart Association 2008 Scientific Sessions.)

Acute Coronary Syndrome

TIMACS: Early invasive management safe in non-ST-elevation ACS, improves outcomes in high-risk cases

Nov 11, 2008 09:00 EST

The findings appear to mandate early intervention in high-risk cases and to support the use of either an early or delayed strategy for patients considered at low to intermediate risk. (American Heart Association 2008 Scientific Sessions.)

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