CardioExchange Archive

Dear Readers,

This year the annual Journal Watch Cardiology Top Stories feature has a new dimension. We are presenting two lists — one from us and one from you. To create the Journal Watch Cardiology 2009: Editors’ Choice list, our editors voted for the stories that they believe to be most important to you and your practices. For the Top 10 Most Read Online list, we looked at which cardiology stories were viewed most often by Journal Watch registered users and subscribers. 

Surprisingly, the lists have only one story in common — it concerns diabetes treatment in patients with coronary artery disease. The story Journal Watch users read most often discussed the number of patients who would be eligible for statin treatment if criteria suggested by the JUPITER trial results were adopted; your second most read story was about travel and venous thromboembolism. By contrast, the most important article in the editors’ opinion analyzed the use of cardiac resynchronization therapy to prevent heart failure. Overall, the most read stories demonstrate the broader primary care interests of the Journal Watch subscribers as a whole.

We hope that you will peruse these lists and see how they fit with your own assessment of the most important developments in cardiology during 2009. Some of these studies — ARBITER, for example — engendered quite a bit of controversy. You might find your own personal favorite in one of these lists or feel that some valuable pearls managed to escape our attention. Let us know what you think by commenting on this story today.

Cardiology Top Stories of 2009: Editors’ Choice

Cardiac Resynchronization Therapy to Prevent Heart Failure: Gathering Momentum
Mark S. Link, MD
MADIT-CRT findings demonstrate a benefit of resynchronization in patients with NYHA class I or II heart failure.
Reviewing: Moss AJ et al. N Engl J Med 2009 Sep 1

Directing Coronary Intervention Using Fractional Flow Reserve
Beat J. Meyer, MD
Assessing the functional relevance of an angiographic stenosis before PCI could improve safety and reduce costs.
Reviewing: Tonino PAL et al. for the FAME Study Investigators. N Engl J Med 2009 Jan 15; 360:213
Ellis SG. N Engl J Med 2009 Jan 15; 360:292

Prasugrel vs. Clopidogrel in Patients with ST-Segment-Elevation MI
Beat J. Meyer, MD
A substudy of TRITON-TIMI 38 confirms the main trial findings that prasugrel is more efficacious but might be less safe than clopidogrel.
Reviewing: Montalescot G et al. Lancet 2009 Feb 28; 373:723
Stone GW. Lancet 2009 Feb 28; 373:695

ARBITER 6-HALTS: A Surprise Knockout
Harlan M. Krumholz, MD, SM
Niacin’s clear win over ezetimibe as an adjunct to statin therapy challenges assumptions about lipid management.
Reviewing: Taylor AJ et al. N Engl J Med 2009 Nov 16

Darbepoetin α in Patients with Type 2 Diabetes, Chronic Kidney Disease, and Anemia
Paul S. Mueller, MD, MPH
The drug provides little benefit and might cause harm.
Reviewing: Pfeffer MA et al. N Engl J Med 2009 Oct 30

Treating Diabetes and Coronary Artery Disease
Harlan M. Krumholz, MD, SM
Prompt revascularization or initial medical therapy? Insulin sensitization or provision? From the BARI 2D trial, no strategy emerged a clear winner.
Reviewing: Frye RL et al. for the BARI 2D Study Group. N Engl J Med 2009 Jun 11; 360:2503
Boden WE and Taggart DP. N Engl J Med 2009 Jun 11; 360:2570

Can Thienopyridines and Proton-Pump Inhibitors Peacefully Coexist?
Harlan M. Krumholz, MD, SM
An observational analysis of trial data confirms the functional interaction but provides no evidence of adverse clinical effects.
Reviewing: O’Donoghue ML et al. Lancet 2009 Sep 1

Surgical Ventricular Reconstruction: Function Fails to Follow Form
Harlan M. Krumholz, MD, SM
This procedure did not improve clinical outcomes in CABG patients.
Reviewing: Jones RH et al. for the STICH Hypothesis 2 Investigators. N Engl J Med 2009 Mar 29
Eisen HJ. N Engl J Med 2009 Mar 2

Exercise Training in Patients with LV Systolic Dysfunction
Frederick A. Masoudi, MD, MSPH
Data from a large randomized trial demonstrate that exercise therapy is safe, but the health gains are modest.
Reviewing: O’Connor CM et al. JAMA 2009 Apr 8; 301:1439
Flynn KE et al. JAMA 2009 Apr 8; 301:1451

Which Revascularization Strategy is Best for Severe Coronary Artery Lesions?
Howard C. Herrmann, MD
Results of the SYNTAX trial failed to show that PCI is noninferior to CABG in patients with 3-vessel or left main disease.
Reviewing: Serruys PW et al. for the SYNTAX Investigators. N Engl J Med 2009 Feb 18
Lange RA and Hillis LD. N Engl J Med 2009 Feb 18

Cardiology Top Stories of 2009: Most Read

Who Might Be Eligible to Receive Statins for Primary Prevention?
JoAnne M. Foody, MD
Roughly four out of five older Americans might, according to results of the JUPITER trial.
Reviewing: Spatz ES et al. Circ Cardiovasc Qual Outcomes 2009 Jan; 2:41

Travel and Venous Thromboembolism
Joel M. Gore, MD
Results of a meta-analysis showed a significant elevation in risk that increased with the duration of the journey.
Reviewing: Chandra D et al. Ann Intern Med 2009 Aug 4; 151:180

Statins for Primary Prevention: Homing in on Effectiveness
Harlan M. Krumholz, MD, SM
A new meta-analysis bolsters the case for benefit.
Reviewing: Brugts JJ et al. BMJ 2009 Jun 30; 338:b2376

Nonsteroidal Anti-Inflammatory Drug Use in Patients with Heart Failure
Frederick A. Masoudi, MD, MSPH
Compelling evidence for avoiding NSAIDs underscores the challenges of pain management in these patients.
Reviewing: Gislason GH et al. Arch Intern Med 2009 Jan 26; 169:141

You’ll Faint When You See the Bill
Frederick A. Masoudi, MD, MSPH
The most expensive tests for evaluating syncope usually don’t influence diagnosis or management, and the least expensive — and most useful — test is underused.
Reviewing: Mendu ML et al. Arch Intern Med 2009 Jul 27; 169:1299

Proton Pump Inhibitors and Clopidogrel: Bad Company?
JoAnne M. Foody, MD
In a large observational cohort of ACS patients, this drug combination was associated with poorer outcomes than was clopidogrel alone.
Reviewing: Ho PM et al. JAMA 2009 Mar 4; 301:937

A Closer Look at Aspirin for Primary Prevention
Harlan M. Krumholz, MD, SM
A meta-analysis of individual patient data from six trials uncovers no clear benefit.
Reviewing: Collins R et al. for the Antithrombotic Trialists’ (ATT) Collaboration. Lancet 2009 May 30; 373:1849
Algra A and Greving JP. Lancet 2009 May 30; 373:1821

Vitamin K for Warfarin-Induced Hypocoagulation
Joel M. Gore, MD
Low-dose vitamin K conferred no more clinical benefit than placebo, despite lowering INRs more rapidly.
Crowther MA et al. Ann Intern Med 2009 Mar 3; 150:293

Treating Diabetes and Coronary Artery Disease
Harlan M. Krumholz, MD, SM
Prompt revascularization or initial medical therapy? Insulin sensitization or provision? From the BARI 2D trial, no strategy emerged a clear winner.
Reviewing: Frye RL et al. for the BARI 2D Study Group. N Engl J Med 2009 Jun 11; 360:2503
Boden WE and Taggart DP. N Engl J Med 2009 Jun 11; 360:2570

TIPS for Reducing Cardiovascular Risk
JoAnne M. Foody, MD
In a large feasibility trial, one small pill had favorable effects on many important risk markers.
Reviewing: Yusuf S et al. for The Indian Polycap Study (TIPS). Lancet 2009 Mar 30
Cannon CP. Lancet 2009 Mar 30