CardioExchange Archive

January 21st, 2011

To Arms! Or, Maybe Not?

Richard A. Lange, MD, MBA and L. David Hillis, MD

According to a recently published opinion piece in a British cardiology journal, enthusiasm for the transradial approach over the femoral approach in primary PCI is not justified. The authors cite numerous problems with the radial approach compared with the femoral approach (i.e., up to a 10% crossover rate, prolonged procedure time, increased radiation exposure for the patient and physician) […]

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January 19th, 2011

What PROSPECT Doesn’t Tell Us

Richard A. Lange, MD, MBA and L. David Hillis, MD

The PROSPECT trial provides some interesting insights about the mechanisms of thrombotic coronary artery disease, but how, if at all, should it change practice? Here are what the findings do and do not demonstrate: What the PROSPECT study says: In ACS patients treated with PCI, major adverse cardiovascular events that occurred during a median follow-up of 3.4 years were as […]

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January 12th, 2011

Maybe TAVI Is Not All It’s Cracked Up To Be

Richard A. Lange, MD, MBA and L. David Hillis, MD

The PARTNER trial of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis was among the hottest cardiology stories of 2010.  Now that the hype is receding, some are questioning whether TAVI is ready for prime time. In three letters to the Editor of the New England Journal of Medicine, our colleagues point out that the […]

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December 21st, 2010

Rick Lange & David Hillis: Looking Back at 2010 and Ahead to 2011

Richard A. Lange, MD, MBA and L. David Hillis, MD

To celebrate the holiday season, CardioExchange asked several of our contributors to choose the 3 most important cardiology-related events of the past year and to make 3 predictions for 2011. Looking back at 2010: 1. Stenting Versus Endarterectomy for Carotid-Artery Stenosis: In patients with carotid artery stenoses, stenting and endarterectomy were associated with similar rates of the primary […]

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December 8th, 2010

The Spin on the Impella Device: PROTECTing Whom?

L. David Hillis, MD and Richard A. Lange, MD, MBA

The PROTECT II study — a prospective, multicenter, randomized, controlled comparison of the Impella cardiac assist device (produced by Abiomed) and the intra-aortic balloon pump (IABP) in patients requiring hemodynamic support during nonemergent, high risk PCI — was stopped early based on a futility determination regarding the primary endpoint at the time of planned interim analysis. What’s […]

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November 16th, 2010

What Does BASKET PROVE Have to Prove?

L. David Hillis, MD and Richard A. Lange, MD, MBA

What to make of new findings that DES are just as good as BMS for treating lesions in large coronary arteries? David Hillis and Rick Lange provide a brief tour of the relevant issues. Getting a handle on the study… Previous data suggested that the use of DES in large native coronary arteries confers no benefit and […]

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November 4th, 2010

Clopidogrel and CYP2C19: What’s All the Fuss About?

Richard A. Lange, MD, MBA and L. David Hillis, MD

You’ve heard a lot lately about so-called “clopidogrel resistance.” That sounds straightforward, but the underlying reason can be complex, possibly related to how the drug is metabolized by subjects with a certain genetic profile. We seek here to provide some perspective about clopidogrel’s metabolic and gene-related complexities. First, some brief background: Clopidogrel, a thienopyridine, is a […]

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September 23rd, 2010

Howdy, PARTNER!

Michael Mack, M.D., E Murat Tuzcu, MD, L. David Hillis, MD and Richard A. Lange, MD, MBA

CardioExchange welcomes Mike Mack and E. Murat Tuzcu, investigators for the PARTNER trial, an ongoing, randomized study of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis at high surgical risk. The first reported findings, published in the New England Journal of Medicine, showed an impressive 20% absolute reduction in 12-month mortality with […]

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August 25th, 2010

Is There a Generation Gap in Cardiology?

Larry Husten, PHD, Harlan M. Krumholz, MD, SM, L. David Hillis, MD and Andrew M. Kates, MD

A brief posting in the Wall Street Journal Health Blog on the clash of generations in the medical workplace recently caught our attention. The Blog summarizes a commentary by Sharon Phelan in Obstetrics & Gynecology, which  posits that “different attitudes about work and life held by members of different generations can create tensions and clashes in the […]

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May 27th, 2010

Should We Aim For FAME?

L. David Hillis, MD

In patients with multivessel CAD suitable for PCI, what’s the best way to determine whether a stent should be placed? Researchers in the Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) study compared outcomes when PCI with drug-eluting stents was guided by angiography alone versus angiography plus measurement of FFR. At 2 years of follow-up, routine measurement of […]

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