CardioExchange Archive

October 26th, 2010

Updated Appropriate Use Criteria for Cardiac CT Published

Larry Husten, PHD

An alphabet soup of medical organizations (ACCF, SCCT, ACR, AHA, ASE, etc.) have updated their appropriate use criteria for cardiac CT. The lengthy document includes an evaluation of 93 clinical scenarios and finds that cardiac CT is appropriate in 38% of them. Use of cardiac CT in the rest of the scenarios is deemed inappropriate […]

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October 4th, 2010

Gene Expression Test Brings Modest Improvement to Patient Classification

Larry Husten, PHD

A gene expression test can improve the prediction of CAD but may not be clinically useful, according to results of the Personalized Risk Evaluation and Diagnosis in the Coronary Tree (PREDICT) study published in the Annals of Internal Medicine. The PREDICT investigators, led by Eric Topol, evaluated a gene expression test based on 23 genes […]

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October 4th, 2010

Widespread Routine Use of Closure Devices Not Recommended

Larry Husten, PHD

Arterial closure devices (ACDs) “have the potential to improve patient comfort,” but the current evidence isn’t sufficient to support routine use after cardiac catheterization, according to a scientific statement from the AHA published in Circulation. Led by Manesh Patel, the committee analyzed the data and concluded that although it is “reasonable” to consider using an […]

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August 16th, 2010

Antagonistic People and Carotid Narrowing

Larry Husten, PHD

Researchers from the NIH’s National Institute on Aging studied 5,614 people in four Italian villages and found that those who scored high on a test of antagonism — particularly those who were manipulative and aggressive — were more likely than their more agreeable counterparts to have carotid thickening, as measured by carotid-artery intima media thickness, […]

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August 2nd, 2010

Framingham: Cardiac Function Linked to Brain Aging

Larry Husten, PHD

Brain age is closely associated with cardiac function, according to a new report in Circulation from the Framingham Heart Study. Angela Jefferson and colleagues collected brain MRI, cardiac MRI, neuropsychological, and laboratory data on 1504 participants in the Framingham Offspring Cohort and found a significant association between neuropsychological and brain MRI variables and cardiac index […]

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July 23rd, 2010

Radiation Exposure in Cardiac Imaging

Jersey Chen, MD MPH

CardioExchange welcomes Jersey Chen to discuss his recent study in the Journal of the American College of Cardiology , which describes radiation exposure from cardiac imaging procedures in the general population. Chen and his colleagues concluded that “cardiac imaging procedures lead to substantial radiation exposure and effective doses for many patients in the U.S.” Your paper […]

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May 27th, 2010

The Tests Say Intervene, but the Patient Feels Fine

Anju Nohria, MD and James Fang, MD

A 58-year-old asymptomatic man with hypertension and hyperlipidemia was noted to have an abnormal electrocardiogram during his routine annual physical examination. His primary care physician ordered a treadmill stress test. The patient exercised for 6 minutes and 39 seconds of a standard Bruce protocol, achieving 8.1 METs. He stopped because of dyspnea. His heart rate increased […]

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March 31st, 2010

Her Cancer Treatment Is Working, but Her Heart Is Failing

Anju Nohria, MD and James Fang, MD

The patient is a 57-year-old woman with a history of Hodgkin disease of the anterior mediastinum. Upon being diagnosed at age 26, she was treated with a staging laparotomy, splenectomy, and 36 Gy of radiation to the mantle and para-aortic areas. She did well until September 2009, when she developed increasing dyspnea on exertion, weight […]

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December 18th, 2009

Deciding When to Bridge

Anju Nohria, MD and James Fang, MD

A 61-year-old man presented with 6 hours of chest pain and ECG changes consistent with an acute anterior-wall myocardial infarction. His cardiac troponin I was 59 ng/mL. Urgent angiography revealed an occluded LAD and 70% proximal OM1, 70% proximal OM2, and 90% proximal RCA stenoses. He was taken to the catheterization laboratory, where an attempt to open the […]

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December 18th, 2009

The CT Scan Is Out of the Bag

Brahmajee Kartik Nallamothu, MD, MPH

No doubt you’ve read about the FDA’s October announcement that it was investigating more than 200 cases of excess radiation exposure — at 8 times the expected level — during perfusion CT scans of the brain at a Los Angeles area medical center. In some patients, the excess exposure resulted in hair loss and reddening of […]

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