CardioExchange Archive

April 7th, 2010

Elevated Glucose Levels and IV Contrast Deliver a Double Hit to Renal Function

mikhailkosiborod

Hyperglycemia before coronary angiography raises the risk for contrast-induced, acute kidney injury (CI-AKI). My colleagues and I reached this conclusion in an investigation of the relationship between pre-procedural glucose levels and CI-AKI in 6,358 patients who underwent coronary angiography during hospitalization for MI. We found found a high risk for CI-AKI among those patients who had pre-procedural hyperglycemia but […]

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April 6th, 2010

• Dronedarone Data Duel

Larry Husten, PHD

Dronedarone Data Duel: Two separate papers in the Journal of the American College of Cardiology offer starkly contrasting views on the role of dronedarone in clinical practice. In a viewpoint and commentary, David Singh and colleagues review the dronedarone data and conclude that although dronedarone “has the ability to control both rhythm and rate” in AF patients, […]

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April 6th, 2010

It’s springtime….that must mean it’s time for that speed dating game we call the fellowship match

James De Lemos, MD

Every year around this time I spend hours thinking about what qualities go into making a good fellow and, equally important, how to figure out if an applicant has these qualities. When we review applications, we have only a few pieces of objective information such as academic pedigree, board scores, and publications; the rest is highly subjective half-truths from the personal […]

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April 5th, 2010

• Update on IMPROVE-IT
• Olympic Hearts

Larry Husten, PHD

Update on IMPROVE-IT: IMPROVE-IT is the much anticipated and highly controversial ongoing study evaluating ezetimibe. In response to the controversy over the drug (see, for example, here and here), and to address the questions that “have been raised about whether the trial will be completed,” the trial investigators have written an editorial that has now been published online […]

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April 1st, 2010

Alcohol or the Knife?

L. David Hillis, MD

Your patient with symptomatic obstructive hypertrophic cardiomyopathy is faced with a choice and asks, “If it were you, would you have alcohol ablation or myectomy?” Recent U.S. studies show that alcohol ablation is safe and effective (i.e., low complication rate, durable hemodynamic effects, and good long-term survival), whereas European studies suggest it is not (due […]

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April 1st, 2010

• Atrial Fibrillation and Dementia Linked
• Predicting Mortality after PCI

Larry Husten, PHD

Atrial Fibrillation and Dementia Linked: The aging of the population will be accompanied by inevitable increases in the incidence of diseases like dementia and atrial fibrillation (AF). Now an epidemiologic study of more than 37,000 consecutive patients from the Intermountain Heart Collaborative Study has found that AF is independently associated with all types of dementia. […]

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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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March 31st, 2010

New York Times Orbits JUPITER

Larry Husten, PHD

A front page story in Wednesday’s New York Times questions the expanding use of statins, and particularly rosuvastatin, in “healthy people.” Following the recent approval of broad new indications for the drug based on results from the JUPITER trial, Times reporter Duff Wilson notes that millions of people may now take the drug “largely as prevention” and that some […]

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March 30th, 2010

• FDA Issues Complete Response Letter For Certriad
• U.K.’s NICE Goes Easier on Dronedarone
• U.S. Justice Dep’t & SEC Look Into Boston Scientific ICD Recall

Larry Husten, PHD

FDA Issues Complete Response Letter For Certriad: The FDA issued a complete response letter for the NDA for Certriad, Abbot’s and AstraZeneca’s combination pill composed of rosuvastatin and fenofibric acid delayed release. The companies did not release any details of the letter, but analysts think it will mean the drug’s approval will likely be delayed […]

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March 29th, 2010

• Screening for Type 2 Diabetes
• FDA Cracks Down on Unapproved Nitroglycerin

Larry Husten, PHD

Screening for Type 2 Diabetes: Kahn et al. used a sophisticated computer model to assess the impact of 8 different screening strategies to detect type 2 diabetes in the US. The researchers concluded that screening is cost effective when started between the ages of 30 and 45 years of age, with screening repeated every 3–5 years. The […]

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