CardioExchange Archive

March 12th, 2010

Friday March 12: Plavix Gets a Black Box

Larry Husten, PHD

The FDA has added a black box warning to the Plavix (clopidogrel) label. The black box warns about people “who do not effectively metabolize the drug… and therefore may not receive the full benefits of the drug.” The warning also informs healthcare professionals about tests that can identify the underlying genetic differences in clopidogrel metabolism […]

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March 11th, 2010

Thursday, March 11 News: Blood Pressure Variability Subject of 4 Simultaneous Papers in Lancet and Lancet Neurology

Larry Husten, PHD

Interest in blood pressure variability is likely to rise considerably with the publication of four simultaneous papers on the subject by Oxford’s Peter Rothwell in the Lancet and Lancet Neurology. Rothwell points out that by relying on traditional assessment of mean systolic blood pressure, researchers have been unable to fully understand the contribution of blood pressure to stroke […]

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March 11th, 2010

Low Diagnostic Yield of Elective Coronary Angiography

Richard A. Lange, MD, MBA

According to a recent study, of almost 400,000 patients referred for elective coronary angiography, only 38% had obstructive CAD.  Those with a positive noninvasive test before angiography were only moderately more likely to have obstructive CAD than those who did not undergo any testing (41% vs 35%, respectively).  However, in a comment in Journal Watch, […]

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March 10th, 2010

Is the Patient-Selection Process for Cardiac Cath Broken?

Pamela S. Douglas, MD

We welcome Pamela S. Douglas, MD, to answer our questions about her research team’s NEJM study on the diagnostic yield of coronary angiography. We encourage you to ask yours.   Background: In this observational study of the CathPCI database of the National Cardiovascular Data Registry (NCDR), 38% of about 400,000 patients without known coronary artery […]

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March 10th, 2010

Wednesday, March 10 News Roundup: Low Diagnostic Yield for Angiography; Is Acute MI Disappearing?

Larry Husten, PHD

Low Diagnostic Yield for Angiography: Coronary angiography as practiced in the U.S. has a startlingly low diagnostic yield, according to an important new study by Patel et al. in the New England Journal of Medicine using data from the ACC National Cardiovascular Data Registry. In 398,978 patients undergoing elective catheterization who did not have known coronary artery […]

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March 9th, 2010

Which Focus for Statin Therapy: Treat More Patients or Ensure Better Adherence?

JoAnne M. Foody, MD

Millions of people who take statins to reduce their cholesterol levels do not adhere to their prescribed regimens. That’s troubling in light of estimates from a recent analysis of data from more than 40,000 participants in the Melbourne Collaborative Cohort Study. It showed that if the percentage of patients with at least 80% adherence to […]

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March 9th, 2010

Tuesday, March 9 News Roundup: Clopidogrel After DES, Obama’s Calcium Scan

Larry Husten, PHD

Clopidogrel After DES: In a retrospective analysis of more than 9,000 patients who received a drug-eluting stent, Petersen et al. found that at 12 months, high use of clopidogrel was associated with a significant reduction in the risk of death or nonfatal MI but at the cost of more bleeding. Low use of clopidogrel was […]

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March 9th, 2010

Monday, March 8 News: What is the “Warranty” for Zero Calcium? 

Larry Husten, PHD

Zero Calcium: What is the “warranty period” for a zero calcium score? Min et al. studied 422 people who had a normal calcium scan (CAC=0) and who then received annual screens. One quarter of the patients had a subsequent calcium score >0 within 5 years, according to the report in the Journal of the American […]

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March 8th, 2010

Cardiology in the Big Tent
Helping our fellows make the most of a national meeting

James De Lemos, MD

Click here to see this blog, originally posted on December 2, 2009.

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March 4th, 2010

Thursday, March 4 News: Apixaban Advances

Larry Husten, PHD

Apixaban, a new factor Xa inhibitor under development, was compared with enoxaparin for thromboprophylaxis following knee replacement surgery in the ADVANCE-2 trial. The new report appears in the Lancet. In the primary efficacy analysis, the primary outcome — the composite of asymptomatic and symptomatic deep vein thrombosis, nonfatal pulmonary embolism, and all-cause death during treatment — was reached in 15% […]

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