CardioExchange Archive

November 30th, 2009

Even Very Low Levels of Cardiac Troponin T Linked to Heart Failure, Cardiovascular Death

Larry Husten, PHD

Even very low levels of cardiac troponin T are associated with increased risk for heart failure and cardiovascular death among patients with stable heart disease, according to an industry-funded study in the New England Journal of Medicine. Using a highly sensitive assay, researchers tested for troponin T in nearly 3700 adults with stable coronary artery […]

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November 29th, 2009

Return to POBA?

Harlan M. Krumholz, MD, SM

We almost never do plain old balloon angioplasty in our place anymore. To many, that technique seems so last century. We have moved on to better procedures that have made restenosis a relatively rare occurrence. We have even changed the name of the procedure. If an intern on rounds utters the word “angioplasty,” we quickly correct him or her, using the […]

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November 24th, 2009

Expand or Restrict Primary PCI?

L. David Hillis, MD

At last week’s AHA meeting, a late breaking clinical trial reported that STEMI patients in Massachusetts who underwent primary PCI at hospitals without cardiac surgery on site had similar rates of death, MI, and target vessel revascularization at 1 year as those who underwent primary PCI at hospitals with cardiac surgery on site.  In contrast, […]

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November 24th, 2009

2009 AHA/ACC Updated STEMI Guidelines Released

Richard A. Lange, MD, MBA

The release of a new update to the STEMI guidelines was announced at the AHA Scientific Sessions.  Guidelines committee members report that the update incorporates evidence from key trials that have emerged over the past two years.  Changes include a greater emphasis on organized systems of emergency care, triage and transfer for PCI, and the possible roles of stenting the […]

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November 24th, 2009

The Rescue Page — An Essential Element of Today’s Health Care Delivery System

Juan J. Rivera, MD, MHS

As the doctor begins to talk to his patient about smoking cessation, he receives the first “rescue” page. He immediately knows that he has violated — again — the 15-minute-per-patient rule, a rule that surprisingly even patients in the waiting area expect their doctors to follow. Nurses, administrators, and patients coalesce into one giant chronometer, […]

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November 24th, 2009

Pharmacist-Physician Collaboration Could Reduce BP in Hypertensive Patients

Larry Husten, PHD

A pharmacist-physician team approach to managing hypertension is “highly effective,” reports Archives of Internal Medicine. Six community-based, family medicine residency clinics were randomized to be either intervention or control sites (some 400 patients with uncontrolled hypertension were enrolled). In the intervention group, clinical pharmacists were encouraged to assess patients’ medication and blood pressure routinely, and […]

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November 23rd, 2009

AHA Roundup

Harlan M. Krumholz, MD, SM

In an unofficial survey of attendees, the most striking feature of this year’s AHA Scientific Sessions was how few attendees there were and how empty the exhibit hall was. The ARBITER study came in a somewhat distant second. With an official estimated total attendance (including exhibitors) just under 22,000, the meeting still drew a robust […]

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November 23rd, 2009

FDA Investigating Possible Link Between Sibutramine and Cardiovascular Events

Larry Husten, PHD

The FDA has issued an early communication regarding a possible increased risk for adverse cardiovascular events associated with sibutramine (Meridia), a prescription drug used to manage obesity. A postmarketing study was conducted in some 10,000 obese patients with stable heart disease or type 2 diabetes plus another risk factor. Preliminary findings show more cardiovascular events occurred […]

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November 20th, 2009

AHA Interventional Recap

Richard A. Lange, MD, MBA

The AHA Scientific Sessions in Orlando this past week certainly provided interventionists with a lot to think about. Here are some of the presentations that caught my attention: 1. Cangrelor Not Beneficial in ACS Patients Receiving Clopidogrel and PCI (see discussion here) 2. (F)Utility of Platelet Assays (see discussion here): The POPULAR trial evaluated 6 platelet assays in […]

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November 20th, 2009

Remembering to Hold the Salt

Joseph S. Ross, MD, MHS

I think we can all agree that counseling patients on diet is one of the least rewarding parts of being a doctor. Nobody likes telling adults what they can and cannot eat. And sometimes the recommendations seem so obvious that, to us, it borders on nagging. Of course patients with hypertension and heart failure should avoid salt. […]

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