CardioExchange Archive

November 17th, 2009

At the AHA:  A Challenge To Uptitrate Losartan in Heart Failure

Larry Husten, PHD

During Tuesday morning’s Late-Breaking Clinical Trials session, investigators presented results of the HEALL trial.  In this study, 3,846 patients with NYHA II-IV heart failure and LVEF ≤40% were randomized to losartan 150 mg versus 50 mg daily.  Over a median follow-up period of 4.7 years, patients in the higher-dose losartan arm had a significantly reduce […]

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November 17th, 2009

Residency work hours

Andrew M. Kates, MD

Apropos of our recent blog on work hours, see this post in the Boston Globe. What are your thoughts? If a reputable program goes on probation, how would this effect your willingness to apply? How do you feel about educational changes — including limiting conferences so that programs may be more compliant?

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November 17th, 2009

At the AHA:  Primary PCI for STEMI At Hospitals With or Without Back-Up Cardiac Surgery

Larry Husten, PHD

At the Monday morning Late-Breaking Clinical Trials Session, Dr. Ather Anis presented results of a Massachusetts-based study designed to compare outcomes for patients receiving primary PCI for STEMI at hospitals with versus without on-site cardiac surgery.  At 30 days, recurrent MI and need for revascularization were more common for patients at a hospitals without on-site […]

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November 17th, 2009

At the AHA: Antiplatelet Therapy Following CABG

Larry Husten, PHD

During the Monday afternoon Late-Breaking Clinical Trials session, results of the CASCADE (Clopidogrel After Surgery For Coronary Artery Disease) trial were presented.  The investigators randomized 113 CABG patients to aspirin plus clopidogrel versus aspirin alone.  By 1 year of follow-up, there was no significant difference in the primary endpoint of vein graft intimal area or in the secondary […]

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November 17th, 2009

At the AHA: Battling Depression Following CABG

Larry Husten, PHD

During Monday afternoon’s Late-Breaking Clinical Trials Sessions, results from the Bypassing the Blues trial were reported and simultaneously published in JAMA.  In this study, 453 patients with and without post-CABG depression were followed for 8 months.  Among patients with depression, a telephone-delivered collaborative care intervention improved quality of life, physical functioning, and mood symptoms.

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November 16th, 2009

ARBITER 6-HALTS: Will you change your practice? Will you halt your use of ezetimibe?

JoAnne M. Foody, MD

ARBITER 6-HALTS provides provocative information and suggests that niacin is the preferred secondary agent once statin therapy is maxed out in high-risk CAD patients with low HDL levels (for the study, go here; for editorials, go here and here; for a summary and analysis of the study, go here; and for a question-and-answer session with the author, go here). […]

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November 16th, 2009

At the AHA: Platelet Function Tests in Practice

Larry Husten, PHD

At the Sunday afternoon Late-Breaking Clinical Trial sessions, results from the POPULAR study were presented.  Among 1,069 patients treated with aspirin and clopidogrel at the time of PCI with stent implantation, several platelet reactivity tests were assessed in their ability to predict ischemic and bleeding outcomes.  Only three of six tests (LTA, VerifyNow, and Plateletworks) […]

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November 16th, 2009

At the AHA: Ticagrelor in STEMI

Larry Husten, PHD

During the Sunday afternoon Late-Breaking Clinical Trials session, the PLATO investigators presented results from a sub-analysis of the 8,430 patients who presented with STEMI in the main trial.  They reported that the reversible oral P2Y12-receptor antagonist, ticagrelor, was associated with reduction in the composite endpoint of MI, stroke, or vascular death when compared to clopidogrel […]

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November 15th, 2009

On PACE to Maintain LV Function

cheukmanyu and Harlan M. Krumholz, MD, SM

CardioExchange Editor:  Were the authors surprised by the magnitude of deterioration in EF seen with RVA pacing over the one year follow-up period of the study?  Could this possibly be related to the method of measurement (i.e., 3D echo) or could it be due to inappropriate pacing in patients with sinus node dysfunction?   Yu: The […]

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November 15th, 2009

Cangrelor Not Beneficial in ACS Patients Receiving Clopidogrel and PCI

Richard A. Lange, MD, MBA

In ACS patients undergoing PCI, giving cangrelor with clopidogrel did not reduce cardiac ischemic events (a composite end-point of death, MI, and ischemia-driven revascularization) compared with clopidogrel alone.       Since they both have the same antiplatelet mechanism of action (P2Y12 inhibitor), what’s the rationale for using cangrelor with clopidogrel? Clopidogrel has two major limitations: its platelet inhibition has […]

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