CardioExchange Archive

November 6th, 2009

This May Be of Interest…

Andrew M. Kates, MD

Along with James, I would like to welcome you to this new endeavor. One of our goals for this site is to provide fellows with access to important articles — be they cutting-edge technology or reviews of important issues within cardiology — from a wide array of sources. We may refer to stories from various journals as well as the other areas of CardioExchange. On the prevention […]

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November 4th, 2009

What, Me Worry? Radiation Exposure from Medical Imaging

Brahmajee Kartik Nallamothu, MD, MPH

Three weeks ago, Cedars-Sinai Medical Center in Los Angeles revealed that since February 2008, 206 patients undergoing CT brain perfusion scans at their hospital routinely received radiation doses 8 times what they should have been. The hospital only became aware of the problem after a patient complained of patchy hair loss. The good news is that […]

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November 4th, 2009

Have We Been Off Track With Off-Pump CABG?

Richard A. Lange, MD, MBA

Off-pump CABG has been heralded as being superior to on-pump CABG, with the contention that it reduces the occurrence of the dreaded complications of cardiopulmonary bypass (stroke and neurocognitive deficits) and utilizes fewer medical resources.  However, the data supporting this contention are scant.   Now, a large randomized study of off-pump versus on-pump CABG in […]

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November 4th, 2009

Forget aspirin in primary prevention?

JoAnne M. Foody, MD

Recent studies (e.g., Drug and Therapeutics Bulletin 2009;47:122; Lancet 2009; 373:1849; BMJ 2008; 347:a1840) suggest that aspirin confers no benefit whatsoever in primary prevention of cardiovascular disease. The more we explore this issue, the more it appears that only individuals at intermediate or high risk are likely to benefit. We know that data in women […]

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November 4th, 2009

Aspirin for Primary Prevention ‘Should Not Be Routinely Initiated’

Larry Husten, PHD

Aspirin “should not be routinely initiated” for the primary prevention of cardiovascular disease, and for patients already taking aspirin, its use should be reviewed, advises the BMJ publication Drug and Therapeutics Bulletin. After considering the recommendations of several meta-analyses, the authors conclude that the available evidence “does not justify the routine use of low-dose aspirin […]

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November 4th, 2009

Darbepoetin—Trick or Treat? Part I

martingallagher and Brahmajee Kartik Nallamothu, MD, MPH

(SEE PART II OF SERIES) When the FDA approved the use of recombinant erythropoietin for patients with renal disease in 1989 it was based upon the ability of this agent to reduce the need for blood transfusion, increase patient’s exercise tolerance and improve quality of life. At the time, the perceived risk of blood transfusion […]

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November 3rd, 2009

Does coronary revascularization make noncardiac surgery safer?

Richard A. Lange, MD, MBA

Does coronary revascularization make noncardiac surgery safer?  If so, when?   On the cardiology consult service today, we evaluated a man who needs a “low risk” gastrointestinal surgical procedure urgently.  He presented to hospital admission with a prolonged hypotensive episode associated with anterior ST depression and mildly elevated troponin levels and without chest pain. He had […]

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November 2nd, 2009

Calling All Fellows and Fellowship Directors

James De Lemos, MD

Welcome to the fellows’ group on CardioExchange! Andy Kates is the fellowship director at Washington University, and I am the director at UT Southwestern; together, we are moderating this section of the website. We are excited about working with you! I also confess to some apprehension, as I tend to be a slow adopter of […]

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November 2nd, 2009

Genetic Testing in Unexplained Thrombosis – Part I

Harlan M. Krumholz, MD, SM

The case. (For an expert’s response, see Part II) A very healthy 44-year-old man who engaged in daily vigorous physical activity suddenly developed shortness of breath and pleuritic chest pain. He was quickly diagnosed with multiple pulmonary emboli. He was not overweight and had no recent history of long trips, injuries, periods of bed rest, […]

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October 31st, 2009

2009 ACCF/AHA Guidelines More Conservative on Perioperative Beta-Blockade

Larry Husten, PHD

The ACCF/AHA have released a focused guidelines update that takes a more conservative stance on perioperative use of beta-blockade in patients undergoing noncardiac and vascular surgery.

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