CardioExchange Archive

April 18th, 2012

Selections from Richard Lehman’s Literature Review: Week of April 16th

Richard Lehman, BM, BCh, MRCGP

This week’s topics include an “awful question” about statin therapy, coronary computed tomographic angiography in the ED, vorapraxar for secondary prevention, and stent wars.

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April 11th, 2012

Study Evaluates Losartan Efficacy in Heart Failure

Larry Husten, PHD

The angiotensin II-receptor blocker (ARB) losartan has labored under the perception that it is not as potent as other ARBs, and some evidence has suggested that it may not confer the same clinical benefits as other ARBs in heart failure patients. In a paper from Denmark published in JAMA, Henrik Svanström and colleagues performed a country-wide registry study […]

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March 19th, 2012

Questions Raised About Antiplatelet Therapy in Chronic Kidney Disease

Larry Husten, PHD

Many people develop chronic kidney disease (CKD) as they grow older, and many people with CKD take antiplatelet agents to prevent cardiovascular events. However, the efficacy of antiplatelet therapy in CKD has not been examined, despite the fact that people with CKD are more likely to die from nonatherosclerotic conditions and are more likely to […]

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March 6th, 2012

Shared Decision Making in Advanced Heart Failure

Larry Allen, MD, MHS

Larry Allen is the lead author and co-chair of the AHA Scientific Statement on Decision Making in Advanced Heart Failure. Patient-centered care ensures that clinical decisions are guided by an individual patient’s values, needs, and preferences; shared decision making is the act of putting this type of care into clinical practice by asking health care providers […]

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February 22nd, 2012

What’s Good for the Goose Is Good for the … Swan?

Tariq Ahmad, MD, MPH

A colleague of mine who is a cardiology fellow recently made this confession: “I really love doing procedures. I can’t wait until the new patient gets here so we can Swan him.” Playing devil’s advocate, I asked: “Would you want to be ‘Swanned’ if you were admitted to the CCU?” Astonished, she replied, “Of course not. I […]

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February 15th, 2012

Mortality-Risk Calculators for AMI and Heart Failure Patients

Harlan M. Krumholz, MD, SM

Two mortality-risk calculators ­– one for patients with acute MI and another for those with heart failure – are now available for free at www.mortalityscore.org. The calculators are based on risk models produced by our research group at Yale for the Center for Medicare and Medicaid Services (CMS). The models are derived from Medicare administrative-claims […]

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January 3rd, 2012

Measuring In-Hospital Mortality Favors Hospitals with Short Stays

Larry Husten, PHD

As a measure of performance and quality, in-hospital mortality systematically favors hospitals with shorter overall length of stay (LOS) times, according to a new study published in Annals of Internal Medicine. This finding may have important implications for quality improvement initiatives that use mortality as a performance measure. Elizabeth Drye and colleagues (including senior author Harlan Krumholz, editor-in-chief […]

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December 28th, 2011

No Mortality Benefit of Low-Molecular-Weight Heparin in Acutely Ill Patients

Larry Husten, PHD

Although venous thromboembolism (VTE) is a serious problem for acutely ill patients in the hospital, a new study published in the New England Journal of Medicine failed to find any improvement in mortality associated with thromboprophylaxis. Ajay Kakkar and the LIFENOX investigators randomized 8307 acutely ill patients to receive enoxaparin or placebo for 10 days. All patients wore elastic […]

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December 22nd, 2011

A New Brave New World? Impact of Technology on Fellowship Training

John Ryan, MD

Last week, CardioMEMS failed to get approval from an FDA advisory panel for treating heart failure based on uncertainty regarding the benefit;  the advisory panel also raised concerns about study bias. This intracardiac device measures pulmonary artery pressures that clinicians can use (in addition to other clinical signals, such as weight gain) to select therapies […]

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December 19th, 2011

FDA Adds New Warnings to Dronedarone (Multaq) Label

Larry Husten, PHD

In an updated safety communication, the FDA announced on Monday that it is adding new warnings  to the dronedarone (Multaq, Sanofi) label. On the basis of results from the PALLAS trial, which was discontinued early due to safety concerns, the drug label will now warn: Healthcare professionals should not prescribe Multaq to patients with AF who cannot […]

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