CardioExchange Archive

March 17th, 2011

Small Study May Help Revive Hope for Stem Cell Therapy

Larry Husten, PHD

Stem cell therapy may help reverse long-term damage after MI, according to a small, preliminary study by a group led by Joshua Hare published in Circulation: Research. Eight patients with LV dysfunction after MI received injections of autologous bone marrow progenitor cells in the LV scar and surrounding area. At one year, as assessed by […]

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March 9th, 2011

ACTIVE I Examines Role for Irbesartan in AF Patients

Larry Husten, PHD

The angiotensin-receptor blocker irbesartan does not significantly reduce cardiovascular events in patients with atrial fibrillation, according to the results of the Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE I), published in the New England Journal of Medicine. Participants had been previously randomized in the ACTIVE A trial or the ACTIVE W trial. More than 9,000 […]

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March 2nd, 2011

A DOSE of Reality: The Challenges of Comparing Effectiveness

Harlan M. Krumholz, MD, SM

An ideal paper for your next journal club — “Diuretic Strategies in Patients with Acute Decompensated Heart Failure” — was just published in NEJM, by the NHLBI Heart Failure Clinical Research Network.  In this study (called DOSE), patients hospitalized with heart failure were randomized to receive different diuretic regimens based on dose and mode of […]

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March 2nd, 2011

Questioning the DOSE

Anju Nohria, MD

Although widely used for decades, the best way to use loop diuretics in patients with acute decompensated heart failure (ADHF) has never been well studied. The Diuretic Optimization Strategies Evaluation (DOSE) study, published in the New England Journal of Medicine, randomized 308 ADHF patients to a bolus every 12 hours or a continuous infusion of furosemide at […]

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February 14th, 2011

CRT Found Beneficial in Less Severe Heart-Failure Patients

Larry Husten, PHD

Cardiac resynchronization therapy (CRT) appears to be beneficial in patients with less severe heart failure (NYHA class I and II), according to a new systematic review published online in Annals of Internal Medicine. In a previous analysis, Nawaf Al-Majed and colleagues had found that CRT was highly beneficial in HF patients with NYHA class III and IV […]

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February 9th, 2011

Trial Finds Benefit in Wireless Pulmonary Artery Monitoring in HF

Larry Husten, PHD

Results of a new trial suggest that an implanted device that provides continuous wireless sensing of pulmonary artery pressures can reduce hospitalizations in patients with heart failure (HF). In a report published online in the Lancet, William Abraham and members of the CHAMPION (CardioMEMS Heart Sensor Allows Monitoring of Pressure to Improve Outcomes in NYHA Class III Patients) Trial Study Group randomized 550 patients […]

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January 11th, 2011

Candesartan Beats Losartan in Swedish HF Registry

Larry Husten, PHD

The Swedish Heart Failure Registry followed more than 5,000 patients treated with the angiotensin II receptor blockers (ARBs) candesartan or losartan between 2000 and 2009. According to a paper published in JAMA, survival at one year was 90% in the candesartan group compared to 83% in the losartan group. Five-year survival was 61% and 44%. […]

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January 6th, 2011

The Shame of Removing Reimbursement for End-of-Life Discussions from Health Care Reform

Barry M. Massie, BA (Harvard), MD (Columbia P&S)

My recent postings have been about heart failure mortality statistics. Dry stuff! It’s not that I am fixated on death, but yesterday, I learned that CMS (Medicare) has decided not to pay for discussions with patients about prognosis and planning end of life care. Reimbursement for such discussions was a key aspect of the health care […]

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January 6th, 2011

Bevacizumab in Breast Cancer Linked to Increase in Heart Failure Risk

Larry Husten, PHD

A meta-analysis in the Journal of Clinical Oncology suggests that bevacizumab (Avastin) significantly raises the risk for heart failure when given to patients with breast cancer. Toni Choueiri and colleagues analyzed data from 3,784 patients and found a significant increase in the incidence of heart failure among those taking bevacizumab compared with those taking placebo […]

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January 4th, 2011

Study Suggests Large Proportion of ICD Implantations Lack Firm Evidence Base

John Spertus, MD, MPH

Study Summary by Larry Husten: An analysis in JAMA of the National Cardiovascular Data Registry (NCDR) shows that a substantial proportion of ICD implantations are not supported by a firm evidence base. Sana Al-Khatib and colleagues examined data from 117,707 patients who received ICDs between January 1, 2006 and June 30, 2009, and found that […]

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