CardioExchange Archive

September 27th, 2010

Carotid Endarterectomy Still Beneficial At 10 Years

Larry Husten, PHD

Carotid endarterectomy (CEA) in asymptomatic patients under 75 years of age reduces the long-term risk of stroke, according to 10-year results from the Asymptomatic Carotid Surgery Trial (ACST), published in the Lancet. The ACST investigators randomized 3120 asymptomatic patients to immediate CEA or to indefinite deferral of CEA. At 5 years, CEA had been performed […]

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September 27th, 2010

Promising Results for New DES in Peripheral Disease

Larry Husten, PHD

A new drug-eluting stent designed to treat peripheral disease showed promising results in the largest trial yet of endovascular treatment in this population. The 12-month results of the Zilver PTX randomized trial comparing a novel paclitaxel-eluting stent versus balloon angioplasty and bare-metal stenting in patients with symptomatic above-the-knee femoropopliteal artery disease were presented at TCT2010 by Michael Dake. […]

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August 31st, 2010

Positive Results for Rivaroxaban in EINSTEIN-DVT

Larry Husten, PHD

The EINSTEIN-DVT study tested the effect of the new oral anticoagulant rivaroxaban in the setting of DVT. The open-label, non-inferiority study randomized more than 3,400 patients with acute, symptomatic DVT to either oral rivaroxaban or conventional therapy with enoxaparin followed by warfarin or acenocoumarol for 3, 6, or 12 months, based on the attending physician’s […]

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August 20th, 2010

A “Good” Heart…

John Mandrola, MD, FACC

John Mandrola, an electrophysiologist and avid cyclist, usually writes about cycling in the Wednesday posts to his blog, Dr. John. Here he examines how antagonism relates to carotid thickness. This Wednesday, it will be easy to combine cycling and medicine. When I saw this study that linked antagonistic personality traits and cardiovascular risk, it was simply impossible […]

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August 9th, 2010

FDA Issues Warning About Inferior Vena Cava Filters

Larry Husten, PHD

The FDA has issued an initial communication informing health professionals that it is evaluating reports of adverse events with the long-term use of inferior vena cava (IVC) filters. The FDA “recommends that implanting physicians and clinicians responsible for the ongoing care of patients with retrievable IVC filters consider removing the filter as soon as protection […]

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June 10th, 2010

Bleeding Avoidance Strategies in PCI

Steve Marso, MD

CardioExchange welcomes Dr. Steven Marso to answer questions about his recent paper in JAMA, which analyzed data from 1.5 million PCI patients from hospitals enrolled in the National Cardiovascular Data Registry (NCDR) to examine the use of bleeding-avoidance strategies. Manual compression was used in 35% of cases, vascular closure devices (VCDs) in 24%, bivalirudin in […]

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June 4th, 2010

Carotid  Stenosis: Stent, Remove or Don’t Touch?

Richard A. Lange, MD, MBA

The Carotid Revascularization Endarterectomy vs. Stenting Trial (CREST) compared carotid stenting with endarterectomy in patients with symptomatic or asymptomatic carotid stenoses. The risk of the composite primary outcome — stroke, MI, or death — was similar for both treatments over the 2.5 years of follow-up. What’s the nitty gritty? Periprocedural stroke was more likely after stenting, […]

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May 27th, 2010

The Tests Say Intervene, but the Patient Feels Fine

Anju Nohria, MD and James Fang, MD

A 58-year-old asymptomatic man with hypertension and hyperlipidemia was noted to have an abnormal electrocardiogram during his routine annual physical examination. His primary care physician ordered a treadmill stress test. The patient exercised for 6 minutes and 39 seconds of a standard Bruce protocol, achieving 8.1 METs. He stopped because of dyspnea. His heart rate increased […]

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May 26th, 2010

Do Hundreds of Left Atrial Burns Reduce Dementia Risk?

John Mandrola, MD, FACC

CardioExchange welcomes this guest post reprinted with permission from Dr. John M, a blog by private-practice electrophysiologist and CardioExchange member, Dr. John Mandrola. “No data are better than bad data…If you can’t see it, don’t call it,” Dr Feigenbaum often admonished us young fellows during the old Thursday Echo conference at IU. Calling more than is actually there seems […]

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May 13th, 2010

All this talk about migraines and PFO closure is giving me a headache!

Richard A. Lange, MD, MBA

Despite a previous randomized trial showing no improvement in migraine headaches with PFO closure, a new study disputes these findings. In patients with refractory migraines (aura in 80%) and at high risk of right-to-left shunting (all had an atrial septal aneurysm, eustachian valve, large shunt, and coagulation abnormalities), PFO closure significantly improved migraine symptoms. Howie Herrmann is […]

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