CardioExchange Archive

August 8th, 2012

Selections from Richard Lehman’s Literature Review: August 8th

Richard Lehman, BM, BCh, MRCGP

This week’s topics include heart failure and depression, endoscopic vs. open vein-graft harvest for CABG, linagliptin vs. glimepiride in those with type-2 diabetes, weight gain with smoking cessation, ACE inhibitors and pneumonia risk, and the effect of speech therapy after stroke.

---

July 16th, 2012

Selections from Richard Lehman’s Literature Review: July 16th

Richard Lehman, BM, BCh, MRCGP

This week’s topics include studies on rhythm vs. rate control in AF, thiazolidinediones and the risk for macular edema, and the effect of acadesine on morbidity and mortality associated with CABG.

---

May 15th, 2012

No Benefit Found for Exercise Echocardiography in Asymptomatic Patients Following CABG Or PCI

Larry Husten, PHD

Routine exercise echocardiography in asymptomatic patients after revascularization does not lead to better outcomes, according to a new study published in Archives of Internal Medicine. Although guidelines generally discourage the practice, post-revascularization stress tests are still commonly performed. Serge Harb and colleagues performed exercise echocardiography on 2105 patients after CABG surgery or PCI and followed them […]

---

May 14th, 2012

Revascularization in New York State: High Questionable Rates for PCI but Not CABG

Larry Husten, PHD

A large study looking at real-world use of elective coronary artery bypass surgery (CABG) and stenting (PCI) in New  York State finds that nearly two thirds of PCI procedures have inappropriate or uncertain indications. By contrast, 90% of CABG procedures were deemed appropriate and 1.1% inappropriate. In a paper published in the Journal of the American College […]

---

April 23rd, 2012

Selections from Richard Lehman’s Literature Review: Week of April 23rd

Richard Lehman, BM, BCh, MRCGP

This week, Richard discusses JAMA’s coverage of patient-centered care and all things CABG in NEJM.

---

April 12th, 2012

Ascertaining ASCERT: How Well Do Registry Data Measure Up to the ‘Bedside Test’?

Øystein Horgmo, BSc

In the ASCERT observational study, stable patients (age 65 or older) with double- or triple-vessel CAD, but not left-main disease, were found to have better long-term survival after CABG than after PCI. ASCERT was a laudable achievement in terms of its scope and the level of collaboration it represents. The ASCERT investigators used inverse probability weighting (propensity […]

---

March 27th, 2012

ASCERT Observational Study Finds Long-Term Advantage for CABG over PCI in High-Risk Cases

Larry Husten, PHD

A very large observational study finds that long-term mortality in high-risk patients is lower after bypass surgery than after PCI. The results, which were first revealed in January at the annual meeting of the Society of Thoracic Surgeons (STS), were presented in final form at the American College of Cardiology by William Weintraub and published simultaneously in the New England […]

---

February 8th, 2012

(In)Appropriate PCI: An (In)Appropriate Critique?

Richard A. Lange, MD, MBA and L. David Hillis, MD

According to a recently published study by Chan and colleagues, only 50% of the PCIs performed for nonacute indications were classified as appropriate, according to appropriate use criteria (AUC); 38% were “uncertain,” and 12% were inappropriate. In a new expedited publication, Marso and colleagues  retort by expressing concerns with the “current” PCI AUC (see also our CardioExchange news coverage here). […]

---

February 8th, 2012

Two Different Perspectives on the CABG Versus PCI Message in ASCERT

Fred H Edwards, MD, MS, Richard A. Lange, MD, MBA and L. David Hillis, MD

At the recent meeting of the Society of Thoracic Surgeons (STS), Fred Edwards presented the high-risk subset of ASCERT (ACCF-STS Database Collaboration on the Comparative Effectiveness of Revascularization Strategies). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to Edwards and Christopher White, the president of the Society for Cardiovascular Angiography and Interventions (SCAI). Rick Lange and David […]

---

January 31st, 2012

Appropriate Use Criteria for Revascularization Updated

Larry Husten, PHD

The ACC, AHA, and other organizations have released updated appropriate use criteria for coronary revascularization. The 2012 Appropriate Use Criteria for Coronary Revascularization Focused Update incorporates data from the SYNTAX trial on the indications for PCI and CABG in patients with symptomatic, multivessel disease, as well as data from the CathPCI registry. Here are some of the key ratings: […]

---