2012 In Review: A Bad Year For Conventional Wisdom

This was a really grim year for anyone who thought we had things pretty well figured out. Time and again conventional wisdom was thrown out the window. 2012 forced the cardiology community to reconsider what it thought it knew about HDL cholesterol, platelet function tests, aspirin resistance, triple therapy, IABP, and more. One device company,…

Click here to continue reading…

2012 In Review: Social Media In Cardiology

For a whole variety of reasons most cardiologists are not really comfortable diving into social media. For some reason they’re more comfortable remaining poolside, reading Braunwald or the latest mini JACC or Circulation than writing a blog or interacting with each other or their patients on Facebook or Twitter. Most cardiologists who do get their feet wet send out a few…

Click here to continue reading…

American Heart Association Lists Top 10 Research Advances

The AHA has published its annual list of the top 10 advances in heart disease and stroke research. It’s probably worth remarking that not a single item on the list is related to drug therapy. I haven’t gone back and checked past lists, but I would bet this hasn’t happened before. Here’s the list: Extended…

Click here to continue reading…

The Dangers Of Going Too Fast

Updated– According to an editorial published online in the BMJ journal Heart, running too hard, too fast, and for too long can be dangerous. The same holds true in publishing. The editorial was hastily released ahead of its scheduled publication time after portions of it were quoted in a Wall Street Journal article on the dangers of endurance sports….

Click here to continue reading…

The Doctor At The Center Of The Insider Trading Scandal

Last week’s big insider trading case offers fresh evidence that financial interests often clash with medical ethics. Of course, the news stories were all about the juicy details of insider trading at a hedge fund based on information leaked by a key academic investigator. This is an important and shocking story. But there’s another story…

Click here to continue reading…

From Barack To Rupert, A Thanksgiving Message

Sorry for this off-topic post, but I couldn’t resist sharing this email message forwarded from a friend in Washington, DC: Thanksgiving Day, The White House Dear Rupert, I thought on this day in particular it would be appropriate for me to send a brief note expressing my gratitude for all that you did for us over…

Click here to continue reading…

Expert Consensus Document Offers Advice On Troponin Tests

A newly published document provides practical advice on the use of the popular and potent troponin tests. The Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations was developed by the American College of Cardiology Foundation in collaboration with several other societies to help address the many complex issues raised by the introduction…

Click here to continue reading…

Nonfasting Lipid Testing Gains Growing Acceptance

Although fasting before a lipid test has long been recommended, a new study and accompanying commentaries make the case that nonfasting lipid levels are acceptable and may even be superior to fasting levels for the assessment of cardiovascular risk. Investigators at the University of Calgary analyzed data from laboratory tests obtained from more than 200,000…

Click here to continue reading…

Dalcetrapib: Another HDL-Raising CETP Inhibitor Bites The Dust

Another HDL-raising CETP inhibitor has failed to demonstrate cardiovascular benefit in a large clinical trial. With the presentation of the dal-OUTCOMES trial at the American Heart Association in Los Angeles andsimultaneous publication in the New England Journal of Medicine, dalcetrapib joins torceptrapib on the list of once-promising CETP inhibitors. In dal-OUTCOMES, 15,871 patients with a recent…

Click here to continue reading…

FREEDOM Lends Strong Support To CABG For Diabetics With Multivessel Disease

Editor’s note: The embargo on FREEDOM was lifted early after a press release was published by mistake.) Diabetics with multivessel disease do better with CABG than PCI, according to FREEDOM (Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease), a large NIH-sponsored study presented at the American Heart Assocation in Los…

Click here to continue reading…

ASPIRE: Aspirin An Attractive Alternative After First VTE

It is unclear what the best approach is for the long-term treatment of people who have had a first unprovoked episode of venous thromboembolism (VTE). Although warfarin is effective at preventing a recurrence, it is inconvenient and raises the risk for bleeding. Newer anticoagulants have not been tested or approved for this population. The ASPIRE…

Click here to continue reading…

AHA 2012: Welcome to LA

The American Heart Assocation meeting gets going tomorrow. Overall the trend is toward smaller US meetings, but someone didn’t tell that to the sign department: And there’s something fishy on the buses:  …

Click here to continue reading…

Rivaroxaban Gains FDA Indications For The Treatment And Prevention Of DVT And PE

The FDA today expanded the indication for rivaroxaban (Xarelto, Johnson & Johnson) to include the treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE) and to reduce the risk of recurrent DVT and PE. The oral anticoagulant is already approved to reduce the post-surgical risk of DVT and PE  after hip and knee replacement…

Click here to continue reading…

International Cardiology Groups Push For Aggressive Public Health Goals

Cardiovascular disease is the largest cause of death in the world and accounts for almost half of all deaths from non-communicable diseases (NCDs). Earlier this year, in response to a high-level UN meeting on NCDs in 2011, the World Health Assembly set a global target  to reduce premature NCD mortality by 25% by the year 2025. Now The…

Click here to continue reading…

News Flash! Company Issues Incredibly Boring Press Release

Last week Abiomed issued a press release (reprinted below) that was about as dull as a press release can get. The main news of the press release was that the PROTECT II study testing the company’s Impella 2.5  circulatory support device had been published online in Circulation. The press release provides no details or information about…

Click here to continue reading…

Study Predicts Renal Denervation Will Be Cost Effective In Resistant Hypertension

Renal denervation (RDN) for resistant hypertension may be cost-effective and may provide long-term clinical benefits, according to a new analysis published in the Journal of the American College of Cardiology. Benjamin Geisler and colleagues developed a model to predict the impact of the Medtronic Symplicity RDN system in patients with resistant hypertension. Over 10 years,…

Click here to continue reading…

More Evidence That Omega-3 Supplements Don’t Work

Once again researchers have failed to find any clinical benefit for omega-3 supplements. In a new meta-analysis and systematic review published in JAMA, Evangelos Rizos and colleagues analyzed 20 randomized controlled trials including  68,680 patients and found no significant effect on any of the endpoints: all-cause mortality: relative risk (RR) 0.96, CI 0.91 – 1.02 cardiac…

Click here to continue reading…

FAME 2: Can FFR Save PCI From Medical Therapy?

Two sharply divergent views have developed about the value of fractional flow reserve (FFR) in PCI. FFR advocates think the new technology can help identify ischemic lesions that will benefit from PCI, thereby helping to salvage or enhance the reputation of PCI. FFR skeptics think that optimal medical therapy is still the preferred option for most…

Click here to continue reading…

The Return Of Vorapaxar, This Time For Post-MI Patients

The once highly-promising novel antiplatelet agent vorapaxar, widely thought to be dead on arrival after unacceptably high serious bleeding rates were found in two large clinical trials, has now returned to active duty. On Sunday the drug’s sponsor, Merck, announced that it would seek approval of the drug, with a narrower indication than originally planned, based on new…

Click here to continue reading…

TNF Inhibitors Linked To MI Reduction In Psoriasis Patients

Psoriasis patients who take TNF inhibitors have a significant reduction in the risk for myocardial infarction (MI), according to a retrospective cohort study published in Archives of Dermatology. Although previous research suggested that the anti-inflammatory effects of methotrexate, an older therapy, may be beneficial in this population, the cardiovascular effects of TNF inhibitors had not been well…

Click here to continue reading…

Observational Study Fills Gaps In Understanding AF Patients With Kidney Disease

Although people with atrial fibrillation (AF) and people with chronic kidney disease (CKD) are both at elevated risk for stroke and other vascular events, people with both conditions have not been well studied, since patients with CKD have been excluded from most clincial trials of stroke prevention for AF. The problem is further compounded because…

Click here to continue reading…

Guest Post: Children Should Have Their Cholesterol Checked

Editor’s Note: CardioBrief is pleased to publish this guest post written by Samuel Gidding, the head of the cardiology division at the Nemours Cardiac Center at A. I. DuPont Hospital for Children and a professor of pediatrics at Jefferson Medical College. CardioBrief invited Gidding, a member of the NHLBI panel that recommended universal lipid screening at ages 9-11…

Click here to continue reading…

Why HCA Is Like Barclays And JP Morgan

Earlier this week the New York Times reported on a pattern of seriously deficient cardiac care at a number of hospitals owned by HCA. Understandably, the most common reaction is simple disgust over more bad cardiology behavior. After the Mark Midei case, after subsequent and even worse cases in Maryland, Pennsylvania, and elsewhere, the easy thing is to…

Click here to continue reading…

TAVI: Belgian Researchers Slam Evidence Base And Overuse In Europe

The growing and enthusiastic adoption of transcatheter aortic valve implantation (TAVI) in Europe has no justification, according to three researchers who performed a health technology assessment for the Belgian government. In a paper published in BMJ, the authors from the Belgian Health Care Knowledge Centre conclude that TAVI should only be used in patients “who are…

Click here to continue reading…

Severe Blood Conservation Appears Safe In Cardiac Surgery For Jehovah’s Witnesses

Severe blood conservation in conjunction with cardiac surgery is not associated with long-term adverse consequences, according to a new study published in Archives of Internal Medicine.  Investigators from the Cleveland Clinic and the NHLBI compared 322 patients who were Jehovan’s Witnesses with an equal number of matched controls. Due to their religious beliefs Witnesses…

Click here to continue reading…