After a Decade, CABG Pulls Ahead of Meds for HF

–Life-saving benefit of CABG now clear in long-term trial follow-up Finally, after 10 years of follow-up, the life-saving benefits of coronary artery bypass graft (CABG) surgery in heart failure patients with coronary artery disease are clear. More than 15 years ago, the NIH funded the original STICH trial to answer a question that was already…

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Study Uncovers Confusion About When To Use An Important Heart Test

Appropriate use criteria (AUC) are designed to help make sure that medical procedures and interventions are performed in people most likely to benefit and, in turn, are not performed in people unlikely to gain benefit. Now a new study published in Annals of Internal Medicine suggests that the AUC for one very widely performed procedure, diagnostic cardiac catheterization, can provide…

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Nonobstructive Coronary Artery Disease Linked to Elevated Risk

A large number of people who undergo elective coronary angiography are found to have nonobstructive coronary artery disease, and these patients have significantly increased risk for myocardial infarction and death, according to a retrospective study published in JAMA. … Click here to read the full post on Forbes.    …

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Stents Lose In Comparisons With Surgery And Medical Therapy

Despite the enormous increase in the use of stents in recent decades, there is little or no good evidence comparing their use to the alternatives of CABG surgery or optimal medical therapy in patients also eligible for these strategies. Now two new meta-analyses published in JAMA Internal Medicine provide new evidence that the alternatives to PCI remain attractive…

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The Good, The Bad, And The Ugly: Stents In The News

Three big stent stories were in the news today. You’d never know that all 3 were about the same topic.   The Ugly   The ugly side of stents is emphasized in David Armstrong’s Bloomberg News story on Mehmood Patel, the Louisiana interventional cardiologist serving a 10-year prison sentence for Medicare fraud. These days Patel “leads health-conscious inmates on…

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Younger Women With Acute Coronary Syndromes Less Likely To Have Classic Chest Pain

Younger women with an acute coronary syndrome are slightly less likely than men to present with the classic symptom of chest pain, according to a new study published in JAMA Internal Medicine. In recent years there has been a growing understanding that women with ACS are less likely to have chest pain and, partly as a result,…

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Large Study Finds Genetic Links To Aortic Valve Calcification

A genetic component is believed to play an important role in valvular heart disease, but the specific genes involved have not been identified. Now an interntional group of researchers has identified genetic variations that increase the risk for valvular calcification. In a paper published in the New England Journal of Medicine, members of the Cohorts for Heart and…

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Autopsy Studies Find Large And Dramatic Drop In Early Atherosclerosis Over 60 Years

Service members who died over the past decade were far less likely to have atherosclerosis than service members who died in Korea or Vietnam, according to a new study published in JAMA. Although it is impossible to fully understand the causes and implications of the finding, the results provide powerful new evidence pointing toward a very…

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Comprehensive Guidelines for Stable Ischemic Heart Disease Released

New comprehensive guidelines for the diagnosis and treatment of stable ischemic heart disease have been released by the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines, along with the American College of Physicians (ACP), American Association for Thoracic Surgery (AATS), Preventive Cardiovascular Nurses Association (PCNA), Society for Cardiovascular Angiography and…

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Meta-Analysis Finds No Advantages for PCI Over Medical Therapy in Stable Patients

Patients with stable coronary artery disease (CAD) today do no better with stents than with medical therapy, according to a new meta-analysis published in the Archives of Internal Medicine. Kathleen Stergiopoulos and David Brown identified 8 trials with 7,229 patients comparing stents to medical therapy in which stents were used in the majority of PCI cases. ”By limiting…

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FDA Approves Medtronic’s Resolute Drug-Eluting Stent for Treatment of CAD, Including Diabetics

The FDA has approved the Medtronic Resolute zotarolimus-eluting stent for the treatment of coronary artery disease. The Resolute DES is approved for use in a wide variety of patients, including diabetics. The new stent uses the same drug-and-polymer combination as the popular Resolute Integrity DES. The Resolute clinical trial program enrolled more than 5,000 patients worldwide, a…

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The Y Chromosome May Explain Why Men Have Earlier Coronary Disease

The earlier onset of coronary artery disease in men has long provoked speculation and research. Now a new study in the Lancet suggests that common variations in the Y chromosome (which is transmitted directly from father to son and does not undergo recombination) may play an important role in the increased risk seen in men. Using…

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CT Angiography Found Less Helpful in Patients With High Calcium Scores

Computed tomography angiography (CTA) has been proposed as a less invasive method to exclude obstructive coronary artery disease (CAD), but no consensus has been achieved about its clinical role in different patient subsets. Now a new report published in JACC from the CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) study shows that CTA may not…

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New Enrollment in FAME II Halted After Interim Analysis Shows Benefits of FFR

Following a positive interim analysis showing that fractional flow-reserve-guided PCI was superior to optimal medical treatment, an independent Data and Safety Monitoring Board (DSMB) has recommended that patient enrollment in the ongoing FAME II trial  be stopped. The news was announced by the trial sponsor, St. Jude Medical. FAME II (Fractional Flow Reserve-Guided Percutaneous Coronary Intervention Plus Optimal…

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Study Finds MR Superior to SPECT, But Clinical Role Is “Uncertain”

Authors of a new study published online in the Lancet state that multiparametric cardiovascular magnetic resonance (CMR) is superior to single-photon emission computed tomography (SPECT) in patients with suspected coronary heart disease (CHD). But at least one expert states that the future role of the technique in clinical practice remains “uncertain.” John Greenwood and colleagues compared…

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