Warning: snark and cynicism ahead. I’ve said it before and I’ll say it again: what the world needs now is another cardiology journal. And so, as if they were reading my mind and the collective mind of the cardiology community, the AMA announced today the launch of a new journal, JAMA Cardiology. The editor-in-chief will…
Missing High Blood Pressure Guideline Turns Up In JAMA
December 18, 2013 by Leave a Comment
After years of delay and many twists and turns, the hypertension guideline originally commissioned by the NIH has now finally been published in JAMA. The evidence-based document contains a major revision of hypertension treatment targets and includes new and somewhat simplified recommendations for drug treatment. The previous US hypertension guideline was published more than a decade ago….
Behind The Curtain: Study Reveals Big Role of Medical Communication Companies
December 17, 2013 by Leave a Comment
Everyone knows that medical information flows out of medical centers and schools, research institutions and the NIH, pharmaceutical companies, journals and medical societies. But one important information source — medical communication companies (MCCs)– “are among the most significant but least analyzed health care stakeholders,” according to Sheila Rothman and colleagues. In a new report in JAMA they set out to explore…
Prolonged Dual Antiplatelet Therapy May Not Be Necessary For Second-Generation Drug-Eluting Stents
October 31, 2013 by Leave a Comment
The precise duration of dual antiplatelet therapy (DAPT) following implantation of a drug-eluting stent (DES) has been the subject of considerable controversy. On the one hand, prolonged therapy may help prevent late stent thrombosis, which was particularly evident in first generation DESs. On the other hand, the risk of stent thrombosis may have diminished in…
New Insights Into Surgery Versus Stents For Diabetics With Multivessel Disease
October 17, 2013 by Leave a Comment
Last year the large NHLBI FREEDOM trial demonstrated that bypass surgery was superior to PCI when treating diabetic patients who have multivessel coronary disease. CABG resulted in significant reductions in death and MI, but this was offset slightly by a higher rate of stroke in the CABG group. Now a new report from FREEDOM published in JAMA suggests that…
Kaiser Program Yields Big Improvements In Hypertension Control
August 20, 2013 by Leave a Comment
A large percentage of the 65 million people with high blood pressure in the United States do not know they have hypertension or have not succeeded in controlling their hypertension. Although many programs have been proposed, there is little evidence that any method can produce long term improvement in hypertension control. In a paper published in JAMA,…
Observational Study Lends Support to CRT Guidelines
August 13, 2013 by Leave a Comment
A large observational study published in JAMA suggests that patients with left bundle-branch block (LBBB) and longer QRS duration derive the most benefit from a cardiac resynchronization therapy defibrillator (CRT-D). The findings appear to support current, but often criticized, guidelines from the American College of Cardiology, American Heart Association, and the Heart Rhythm Society, in which a class I recommendation…
Study Questions Role Of Dual-Chamber ICDs For Primary Prevention
May 14, 2013 by Leave a Comment
Dual-chamber ICDs are implanted in a majority of primary prevention patients without a pacing indication who receive an ICD. Although there are a number of theoretical advantages with dual-chamber devices, these devices are more likely to cause complications. Although CMS requires providers to justify the medical necessity of dual-chamber devices, current guidelines from the AHA/ACC…
Study Suggests Benefit For Beta Blockers During Noncardiac Surgery
April 23, 2013 by Leave a Comment
The use of perioperative beta-blockade for noncardiac surgery has been declining as a result of the controversial POISE study, which turned up evidence for harm associated with extended-release metoprolol in this setting. Now a large new observational study published in JAMA offers a contrary perspective by suggesting that perioperative beta-blockade may be beneficial in low-…
A Guide To The Raging Debate Over The NIH’s TACT Chelation Trial
April 2, 2013 by 7 Comments
(Updated) The publication in JAMA of the NIH’s Trial To Assess Chelation Therapy (TACT) trial has provoked a fascinating debate in the blogosphere. The vast majority of responsible physicians and healthcare professionals have little interest in chelation therapy per se, but the TACT trial has raised many important questions about the nature of medical evidence. Here’s a brief…
Controversial NIH Chelation Trial Published In JAMA
March 26, 2013 by Leave a Comment
Final results of the troubled NIH-sponsored TACT trial testing chelation therapy for coronary disease have now been published in JAMA. Last November, when the preliminary results were presented at the American Heart Association meeting, the positive finding in favor of chelation therapy surprised many observers, though the investigators and senior AHA representatives expressed considerable caution about the proper…
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