Lipid/Metabolic
Vytorin rides out choppy SEAS
10 COMMENTS - Sep 2, 2008 11:00 EDT
The SEAS data were presented today at the European Society of Cardiology, but the focus turned to the cancer risks observed in the trial. An analysis of ongoing studies—IMPROVE-IT and SHARP—suggests the finding is a play of chance, but others, including prominent New England Journal of Medicine editorialists, say there is uncertainty about the safety and efficacy of the drug. (European Society of Cardiology Congress 2008. Rossebø AB et al. Peto R et al. N Engl J Med; published online before print September 2, 2008.)
Interventional/Surgery
SYNTAX: DES statistically inferior to CABG for complex coronary disease; plus CARDIA results
9 COMMENTS - Sep 1, 2008 09:45 EDT
UPDATED // While DES results failed to meet the test of noninferiority to CABG for a composite end point of death, MI, stroke, and revascularization, the two strategies had comparable rates of "hard" clinical events at one year. Rates of stroke were higher for CABG, while repeat procedures were more common for PCI. (European Society of Cardiology Congress 2008.)
Hypertension
ARBs unable to TRANSCEND placebo in high-risk patients
6 COMMENTS - Aug 31, 2008 12:15 EDT
The angiotensin-receptor blocker telmisartan has fared no better than placebo in TRANSCEND in patients at high-risk of cardiovascular disease unable to tolerate ACE inhibitors, seemingly providing more questions than answers. (European Society of Cardiology Congress 2008. Lancet; published online before print August 31, 2008.)
Heart failure
Omega-3 fatty acids, but not statin therapy, cuts mortality and hospitalizations in heart failure
3 COMMENTS - Aug 31, 2008 11:00 EDT
Omega-3 fatty-acid supplementation is an "effective, safe, simple, and cheap" option for patients with chronic heart failure, say investigators. Statin therapy, on the other hand, should not be prescribed in heart-failure patients. (European Society of Cardiology Congress 2008. Lancet; published online before print August 31, 2008.)
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Editorial series
A series of discussions among editorial leaders, developed by theheart.org

Cardiology panels
Clinical trials under the microscope: A critical look at current practice
1 COMMENT - Jul 29, 2008 09:52 EDT
Join Drs Harlan Krumholz, Robert Harrington, Steven Nissen, and Frans Van De Werf as they give clinical trials a spirited going-over, from how they are being conducted to who is conducting them, and get into some of the sticky issues around sponsorship and data management.
The Cardiology Show
ESC 2008: The Munich Summit
Sep 5, 2008 15:30 EDT
Join Drs Valentin Fuster, William Boden, Antonio Colombo, Raymond Gibbons, Franz Messerli, Marc Pfeffer, Philip Poole-Wilson, Philippe Gabriel Steg, Renu Virmani, and Harvey White as they steer through the depths of the SYNTAX trial and navigate the sometimes contentious issues between choosing CABG or PCI.
Cardiology panels
Heart-failure overview: ACC 2008
Jul 15, 2008 16:33 EDT
Join Dr Melissa Walton-Shirley as she talks to Drs Ileana Piña, Clyde Yancy, and cardiology fellow Eiran Gorodeski about the current state of treatment for decompensated congestive heart failure, why we need to remember the fundamentals, and some exciting data from the PROTECT-1 pilot study.
Dr Clyde Yancy
Cardiology panels
Rethinking hypertension: It's not how low you go, but how you get there
Jun 30, 2008 10:15 EDT
Join Drs Clyde Yancy and Robert Harrington as they discuss the clinical implications of ONTARGET and ACCOMPLISH, why they are reconsidering their skepticism about combination therapies in the treatment of hypertension, and how lowering blood pressure may be more than just a numbers game.
Discussion and opinions
Lively, interactive exchanges moderated by thought leaders, staff or contributors to theheart.org

Topolog
SYNTAX: Putting it in context
Sep 4, 2008 10:22 EDT
At ESC in Munich, hotline results from SYNTAX and CARDIA were presented. What are the implications for deciding on PCI vs CABG?
Fellows' Corner
WSJ article on Taxus Liberte study: statistical smoking gun or media hype?
Jul 31, 2008 14:55 EDT
theHeart.org Discussion Forum
Join Forum Moderator Dr. Melissa Walton-Shirley as she blogs from the ESC in Munich
May 14, 2008 15:43 EDT
Read about our forum moderator's heroic and sometimes comic efforts to get a smoking ban passed by her city council in tobacco country.
theHeart.org Discussion Forum
Discussion Forum
May 14, 2008 15:52 EDT
theheart.org Forum, where discussions among healthcare providers, clinicians, and researchers reflect our common goal of decreasing cardiovascular morbidity and mortality around the world.
Acute coronary syndrome
Dose-ranging study of novel anticoagulant promising
Sep 5, 2008 17:15 EDT
The addition of apixaban to antiplatelet therapy resulted in an increase in bleeding, but there was also an observed trend toward a reduction in clinically relevant ischemic events, a new dose-ranging study has shown. (European Society of Cardiology Congress 2008.)
Arrhythmia/EP
Medtronic ICD software upgrade targets Sprint Fidelis lead-fracture issue
Sep 5, 2008 17:00 EDT
Heart failure
ICD discharges: Underappreciated meaning highlighted in SCD-HeFT analysis
Sep 4, 2008 09:45 EDT
The risk of death from any cause climbed whenever a primary-prevention ICD discharged, but the shocks were a warning, not a killer; another secondary analysis of the trial suggests that patients' quality of life didn't suffer because they had been implanted with ICDs. (Pool JE et al. Mark DB et al. N Engl J Med 2008; 359:1009-1017, 999-1008.)
Brain/Kidney/Peripheral
PROFESS: No neuroprotective effect of dipyridamole, aspirin, or telmisartan in recurrent stroke
Sep 3, 2008 15:30 EDT
In this third factorial analysis of the PROFESS trial, researchers found no sign of neuroprotection from a recurrent stroke with dipyridamole, aspirin, or telmisartan. (Diener HC et al. Lancet Neurol; published online before print August 29, 2008.)
Hypertension
New ONTARGET analysis shows lower not necessarily better when it comes to BP
5 COMMENTS - Sep 3, 2008 12:45 EDT
A new observational analysis of the ONTARGET study shows that lower is not necessarily better when it comes to blood pressure in this patient population, with coronary heart disease or diabetes plus additional risk factors. Although there was evidence that lower BP was better for stroke, there was a suggestion of harm when BP was reduced below 130 mm Hg systolic for the outcome of cardiovascular death in diabetics. (European Society of Cardiology Congress 2008.)
Arrhythmia/EP
ATHENA analysis suggests cut in stroke risk with dronedarone for atrial fib
Sep 3, 2008 11:45 EDT
The post hoc finding, which was relative to placebo, is unusual for an antiarrhythmic agent. The investigational drug is envisioned as a potentially safer alternative to amiodarone. (European Society of Cardiology Congress 2008.)
Heart failure
Immunosuppression improves LV function in virus-negative inflammatory cardiomyopathy
1 COMMENT - Sep 3, 2008 10:30 EDT
The findings support a strategy of first testing patients for persistent viral load before choosing a treatment strategy. (European Society of Cardiology Congress 2008.)
Prevention
EUROASPIRE III: Not enough being done in the treatment of high-risk primary-prevention patients
4 COMMENTS - Sep 3, 2008 09:30 EDT
Investigators told the audience that almost 85% of patients wanted to know their risk of heart disease, but very few knew their real risk, assuming they were as healthy as men and women their own age. Also, more than 80% of those participating in the survey were not provided with a professional lifestyle and risk-factor management program, despite evidence that such programs are effective. (European Society of Cardiology Congress 2008.)
Interventional/Surgery
Adding tirofiban in aspirin/clopidogrel nonresponders cuts periprocedural MI
1 COMMENT - Sep 3, 2008 08:15 EDT
A new study in low-risk, elective-PCI patients who were also nonresponsive to aspirin and/or clopidogrel shows that adding tirofiban during PCI can cut MI rates by more than 40%, as compared with patients given a placebo infusion. (European Society of Cardiology Congress 2008.)
Brain/Kidney/Peripheral
Sodium bicarbonate no protection against contrast nephropathy
Sep 2, 2008 16:00 EDT
Using sodium bicarbonate does not prevent contrast-medium-induced nephropathy in patients with moderate to severe renal dysfunction, a new randomized study has found. (Brar SS et al. JAMA 2008; 300:1038-1046.)
Lipid/Metabolic
Mixed results for Lp-PLA2 inhibitor as a hoped-for stabilizer of coronary plaques
Sep 2, 2008 13:15 EDT
A year of treatment with darapladib failed to influence an indirect measure of plaque stability, a primary end point in the trial, among patients who had been referred for cath because of symptomatic CAD; however, it did show an effect on some secondary measures. (European Society of Cardiology Congress 2008. Serruys PW et al. Circulation 2008; 118:1172-1182.)
quote
I'm not aware of any data that would support [the hypothesis] that ezetimibe causes fatal cancer within three years after the onset of treatment. I don't know of anything that can do that, except maybe a Chernobyl catastrophe.
— Dr Terje Pedersen
Most popular news
  1. The data stop here: Primary-prevention ICDs for the very elderly
  2. US interventionalists shift to newer-generation DES despite lack of long-term evidence
  3. One-year results for PCI subset in ACUITY show no differences in ischemic events or mortality
  4. Low LDL cholesterol, but not statin use, associated with an increased risk of cancer
  5. Radial-access PCI rarely performed but associated with 58% less bleeding than femoral PCI
  6. PROFESS trial published: Combination therapy falls short of noninferiority vs clopidogrel
  7. Merck disguised Vioxx marketing as safety trial, analysis of company documents charges
  8. Duke cardiologist gets National Medal of Science
  9. FDA looking into Vytorin and cancer risk, but interim analysis reassuring for patients to continue with medication
  10. Mixed results for transapical valve procedure prompt new doubts and reassurances
Poll
Based on SYNTAX, will you now be more likely to recommend
See: SYNTAX: DES statistically inferior to CABG for complex coronary disease; plus CARDIA results
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Features
Interventional/Surgery
US interventionalists shift to newer-generation DES despite lack of long-term evidence
3 COMMENTS - Aug 28, 2008 10:00 EDT
Some interventionalists admit they are acting on instinct, assuming the Xience/Promus to be a potent antirestenotic device similar to the Cypher, since both use limus-drugs, and hedging their bets that the Endeavor may be the best bet when compliance to dual antiplatelet therapy is a concern. But not everyone is convinced.
Interventional/Surgery
Mixed results for transapical valve procedure prompt new doubts and reassurances
5 COMMENTS - Aug 19, 2008 17:00 EDT
More and more surgeons and interventionalists are getting their hands on the Edwards transcatheter aortic valve, now that it has CE Mark approval in Europe and the PARTNER trial ramps up in the US. Rumors of higher mortality rates with the transapical delivery method are fueling debate over appropriate patient selection, delivery technique, and what the future holds.
Heart failure
The Management of Congestion in ADHF
Aug 5, 2008 08:49 EDT
Congestion, volume overload, dyspnea, decompensation all leading to hospitalization. Just what starts this cascade and how does a clinician stop the cycle. Is it as simple as a prescribing a diuretic? Don't bet on it.