New Resuscitation Strategies Fail To Improve Outcomes After Cardiac Arrest

Two trials from the Resuscitation Outcomes Consortium (ROC) investigators were unable to demonstrate meaningful improvements to resuscitation strategies after cardiac arrest. The two trials, one testing an impedance threshold device and the other a strategy comparing early and late rhythm analysis, have been published in the New England Journal of Medicine….

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No Benefit for Routine Counterpulsation Found in CRISP AMI

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Routine use of intra-aortic balloon counterpulsation (IABC) in STEMI patients who do not have cardiogenic shock does not reduce infarct size, according to a new trial. Results from the  CRISP AMI (Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction) were presented at the European Society of Cardiology meeting in Paris by Manesh Patel and published…

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Paris or Orlando? A Tale of Two Cities

KONICA MINOLTA DIGITAL CAMERA

‘ Paris, where the European Society of Cardiology is currently holding its annual meeting, is one of the world’s great cities. Orlando is the world capitol of medical meetings. Here are just a few of the differences. (Thanks as indicated for the suggestions.) Paris has a bewildering variety of long-distance trains, commuter trains, and subways….

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More Emphatic Benefits Found For High Risk Subgroups Taking Eplerenone

Last November the main results of the EMPHASIS-HF trial demonstrated that eplerenone was significantly better than placebo in reducing the risk of death and hospitalization in patients with systolic heart failure and mild symptoms. Now a new analysis of the trial, presented by Bertram Pitt at the European Society of Cardiology meeting in Paris, reinforces…

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Not Shocking: French Studies Evaluate Remote Monitoring of ICDs

Remote monitoring of ICDs can reduce inappropriate shocks, but the overall clinical benefit and cost effectiveness of the technology has not yet been demonstrated, according to two new studies presented in Paris at the European Society of Cardiology meeting. Salem Kacet presented the ECOST (Effectiveness and Cost of ICD Follow-Up Schedule with Telecardiology) study in…

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Shortfalls in Secondary Prevention Represent a “Colossal Human Tragedy”

It shouldn’t come as a surprise, but an international epidemiological study shows large shortfalls in the use of established drugs for secondary prevention of coronary disease and stroke. The shortfalls are dramatically acute in poor countries, said Salim Yusuf, who presented the results of the Prospective Urban Rural Epidemiological (PURE) study at the ESC in Paris…

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ARISTOTLE Study Finds the Golden Mean of Anticoagulation

Chris Granger and Lars Wallentin at the ESC Press Conference

In ancient Greece the philosopher Aristotle thought the golden mean was the desirable middle between two extremes, one of excess and the other of deficiency. In cardiology, apixaban may be the golden mean of anticoagulation, achieving the ideal balance of reduced strokes and deaths without causing any additional bleeding complications. The Apixaban for Reduction in…

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Paris Is Beautiful

Paris Opera

Paris is such a beautiful city. Unfortunately I won’t be seeing much of it for the next few days. Look for European Society of Cardiology coverage starting Sunday morning….

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Ambulatory BP Monitoring Gains NICE Recommendation in UK

Ambulatory blood pressure (ABP) monitoring is receiving a strong endorsement in the UK from NICE (National Institute for Health and Clinical Excellence). The recommendation is based on a cost-effectiveness study published in the Lancet. Kate Lovibond and colleagues found that compared to additional measurements in the clinic or home measurements, ABP monitoring was highly cost effective in…

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Door-to-Balloon Time Closing In On One Hour

The door-to-balloon (D2B) time has fallen substantially since the launch of the D2B Alliance campaign in 2006, according to a new report in Circulation. Harlan Krumholz (editor-in-chief of CardioExchange) and colleagues analyzed data reported to CMS from the beginning of 2005 through September 2010. D2B dropped from 96 minutes in 2005 to 64 minutes in the first…

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William Kannel, Former Director of the Framingham Heart Study, Dead at 87

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William Kannel, the cardiovascular epidemiologist who helped find most of the major risk factors for cardiovascular disease during his lifelong association with the Framingham Heart Study (FHS), died on Saturday at the age of 87. Indeed, Kannel coined the term “risk factor” in a 1961 article in Annals of Internal Medicine. Kannel “made the courageous…

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Why Health Journalism Shouldn’t Be a Popularity Contest

In response to criticism about TV health journalists by Gary Schwitzer and myself (in a previous post), ABC news health reporter Richard Besser asked his followers on Twitter: What do you think? Did I get it wrong? So Besser gives the appearance of being open-minded, and who could find fault with that? But here’s the problem: health…

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CNN, ABC, and NBC Dumb Down the News About CV Screening

Last Thursday the Lancet published an extraordinarily interesting and complex study looking at the relative value of CRP tests and CAC (coronary artery calcium) scans (see my report here). Coincidentally, CNN, NBC and ABC this week ran reports on the same general topic. Exit complexity. Enter stupidity. Health journalism watchdog Gary Schwitzer and his Health…

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Is Coronary Calcium Better Than CRP for Predicting CV Events?

A new study suggests that people with low LDL levels and high CRP levels may benefit from coronary artery calcium (CAC) scans to identify those who are most likely to benefit from statin therapy. In a paper published in the Lancet, Michael Blaha and colleagues analyzed data from 950 people enrolled in the Multi-Ethnic Study…

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Details of Updated UK Heart Failure Guidelines Raise Some Eyebrows

Although the updated heart failure guidelines from the U.K.’s National Institute for Health and Clinical Excellence (NICE) are broadly consistent with similar guidelines from Europe and the U.S., outside experts are questioning several key details of the update. A summary of the new guidelines has been published in the Annals of Internal Medicine, along with…

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AHA 2011 in Orlando: Late-Breaking Clinical Trials

Late-Breaking Clinical Trials I. Sunday, Nov 13, 2011, 3:45 PM – 5:13 PM West Hall B4 Moderators: Jeffrey Weitz, Hamilton, ON, Canada; Gilles Montalescot, Paris, France 3:45 PM: Intracoronary Compared with Intravenous Bolus Abciximab Application During Primary Percutaneous Coronary Intervention: AIDA STEMI Trial Holger Thiele, Herzzentrum Leipzig, Leipzig, Germany; Jochen Wöhrle, Univ of Ulm, Ulm, Germany; Rainer Hambrecht,…

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Meta-analysis Finds Beta-Blockers May Be Less Effective in US Population

Beta-blockers may not be as effective in the U.S. as in the rest of the world, according to a meta-analysis published in the Journal of the American College of Cardiology. Christopher O’Connor and colleagues analyzed data on patients enrolled in the MERIT-HF, COPERNICUS, CIBIS-II (which did not enroll U.S. patients) and BEST trials. Some 4,200…

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Bare Metal Stents: The Next New Thing?

Although drug-eluting stents (DES) have largely supplanted bare metal stents (BMS) in clinical practice, a new study published in Circulation suggests that using these devices in all patients  may represent an inefficient use of healthcare resources. Lakshmi Venkitachalam and colleagues analyzed data from 10,144 PCI patients enrolled in the Evaluation of Drug Eluting Stents and…

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Guest Post: When Patients Can’t Afford a Medication

Editor’s Note: The following guest post by Beth Waldron is reprinted with permission from ClotConnect, a valuable resource for patients about blood clots and clotting disorders. Waldron is the program director of the UNC-Chapel Hill Blood Clot Outreach Program. Prescription Assistance: When Patients Can’t Afford a Medication Beth Waldron, Program Director of the Clot Connect project, writes…. Approximately 1…

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Danger of Cigarettes Greater in Women Than in Men

youve_come_a_long_way_baby

When compared with men, women have a significant 25% increase in risk for coronary heart disease caused by cigarettes, according to a large meta-analysis published in the Lancet. Rachel Huxley and Mark Woodward analyzed data from 2.4 million participants in studies that adjusted for cardiovascular risk factors and found that the female-to-male relative risk ratio…

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Rivaroxaban (Xarelto) Compared to Warfarin in AF Patients

The ROCKET AF (Stroke Prevention Using the Oral Direct Factor Xa Inhibitor Rivaroxaban Compared With Warfarin in Patients with Nonvalvular Atrial Fibrillation) trial tested rivaroxaban (20 mg/day) against warfarin in 14,264 patients with atrial fibrillation (AF).  The results of the trial, which were first presented last November at the American Heart Association, have now been…

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A Failure to COOPERATE: Wall Street Journal Looks at Flawed Papers

Today’s Wall Street Journal has a decent feature article by Gautam Naik about mistakes in science and retracted journal articles, although I don’t think it contains any important new information. The article is well worth reading, but it should be pointed out that most its content– and much more as well– has been covered extensively…

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New Study Finds Wide Variation Among Hospitals in Diagnostic Yield for Angiography

Last year a report in the New England Journal of Medicine from the National Cardiovascular Data Registry (NCDR) raised concerns about the low diagnostic yield for diagnostic coronary angiography. Now a new analysis of the NCDR registry appearing in the Journal of the American College of Cardiology finds a great deal of variability between hospitals…

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Bernadine Healy, Former Head of NIH and American Red Cross, Dead of a Brain Tumor

Healy

CardioBrief has received a report that Bernadine Healy, a cardiologist who served as the first woman to head the NIH and as a president of the American Red Cross, died on Saturday from complications of a brain tumor. She was married to cardiac surgeon Floyd Loop, a former CEO of the Cleveland Clinic. She had…

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USA Today Finds Disparity Between Hospital Performance and Public Perception

Patients may think they’re going to a high quality hospital when in fact they’re not, according to an analysis of Medicare data appearing in USA Today by reporters Steve Sternberg and Christopher Schnaars. The USA Today website also contains an interactive graphic with a user-friendly interface to help readers compare hospital death rates and readmission…

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