Cardiology in 2013: Like A Wrecking Ball

Perhaps I’m being overdramatic but I think  the best metaphor for the year in cardiology is Miley Cyrus on the wrecking ball. The Guidelines Wrecking Ball: Like Hannah Montana guidelines are supposed to be boring and reliable.  But in 2013 the guidelines were more like Miley Cyrus. Like a wrecking ball, the NIH abandoned its long-entrenched and highly influential role in producing…

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Missing High Blood Pressure Guideline Turns Up In JAMA

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….

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Dispatch From The Wild Frontier Of The Statin Wars

The long simmering controversy over the relative benefits and harms of statins has heated to a high boil with the release of the new AHA/ACC US guidelines. But nowhere is the battle more intense right now than in Australia where, according to the National Heart Foundation, a TV show may be the cause of 2,000 heart attacks…

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After Long Wait, Updated US Cardiovascular Guidelines Now Emphasize Risk Instead Of Targets

Updated cardiovascular health guidelines were released today by  the American Heart Association (AHA) and the American College of Cardiology (ACC). The guidelines are designed to provide primary care physicians with evidence-based expert guidance on cholesterol, obesity, risk assessment, and healthy lifestyle. The new guidelines reinforce many of the same messages from previous guidelines, but also…

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Observational Study Lends Support to CRT Guidelines

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…

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Hypertension And Cholesterol Guidelines Delayed Again As NHLBI Gets Out Of The Guidelines Business

The National Heart, Lung, and Blood Institute (NHLBI) will no longer issue guidelines, including the much-delayed and much-anticipated hypertension (JNC 8) and cholesterol (ATP IV) guidelines. Instead, the NHLBI will perform systematic evidence reviews that other organizations, including the American Heart Association and the American College of Cardiology, will use as a resource for their own guidelines….

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New Guidelines Define State-of-the-Art STEMI Care

New guidelines published online today in Circulation and the Journal of the American College of Cardiology provide an efficient overview of the best treatments for STEMI patients. (Click here to download the PDFs of the full version (64 pages) or the executive summary  (27 pages) of the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction.) “We’re looking to a future where more…

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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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Screening For AAA Comes Under Renewed Scrutiny And Criticism

A 2007 Medicare initiative to increase AAA (abdominal aortic aneurysm) screening in appropriate patients failed to prevent AAA rupture or reduce all-cause mortality, according to a new study published in Archives of Internal Medicine. The larger implications of the study are unclear, but two accompanying papers, an invited commentary and a perspective, emphasize the darker side of…

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Updated Rhythm Device Guidelines Clarify And Expand CRT Criteria

A newly released update of 2008 guidelines for device-based therapy of cardiac arrhythmias contains some much-needed clarification about indications for cardiac resynchronization therapy (CRT). The document was developed jointly by the American Heart Association, the American College of Cardiology, and the Heart Rhythm Society. Highlights of the documents include: The Class 1 recommendation for CRT…

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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…

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Industry PR Efforts Influence Debate On Cholesterol Screening Guidelines For Children

Note: This post is accompanied by a separate guest post by James Stein. What role should industry play in discussions about guidelines, especially when the debate about those guidelines includes allegations that industry may have influenced the final product of the guidelines? Should a public relations agency that represents a company with a product that…

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Guest Post: An Electrophysiologist Looks At The New HRS/ACCF Pacemaker Guidelines

Editor’s Note: The following guest post is published with the permission of its author,  Edward J. Schloss, MD, (Twitter ID @EJSMD) the medical director of cardiac electrophysiology at Christ Hospital in Cincinnati, OH. Overview of the New HRS/ACCF Pacemaker Guidelines by Edward J Schloss MD  Since the development of the first dual chamber pacemakers in the 1980s, doctors…

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Has COURAGE been vindicated?

The ACC, the AHA, and a whole alphabet soup worth of other cardiovascular organizations (SCAI, STS, AATS, ASNC, ASE, HFSA SCCT) have published (or in some cases just endorsed) a report, called the ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization. The report  will probably provide comfort to those who were big supporters of COURAGE. I’m guessing…

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