July/August 2014

Guidelines designed to lower the risk of atherosclerotic cardiovascular disease continue to spark controversy many months after their publication, primarily over two flash points: abandonment of cholesterol goals and the use of a new risk estimator.

Lines are straight and narrow. Tacking “guide” before them in the medical world, where the best course of action may not be straightforward and contributing factors can be wide, may create confusion.

It may seem like merely a local skirmish, but an effort by interventional cardiologists in the state of Washington to ensure coverage for drug-eluting stents serves as a roadmap for local and national initiatives targeting other advanced technologies.

One decision some cardiology groups may wrangle with is whether or not to launch a peripheral artery disease (PAD) program. 

Managing heart failure (HF) presents daily challenges for many patients. Reasons range from a lack of understanding about treatments to the inability to care for themselves due to symptoms.

The number of transcatheter aortic valve replacement (TAVR) procedures in the U.S. has been growing with FDA approval of two devices and ongoing clinical trials evaluating other new technologies.

Making cardiac catheterization labs (CCLs) more efficient less wasteful could go a long way toward reducing the large carbon footprint associated with healthcare, according to a new commentary published in JACC: Cardiovascular Interventions.

Cath lab directors must balance the availability of products such as stents with costs in an environment where demand can change quickly.

The first stages of Choosing Wisely tackled less contentious issues in its successful rollout. Now it is time to step up efforts in ambition and scope.

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