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Coronary Intervention & Surgery

 - male patient

Cardiologists whose patients are not good candidates for dual antiplatelet therapy (DAPT) may have an option beyond a bare metal stent. Results from a trial presented March 31 at the American College of Cardiology (ACC) scientific session in Washington, D.C., showed that treatment with a drug-eluting stent (DES) in combination with a personalized DAPT approach appeared to be safe and effective at one year.

 - Balance

Drug-eluting stents may be as safe a choice as bare metal stents when followed by a blood thinning regimen tailored to individual patients, based on the results of a research letter published March 31 in the JAMA.

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Although previous research suggested that metformin may preserve left ventricular ejection fraction (LVEF) after STEMI, research presented March 31 at the American College of Cardiology (ACC) scientific session in Washington, D.C., found metformin did not improve LVEF in post-STEMI nondiabetic patients after they underwent PCI.

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WASHINGTON, D.C.—Wasn’t that special? Dana Carvey, of Saturday Night Live, fame treated attendees at the American College of Cardiology (ACC) scientific session in Washington, D.C., to an acceptance speech that was part roast and part comedy show on March 29.

 - Systematic radiation reduction possible for fluoroscopic procedures

Interventional cardiologists who participated in a 90-minute course that emphasized radiation safety principals reduced patient radiation dose by 48 percent in diagnostic catheterizations.

 

More Stories

FDA panel gives cangrelor a no-go

An FDA panel voted 7-2 against approval of The Medicine Company’s antiplatelet drug cangrelor for patients undergoing PCI.

Progress & concerns

Several studies fell in the eyebrow-raising category this week, one as a pleasing surprise and two as alarms.

PCI victory? More die from non-cardiac causes post-procedure

Cancer, chronic diseases and other non-cardiac conditions are now the leading causes of death after PCI, a shift away from cardiac causes that has occurred over the past two decades, according to a study published online Feb. 10 in Circulation.

 

Some durable-polymer DES may trump biodegradable stents

Biodegradable-polymer drug-eluting stents (DES) may take a backseat to one type of second-generation durable-polymer stent, based on a network meta-analysis published in the Feb. 4 issue of the Journal of the American College of Cardiology.

Testosterone therapy may double heart attack risk

Testosterone therapy may increase the risk of MI considerably in older men and younger men with heart disease, according to a study published online Jan. 29 in PLOS One. The study found the risk in younger men with a history of heart disease to be more than doubled after starting treatment.

Expanded PCI improving treatment times in U.K.

Expanding PCI services in the U.K. among patients with acute coronary syndromes has led to faster treatment times, according to the British Cardiovascular Intervention Society’s National Audit of PCI published online on Jan. 30.

1 in 7 surgeries deemed cardiovascular procedures

Cardiology-related procedures dominated a federal list of surgeries at short-stay hospitals. The list compiled by the Centers for Disease Control and Prevention was based on discharges in 2010.

Survival good 15 years after pediatric heart transplants

More than half of a group of infants and children who underwent heart transplantation at a California hospital starting in 1985 survived at least 15 years after surgery, according to research presented at the annual meeting of the Society of Thoracic Surgeons in Orlando, Fla.

Low-risk chest pain may account for most PCI readmissions

Readmission after PCI is common, and a study published online online Jan. 14 in Circulation: Cardiovascular Interventions found that PCI readmissions were most often due to recurrent chest pain or angina symptoms that were typically not caused by a heart attack. Instead, the symptoms were often related to diagnostic studies or procedures.

MI outcomes may be worse when treated during off-hours

Patients who present with heart attacks during off-hours may have worse outcomes than patients who seek treatment during regular hours, according to an analysis published online Jan. 21 in BMJ. Patients with acute MI had higher mortality rates and STEMI patients had longer door-to-balloon times.

Anatomic burden better predictor than ischemic burden

Coronary anatomic burden is a better predictor of death, MI and non-ST-segment elevation acute coronary syndromes (NSTE-ACS) than ischemic burden among patients with coronary artery disease and evidence of myocardial ischemia, a study published online Jan. 15 in JACC: Cardiovascular Interventions found.

 

Q&A: Co-PI Jeffrey Popma on CoreValve’s FDA approval

Medtronic announced on Jan. 17 that the FDA had approved its CoreValve System for patients with severe aortic stenosis who undergo transcatheter aortic valve replacement, based on results from the CoreValve Extreme Risk clinical trial. Co-principal investigator Jeffrey J. Popma, MD, director of interventional cardiology at the Beth Israel Deaconess Medical Center in Boston, talked with Cardiovascular Business about the impact of the FDA’s decision.

Report targets cognitive outcomes after cardiovascular procedures

The Agency for Healthcare Research and Quality is making a draft report that assessed cardiovascular procedures and their subsequent effect on cognitive function available for public review.

FDA panel united against approval of Xarelto

An FDA advisory panel voted 10-0 with one abstention against approval of the oral anticoagulant rivaroxaban to reduce the risk of thrombotic cardiovascular events in patients with acute coronary syndrome.

Eyeball test may not see risk accurately

Statistical estimates of mortality risk after cardiac surgery are more accurate than physician estimates based on clinical assessments—also known as the “eyeball test”—although both methods tend to overestimate risk, a study published online Jan. 14 in Circulation: Cardiovascular Quality and Outcomes found.

Stem cells may not improve post-STEMI LV function

Administering stem cells after STEMI did not improve left ventricular ejection fraction after one year, according to a research letter published in the Jan. 15 issue of JAMA.

Dense coronary artery plaque may lower heart disease risk

The denser coronary artery plaque is, the lower the risk may be of coronary heart disease and cardiovascular disease, according to a study published in the Jan. 15 issue of JAMA. This finding suggests that the current method of predicting risk, the Agatson coronary artery calcium score, may need to be re-evaluated.

Hospital quality tied to racial disparity in post-CABG deaths

Nonwhite patients are more likely to die after CABG than white patients, and this disparity may be due in part to blacks’ poorer access to high-quality hospitals, a study published online Jan. 8 in JAMA Surgery found. Other unexplained factors may also contribute to the racial differences.

Vorapaxar, rivaroxaban up for review

The FDA’s Cardiovascular and Renal Drugs Advisory Committee faces a full docket of applications for treatments for acute coronary syndrome and other diseases in January and February.

Blood conservation strategy lowers transfusion risk during AVR

Using a blood conservation strategy in patients undergoing aortic valve replacement (AVR) reduced the need for blood transfusions without increasing mortality or morbidity, according to a study published in the January issue of Annals of Thoracic Surgery.