March 24th, 2011
Study Finds Pioglitazone Prevents Progression To Diabetes
Larry Husten, PHD
Pioglitazone significantly reduces the development of type 2 diabetes in people with impaired glucose tolerance, according to the results of the ACT NOW study published in the New England Journal of Medicine. Ralph DeFronzo and colleagues randomized 602 patients with impaired glucose tolerance to pioglitazone or placebo. During a median followup of 2.4 years, diabetes […]
March 23rd, 2011
Fibrate Prescriptions: A Tale Of Two Countries
Larry Husten, PHD
During the past decade, fibrate use more than doubled in the U.S. but remained relatively stable in Canada, according to a study just published in JAMA. In January 2002, fibrate use was similar in the two countries: 336 prescriptions per 100,000 population in the U.S. versus 402 per 100,000 in Canada. By December 2009, the […]
March 23rd, 2011
New Protocol Identifies Low-Risk Chest-Pain Patients
Larry Husten, PHD
Investigators in the Asia-Pacific region are proposing a “reliable, reproducible, and fast” 2-hour protocol to identify chest-pain patients in the emergency department who have a low short-term risk of having a major adverse cardiac event and who may therefore be suitable for early discharge. The accelerated diagnosis protocol (ADP) consists of the TIMI score, ECG, and […]
March 22nd, 2011
Good News And Bad News About Physical And Sexual Activity and Cardiac Events
Larry Husten, PHD
The bad news is that physical and sexual activity can trigger acute cardiac events. The good news is that the immediate increase in risk becomes much smaller with more frequent activity, and the long-term overall benefits of activity remain unchallenged. These are the key findings of a meta-analysis by Issa Dahabreh and Jessica Paulus published […]
March 22nd, 2011
Study Explores Lowering the Troponin Diagnostic Threshold
Larry Husten, PHD
Lowering the troponin diagnostic threshold can significantly improve outcomes after MI, claim Scottish investigators in a report published in JAMA. More than 2,000 patients with suspected ACS were studied. Sixty-four percent of patients had troponin concentrations below 0.05 ng/mL, 8% had concentrations from 0.05 to 0.19 ng/mL, and 28% had concentrations 0.20 ng/mL or higher. […]
March 22nd, 2011
AHA Releases New Recommendations for Management of Acute VTE
Larry Husten, PHD
The AHA is offering new guidance for the management of patients with pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension. The scientific statement is published online in Circulation. In addition to advice about anticoagulant therapy, the statement offers extensive recommendations about the appropriate use of fibrinolytic agents, catheter-based and surgical interventions, and […]
March 22nd, 2011
PROTECT Compares Unfractionated Heparin And Dalteparin In Critically Ill Patients
Larry Husten, PHD
ICU patients are at high risk to develop venous thromboembolism. Published in NEJM, PROTECT (the Prophylaxis for Thromboembolism in Critical Care Trial) compared the effects of the low-molecular-weight heparin dalteparin with unfractionated heparin (UFH) in 3746 critically ill patients. There was no significant difference between the two groups in the primary outcome of the trial. […]
March 18th, 2011
Dabigatran Dialogue: Two Experts Answer Our Questions and Yours
Samuel Goldhaber, MD and Elaine Marie Hylek, MD, MPH
In a series of blog posts on CardioExchange, Samuel Goldhaber, Director of the Venous Thromboembolism Research Group in the Cardiovascular Division at Brigham and Women’s Hospital, has been guiding us on best practices around dabigatran. Recently, he teamed up with Elaine Hylek, Director of the Thrombosis and Anticoagulation Service at Boston University School of Medicine, […]
March 18th, 2011
Cardiology Training Around the World — A Survey
John Ryan, MD, Andrew M. Kates, MD and James De Lemos, MD
A few months ago, we started a discussion on the Fellowship Training blog at CardioExchange about the differences in cardiology training around the world. Because the response we received was so enthusiastic, we decided to learn more about how different countries train their cardiologists. We have now created a short survey that we would like […]
March 17th, 2011
Meta-Analysis Suggests Worse Outcomes For Rosiglitazone Compared To Pioglitazone
Larry Husten, PHD
There are no long-term trials directly comparing rosiglitazone and pioglitazone. In an article published in BMJ, Yoon Kong Loke and colleagues performed a systematic review and meta-analysis of 16 observational studies with more than 800,000 thiazolidinedione users in an attempt to assess the relative cardiovascular effects of the two drugs. When compared with pioglitazone, rosiglitazone […]