November 11th, 2011
Transapical TAVR on the Ropes: Is It Down for the Count?
Richard A. Lange, MD, MBA and L. David Hillis, MD
STACCATO showed more adverse events with transapical transcatheter aortic valve replacement (TAVR) than with aortic valve replacement (AVR) in low risk, elderly patients. In patients with severe, symptomatic aortic stenosis who are believed to have high surgical risk, PARTNER substudy results presented at the AHA show Transapical TAVR provided no increase (and even a possible decrease) […]
November 11th, 2011
Shaky Start Ends STACCATO
L. David Hillis, MD and Richard A. Lange, MD, MBA
The STACCATO trial planned to randomize 200 low-risk patients to transcatheter aortic heart valve implantation (TAVI) via the transapical approach (with the Sapien valve from Edwards Lifesciences) or surgical aortic valve replacement (AVR). The primary endpoint was a composite of death, stroke, and renal failure at one month. After enrolling only 70 patients (34 TAVI […]
November 11th, 2011
TAVI at TCT: Enthusiasm Tempered by Poor Transapical Outcomes
Larry Husten, PHD
Continued enthusiasm for transcatheter aortic valve implantation (TAVI) with the Edwards’ Sapien device was tempered somewhat by poor outcomes observed in the group of patients for whom the procedure was performed using the transapical instead of the transfemoral approach. Results of 3 new studies from the PARTNER trials and a controversial new trial, STACCATO, were […]
November 10th, 2011
What’s This Fellow Looking Forward to at AHA?
John Ryan, MD
Fellowship Training co-moderator John Ryan discusses the studies he’s most looking forward to checking out at the AHA Scientific Sessions 2011 meeting. See what he has to say and share your own suggestions and comments. ADOPT: The past twelve months have seen the now famous introduction of novel anticoagulants for AFib. The potential for these […]
November 10th, 2011
The AHA in Orlando: A Preview
Larry Husten, PHD
The AHA 2011 Scientific Sessions start this weekend in Orlando. CardioExchange received a preview of some of the many expected highlights of the meeting from Program Chair Elliott Antman. (Click here to view AHA videos of Antman’s meeting previews.) Antman stressed the sheer size and magnitude of the meeting: 742 individual sessions, 4238 abstracts selected out […]
November 9th, 2011
Obstructive Lesions Found in Patients with Calcium Scores of Zero
Larry Husten, PHD
A small but significant number of symptomatic patients with calcium scores of zero have obstructive coronary artery disease (CAD), according to a new study published in the Journal of the American College of Cardiology. Todd Villines and colleagues studied 10,037 symptomatic patients without known CAD enrolled in the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International […]
November 9th, 2011
18 Months After ACCORD, FDA Says Fenofibrate May Not Lower Risk for MI or Stroke
Larry Husten, PHD
Eighteen months after the ACCORD (Action to Control Cardiovascular Risk in Diabetes ) trial found no benefit for the addition of fenofibrate to simvastatin in patients with type 2 diabetes, the FDA has issued a safety communication. The agency changed the label for Trilipix (fenofibric acid, Abbott) and is notifying healthcare professionals that the drug “may […]
November 9th, 2011
How to Prep for AHA: An Expert’s Advice for Fellows
John Ryan, MD and Thomas Ryan, MD
Dr. Thomas Ryan explains how fellows can get the most from the American Heart Association Scientific Sessions, both as attendees and as presenters. Dr. Ryan is Professor of Medicine (Emeritus) at Boston University, a former AHA president (1984–1986), a former Chief of Cardiology at Boston University (1971–1994), and a recipient of the AHA Chairman’s Award […]
November 8th, 2011
Financial Incentives Increase Use of Stress Tests
Larry Husten, PHD
Following coronary revascularization, patients are more likely to undergo cardiac stress testing if their physician has a financial interest in the test, according to a new study published in JAMA. Bimal Shah and colleagues examined insurance data from 17,847 patients who underwent revascularization, dividing their physicians into three groups: those who billed for technical and professional […]
November 8th, 2011
Wrestling with Uncertainty in Clinical Practice
John E Brush, MD
About a week ago I was asked to consult on a patient I’ll call Betty. This delightful 92-year-old woman, who lived alone, was admitted during the night with pain in the upper chest and shoulders. She had been feeling this discomfort off and on for 2 days, and when it woke her from sleep, she […]