Cardiology

A recent study of thienopyridine use among patients who had undergone percutaneous coronary intervention (PCI) in a large hospital network found that the antiplatelet drug ticagrelor was more frequently prescribed in higher risk, less stable patients.

Treatment with rivaroxaban reduced the long-term risk of cardiovascular death, myocardial infarction, or stroke in patients with ACS on a thienopyridine such as clopidogrel, regardless of PPI use.

Initial results from human clinical trials involving the use of bioengineered blood vessels could point the way to cost-effective alternative therapies for hemodialysis patients with end-stage renal disease.

Patients with heart failure who received left ventricle augmentation with Algisyl-LVR hydrogel implant experienced improved quality of life and functional capacity compared to similar patients treated with optimal medical therapy.

Results from a recent study show that intensive statin therapy in patients with acute coronary syndrome does not increase the risk of kidney injury.

Patients with non-ST-segment elevation (non-STEMI) acute coronary syndrome and peripheral artery disease (PAD) treated with the PAR-1 antagonist vorapaxar experienced a reduction in ischemic events and other outcomes compared to patients who received placebo, with no increased risk of bleeding compared to patients who did not have PAD.

Antiarrhythmic drug therapy was associated with increased risk of rehospitalization after one year in a population of elderly patients with atrial fibrillation and CAD.

Although they had more cardiovascular comorbidities, patients with atrial fibrillation and diabetes experienced rates of ischemic stroke comparable to those in AF patients without diabetes.

Analysis of health claims data indicates that physicians are underprescribing anticoagulant treatment in large numbers of patients with atrial fibrillation who are at high risk of stroke and low risk of bleeding.

Researchers reported finding large differences in the incidence rates of major cardiovascular disease across a broad range of immigrant groups to Canada.

Although oral antiplatelet therapy is broadly supported as preventive therapy for patients with established atherosclerotic vascular disease, researchers say emerging evidence for specific agents shows heterogeneous outcomes by symptomatic vascular bed, and patterns of use may vary by symptomatic territory.

Treating Hispanic patients with stable CAD with daily low-dose aspirin plus ticagrelor provided lower levels of on-treatment platelet reactivity with a faster onset and greater extent of platelet inhibition, compared to treatment with aspirin plus clopidogrel.

Study results confirm the validity of the Seattle Angina Questionnaire section focusing on chronic angina frequency, showing it correlated strongly with patients' daily diary entries regarding angina frequency and medication use.

Researchers with the Oregon Sudden Unexpected Death Study are working to understand the mechanisms of sudden cardiac arrest by "searching for novel determinants of this condition that will facilitate the identification of subjects at risk, with the overall goal of improving prevention of sudden cardiac arrest" and improving the current low rate of successful resuscitation.

Study results presented at AHA 2013 show that nearly half of patients with nonvalvular atrial fibrillation (NVAF) are at high risk of discontinuing their medications. However, patients taking novel anticoagulants such as dabigatran or rivaroxaban were less likely to stop their medications.

Long term survival after cardiac resynchronization therapy in patients with atrial fibrillation and atrioventricular junction ablation is similar to that observed in patients in sinus rhythm, but death rate is elevated for atrial fibrillation patients treated with rate-slowing drugs.

Genotyping and access to more genetic information about patients may allow clinicians to minimize side effects associated with treatment for schizophrenia by choosing antipsychotic agents based on their unique molecular binding profiles and using the lowest effective doses.

Study looks at an integrated care model for treating bipolar depression that incorporates a multidisciplinary care team, individualized lifestyle interventions, focused patient education, weight loss and nutrition counseling, and efforts to promote treatment adherence.

Study results show hyponatremia is closely associated with all-cause mortality in patients with chronic kidney disease (CKD), but few previous studies have examined this relationship.

During a follow-on session at the 2013 Southern Hospital Medicine Conference, Steven Cohn, MD, discussed the effect of PCI on subsequent non-cardiac surgery outcomes, monitoring specific hormone levels as indicators of cardiovascular risk, and other hot topics in perioperative medicine.

Presentation at the 2013 Southern Hospital Medicine Conference reviewed the clinical application of several key risk indices, including the Revised Cardiac Risk Index and the Vascular Study Group of New England Risk Index.

Hepatitis C, HIV, C. diff, and other infectious diseases can present complex clinical challenges in the hospital setting.

Suma Jain, MD, a pulmonologist at the Ochsner Clinic Foundation, provides a clinical update on the diagnosis and treatment of pulmonary hypertension (PH).

A recent study found that drug regimens containing renin-angiotensin system (RAS) inhibitors are associated with a lower risk of cardiovascular and all-cause deaths among patients starting hemodialysis, compared to regimens containing only beta blockers (BBs).

Primary prevention measures for upper GI bleeding should include NSAIDs, antiplatelet therapy, and anticoagulants appropriately, while secondary preventive measures should include testing and treating H. pylori and using long-term PPIs when appropriate.

Observing that atrial fibrillation (AF) is estimated to increase the risk of stroke fivefold, a cardiologist at the John Ochsner Heart and Vascular Institute discussed stroke reduction management by treating AF.

In his "Venous Thromboembolism: New Evidence and Best Practice" presentation, Steven Deitelzweig, MD, a hospitalist at Ochsner Medical Center, reviewed new oral anticoagulants (NOACs) used to treat venous thromboembolism (VTE).

A recent study presented at Kidney Week 2013 suggests that a plain X-ray is a reliable and inexpensive tool for assessing the risks of cardiovascular events and death in patients who have chronic kidney disease (CKD) and are not on dialysis.

Researchers discover that metabolic syndrome (MetS) is associated with poorer executive function (EF), but the syndrome's components aren't additive.

Research findings presented at the 2013 Clinical Congress of the American College of Surgeons indicate that same-hospital readmission rates are poor predictors of all-hospital readmission rates.