Cardiology

Here are the results from two presentations on outcomes in the management of stable and unstable angina and chest pain at the American Heart Association Scientific Sessions 2009.

Wednesday at the American Heart Association Scientific Sessions 2009, the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines announced the release of the long-awaited update to the guidelines for management of patients with ST-elevation myocardial infarction and the management of patients undergoing percutaneous coronary intervention.

Nearly a dozen posters were presented during this final-day poster session, featuring results of studies looking at such topics as postmenopausal hormone therapy, pericardial fat, birth weight in women, chronic kidney disease, metabolic syndrome, pulmonary toxicity associated with amiodarone, and risk stratification schemes. The results of these studies are highlighted.

This plenary session featured several distinguished speakers from across Europe and North America who reviewed the latest information in the area of atrial fibrillation.

I have been following with interest all the discussions about the new Medical Home (aka, the Patient Centered Medical Home) concept. This is our silver bullet that will improve patient access, raise quality levels, increase overall satisfaction and save billions of healthcare dollars - all at the same time!

This abstract poster session featured the topics of left atrial scar remodeling, closure of gap lesions, incidence of complete circumferential scar of the pulmonary vein antra, contact force mapping and ultrasound, antral isolation of pulmonary veins, radiofrequency ablation versus visutally guided laser balloon ablation, regional differences in left atrial wall thickness, and more. Highlights of these research posters are offered below.

Study results from the MERLIN-TIMI 36 Trial looking at the risk of ischemia and nonsustained ventricular tachycardia (NSVT) alone or combined in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) were presented during an abstract oral session at the American Heart Association Scientific Sessions 2009.

A study presented Tuesday at the American Heart Association Scientific Sessions 2009 looked at the relationship between coronary micro-vessel spasm, epicardial coronary artery spastic angina, and non-obstructive coronary artery disease.

This session focused on the current state of practice for atrial fibrillation (AF) ablation; the pathophysiology of AF, including genetics, atrial structure, and neurologic input; and clinical and epidemiological insights into imaging AF substrate.

Results from several interesting studies that looked at efforts to decrease door-to-balloon time in ST-elevation myocardial infarction (STEMI) and whether time reductions had any effect on mortality rates were presented during abstract poster sessions and abstract oral sessions Monday and Tuesday at the American Heart Association Scientific Sessions 2009.

This abstract oral session, featuring presenters who were given 15 minutes to review their research, provided attendees with information on the E/e’ ratio as a prognostic predictor in patients with atrial fibrillation (AF), the association between atrial and ventricular ECG findings and cardiac circulating biomarkers, stiffness of the left atrium, left atrial function as a predictor of first AF in older adults, and the mechanism of improvement of cardiac function in patients with AF. The studies are reviewed here.

This abstract session featured presenters for studies that focused on the importance of atrial surface area and refractory period in sustaining atrial fibrillation (AF), mechanisms of CFAE formation in the posterior left atrium during induced AF, the left atrial ganlionated plexus, and complex fractionated atrial electrogramm versus liner ablation for persistent AF.

Research indicates that patients with CVA were more likely to be older, female, have moderate-to-severe renal disease, and have a history of stroke unrelated to prior angioplasty.

The results of a study that looked at the competing effects on left ventricular hypertrophy (LVH) of hypokalemia and treatment with hydrochlorothiazides (HCTZ) in hypertensive patients were presented Monday, November 15 at the American Heart Association Scientitifc Sessions 2009.

This all-day abstract poster session featured researchers presenting results of studies focused on such topics as atrial fibrillation following pulmonary transplantation, use of Digoxin in atrial fibrillation, supplementation of Omega 3 PUFA plus antioxidante vitamins to prevent postoperative atrial fibrillation, and the impact of hypothyroidism on atrial fibrillation treatment strategy outcomes. The results are highlighted here.

Research shows that early-stage CKD is related to atherosclerosis; therefore, management of CKD might lower the incidence of coronary spastic angina

Although treatment with low-dose aspirin is standard care for secondary prevention of cardiovascular (CV) events, some studies have shown that up to half of all patients stop taking aspirin. Other studies have shown that discontinuation of aspirin in these patients is linked to an increased risk of MI and other ischemic events.

Does adherence to ACC/AHA guideline therapies in patients with non-ST-elevation myocardial infarction (NSTEMI) result in reductions in one-year post-discharge mortality rates?

Although previous studies have shown that women are less likely to receive acute reperfusion treatment for ST elevation myocardial infarction (STEMI) in clinical practice, there is comparatively little data on "gender differences in adjunctive treatment and outcome in the setting of primary PCI." Given this lack of data, what is the impact of female gender on hospital outcome of primary percutaneous coronary intervention (PCI) in patients with STEMI in clinical practice?

Does the evidence support the guidelines that recommend immediate reperfusion therapy for patients presenting with a new or presumed new left bundle branch block (LBBB)? A study presented during the "Women, STEMI, and PCI Trials" Abstract Oral Session Tuesday morning at the American Heart Association Scientific Sessions 2009 provided a surprising answer to that question.

This abstract oral session featured top cardiology researchers who were given a mere 15 minutes to review the highlights of their most recent work. The reasons for their studies and what they found are covered below.

Drs. Akar, Knight, and Mithilesh presented several case studies to help explain key procedures and techniques in the management of arrhythmias after ablation of atrial fibrillation.

Two studies presented during this abstract poster session focused on atrial fibrillation; the key points from both are covered here.

Women with high testosterone levels are at an elevated risk--as much as three times those with lower levels--of coronary heart disease and the metabolic syndrome.

Researchers are finding that interactive game systems like Nintendo's Wii are especially helpful for people with chronic health conditions. Playing the games increases physical activity and can even improve the ability to care for oneself.

In light of the fact that one-third of patients with heart failure are not receiving the most effective medications, the Mayo Clinic provides and overview of treatments recommended by national guidelines.

Do women face a higher risk of death compared with men following treatment with primary percutaneous coronary intervention (PCI) following ST elevation myocardial infarction (STEMI)? A study presented during the "Women, STEMI, and PCI Trials" Abstract Oral Session Tuesday morning at the American Heart Association Scientific Sessions 2009 sought to answer that question.

This poster presentation, part of the “Ion Channels and Cardiac Rhythm” abstract poster session, reviewed the results of study that Daniel Bartos and colleagues conducted in order to determine the mutation behind the development of familial atrial fibrillation (FAF2 and long QT syndromes (LQT1).

This heavily trafficked poster session featured posters focused on left atrial pressure waveform analysis, intracardiac echocardiography, pressure-guided cryoballon isolation of the pulmonary veins, radiofrequency ablation, atrial fibrillation due to mitral valve disease, a non-contact mapping system, and the mechanism of chronic atrial fibrillation. MDNG had the pleasure of meeting with some of the presenters, and summaries of their posters are provided below.