Heart Failure

Preventive angioplasty may be the next big thing. In a study presented at the American College of Cardiology meeting in San Diego, CA, researchers recommended complete revascularization of constricted arteries in patients who had a STEMI heart attack.

Patients with acute coronary syndrome undergoing angioplasty who got the anticoagulant bivalirudin (Angiomax/Medicines Company) had significantly lower rates of bleeding complications and death than controls, according to a Dutch study.

About two-thirds of surgeons performing mitral valve surgery on patients with atrial fibrillation (AF) do ablation procedures at the same time. There are no official guidelines on when to do both. Trying to provide more information to guide such decisions, a US-Canada team randomized a group of these patients to either valve repair alone, or valve repair with ablation. The dual approach seems better.

Interventional cardiologists would do better to access heart arteries through a patient's arm than groin, a Dutch study found. Though the radial approach is technically more difficult, it is safer with a lower risk of severe bleeding.

Physicians may think patients over 80 are too old to benefit from agressive care to treat unstable angina or clogged arteries that caused a heart attack. Think again, a Norwegian researcher said at the American College of Cardiology meeting in San Diego, CA. These patients were 47% more likely to survive and healthier after invasive procedures than a group that got non-invasive care.

The practice of using a syringe to suck a blood clot out of a coronary artery when a heart attack patient is undergoing angioplasty is common. But a study of 10,000 patients showed this manual thrombectomy procedure was associated with a higher rate of strokes in these patients.

In patients with heart failure and atrial fibrillation, those who had catheter ablation had better results than those who took the anti-arrhythmic medication amiodarone, reported researchers at Albert Einstein College of Medicine in New York City.

When patients have chest pain, a CT scan can rule out disease or find it, the SCOT-HEART study found. That led to some patients learning they did not need treatment and others getting interventions that saved lives.

Only 1 in 5 patients who might benefit from an implantable defibrillator after being hospitalized for heart failure gets counselling on that option, a Duke study found.

A recent study comparing outcomes from ablation to treatment with medication showed the procedure provided greater benefit for atrial fibrillation patients with congestive heart failure.

A new class of cholesterol-lowering drugs is emerging, known as PCSK9 inhibitors. Reporting on results of a safety and efficacy trial of Amgen's entry in this race, evolocumab, showed it did better than standard therapy when it came to adverse events and cholesterol lowering, and showed promise for reducing cardiac events.

AstraZeneca researchers report that a new drug call MED12452 is being developed as an antidote for patients who need to reverse the effects of ticagrelor (Brilinta/AstraZeneca) on an emergency basis. That could be important for patients taking ticagrelor who need emergency surgery or are bleeding from an accident.

The time and money involved in screening echocardiography of stress testing in asymptomatic individuals with no cardiac risk factors is likely not worth it, an analysis of the US Air Force School of Aerospace Medicine's database found

In previous studies, interleukin-6 has been cited as a predictor of mortality in patients with acute decompensated heart failure. But a study by researchers at the Cleveland Clinic challenges that finding.

Physicians could help heart failure patients suffering from reduced left ventricular ejection fraction (HFrEF) by using pulmonary artery pressure management.

Wavefront pacing affects accuracy in voltage mapping scars in the heart, UCLA researchers report.

Time is important in getting patients with advanced heart failure (HF) to appropriate care. In a new study, a Utah research team reports on a new electronic approach.

Amgen's monoclonal antibody evolocumab (formerly called AMG 145) did well at inhibiting proprotein convertase subtilisin/kexin 9 (PCSK9) and reducing LDL cholesterol in a group of older patients, researchers report.

Certain metabolites could be used as new biomarkers for heart failure with preserved ejection fraction.

In patients with heart failure with preserved ejection fraction (HFpEF) pulmonary artery hypertension and right ventricular dysfunction are common and associated with mortality. A Duke team looked at ways to improve pulmonary vascular tone.

The patient is a 48-year-old male with "heart trouble" since the age of 6 years, after having rheumatic fever. He was treated with digitalis and diuretics until he was 31 years of age when he was admitted for heart failure and underwent closed commissurotomy.

There are many factors which can contribute to a patient suffering from heart failure. Recent research looked at more specific risk factors for the condition and how it can help with future patient treatment.

The American College of Cardiology 2015 Annual Scientific Session and Expo is set to begin March 14 in San Diego, CA. MD Magazine's editorial and video team will be there to provide breaking news, physician interviews, and analysis of the 3-day event. Some of the studies presented will likely change the practice of cardiology. Here's a preview.

New research suggests that low testosterone levels in older men are less likely to lead to cardiovascular disease than a sign of underlying problems that are the real cause.

Worsening renal function over time is associated with poorer outcomes in patients with acute and chronic HF. Although this association is established in patients with reduced ejection fraction, there are no data about the relationship between WRF and outcomes in HF patients with preserved ejection fraction.

It is generally accepted that drug-eluting stents (DES) decrease the risk of restenosis in native coronary arteries compared with bare metal stents. However, the overall safety and benefit of DES implantation, including long-term benefits, in saphenous vein bypass grafts remains the subject, at least to some extent, of continued evaluation.

Is degree of diffuse myocardial fibrosis associated with severity of diastolic dysfunction in heart failure with preserved ejection fraction?

Implantable cardioverter-defibrillators (ICDs) have prevented cardiac arrests and deaths, but they carry a risk of giving patients shocks when they don't need them. That inappropriate shock rate has been estimated as occurring in 10 to 20% of patients with the devices, causing unnecessary hospital admissions, and a negative impact on patients' quality of life. They are also associated with increased morbidity and mortality for some patients. But in a study in Heart Rhythm Angelo Auricchio, MD, PhD, and colleagues report on technological improvements in a Medtronic device that has reduced those shocks to 1.5% with a dual/triple chamber defibrillator and 2.5% for a single chamber ICD after one year.

In the wake of Joan Rivers' untimely death last year, ambulatory surgery centers have come under increased scrutiny. Several recent articles in the literature look at this complicated area of surgical practice.

While rheumatoid arthritis makes the most headlines in the field of rheumatology a recent push has been made to bring more attention to patients with rheumatic heart disease.