Dr. Califf's Perspective on Quality-Care Initiatives

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Cardiology MedPulse®

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NEW FEATURES THIS WEEK

Atherothrombosis Expert Column. Bridging Quality-Care Initiatives With Improved Patient Outcomes: A Leap of Faith?

What is more important: advances such as "sequence-based genomic typing," or just good evidence-based medicine?

ECG of the Week. What Is the Rhythm? (III)

Test your diagnostic skills with our most recent interactive case. -- Based on the findings in leads I, II, V2, and V3, is it atrial fibrillation, flutter or multifocal atrial tachycardia?

Hypertension Highlights. New Hypertension Data Says It's the Blood Pressure -- Whether With CCBs, a New Alternative to ARBs, Weight Loss -- or T-type Calcium Channels

New data on calcium channel blockers vs beta-blockers; alternatives to ARBs: findings show equivalency; and what about weight loss?

PUBLISHER'S CIRCLE: READ FULL-TEXT ARTICLES

In-Hospital Initiation of Cardiovascular Protective Medications for Patients Undergoing Percutaneous Coronary Intervention: Taking Advantage of the Teachable Moment

A review of the rationale for in-hospital initiation of cardiovascular protective therapies in PCI patients and evidence supporting in-hospital initiation of protective medications as the standard.J Invasive Cardiol 15(11) 2003

Are Statins Indicated for the Primary Prevention of CAD in Octogenarians? Antagonist Viewpoint

Although statins reduce morbidity and mortality in younger patients, epidemiologic and clinical data do not support routine use of these agents in patients older than 80 years for primary prevention.Am J Geriatr Cardiol 12(6) 2003

Perspectives in the Management of Chronic Coronary Artery Disease

In light of current knowledge, what principles can be applied to management of chronic coronary artery disease?Heart Dis 5(6) 2003

Risk Determination of Dyslipidemia in Populations Characterized By Low Levels of High-Density Lipoprotein Cholesterol

In populations at risk for CHD with low HDL, qualification of subjects for treatment based on either the TC/HDL ratio or LDL thresholds identifies more high-risk subjects than LDL threshold values.Am Heart J 146(6) 2003

NEWS

Benefits of Cardiac Resynchronization Therapy Sustained For at Least 24 Months

CRT improves quality of life, functional status, and exercise capacity in heart failure patients and the benefits are sustained through at least 24 months, regardless of disease etiology.

The Role of Tissue Doppler Imaging in Predicting Response to CRT

Emory University researchers report that tissue Doppler imaging is "highly sensitive" in predicting response to CRT, but will it replace QRS duration as a marker of dyssynchrony?

CME -- ACP/AAFP Issues Guidelines for Management of Atrial Fibrillation

The joint commission made six recommendations for internists and family physicians to manage patients with atrial fibrillation, except for those cases occurring after surgery or MI.

CME -- Fitness Important for Cardiovascular Health

The protective role of fitness was independent of other cardiovascular risk factors except for weight, according to a longitudinal population cohort study.

CME -- Microalbuminuria Linked to Cardiac Risk in Hypertensive Patients With LVH

Based on the prospective LIFE study, the investigators suggest that detection of microalbuminuria in hypertensive patients may help the clinician decide when to start therapy.

MEDSCAPE MEDICAL NEWS & REUTERS HEALTH

Valsartan and Amlodipine Have Disparate Effects on Renal Hemodynamics

For patients with essential hypertension, the angiotensin-I receptor blocker valsartan and the calcium channel blocker amlodipine control blood pressure equally well, but have markedly different effects on the renal system, according to German researchers.

Screening for Proteinuria Not Cost Effective for Normotensive Middle-Aged Adults

Routine screening for urine protein is cost-effective only when limited to high-risk groups, such as those age 60 and above or those with hypertension or diabetes, physicians at s Hopkins Medical Institutions report.

Actelion Gets Australian Backing for Tracleer

Swiss biotechnology firm Actelion said on Monday its product Tracleer used to treat pulmonary arterial hypertension had been recommended for listing and government reimbursement in Australia.

Women With Ischemic Heart Failure at Higher Risk for Death Than Men

Among patients with heart failure, women seem to fare better than men if the etiology of the disease is nonischemic, new study findings suggest. But when ischemic disease is the cause, women are at higher risk of death than their male counterparts.

Systolic Dysfunction Does Not Predict Mortality in Women With Heart Failure

Systolic dysfunction is predictive of long-term mortality in men, but not women, with heart failure, according to the findings of a new study. In fact, a high percentage of women with heart failure had a normal left ventricular ejection fraction, suggesting that this is "an independent gender-related biological factor," researchers report in the European Heart Journal.

Stem Cells Implants May Aid Post-Infarction Ventricular Function

Autologous intramyocardial injection of cultured skeletal muscle-derived stem cells appears to improve LV function in patients with non-acute MI, Spanish researchers report in the European Heart Journal.

Catheter Procedure Feasible Way to Deliver Myoblasts to Heart Failure Patients

In preclinical studies, transplanted autologous skeletal myoblasts have shown promise as a treatment for injured myocardium. Now, new research by Dutch investigators indicates that a percutaneous procedure is a feasible method of delivering such cells to patients with post-MI heart failure.

Consensus Report Shows Need for More Aggressive in-Hospital Glucose Control

Better control can help decrease length of stay and reduce morbidity and mortality, especially in diabetics admitted for cardiovascular conditions.

Adding Abciximab to Primary Stenting Improves MI Outcomes

As a treatment for acute MI, adding abciximab to primary stenting of the infarct-related coronary artery does seem to lower the risk of adverse cardiovascular outcomes, according to results of a multicenter study.

Risk Factors Often Absent When Thromboembolism Develops After Long Air Flights

Long-haul air travel increases the risk of venous thromboembolism, occurring in about 1% of travelers regardless of preexisting risk factors, investigators report The Lancet.

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