General Cardiovascular
- Diagnosis, Imaging, Screening
- General Information
- Guidelines
- Internet Sites
- Risk Factors
- Risk Reduction
- Treatment
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Notes
The Guidelines section will contain 2008 and some 2007 updated published guidelines. To view Guidelines from previous years, view the Guideline sections or the Article sections or our Monthly Online Newsletter (under the Guidelines section).
Cardiovascular - General
Daily Treatment Report
Cognitive Therapy-CBT-Psychotherapy
Device Therapy
Coated Stents Better Than Bare Metal Ones in Short Run
Long-term benefit-risk balance of drug-eluting vs. bare-metal stents in daily practice: does stent diameter matter? Three-year follow-up of BASKET. (Eur Heart J. 2008)
Long-Term Clinical Outcomes After Drug-Eluting and Bare-Metal Stenting in Massachusetts (Circulation. 2008)
Safety of drug-coated stents. (Expert Opin Drug Saf. 2008)
Bare-Metal and Drug-Eluting Stents: What’s the Bottom Line?
Outcomes Following Coronary Stenting in the Era of Bare-Metal vs the Era of Drug-Eluting Stents (JAMA. 2008) “Conclusion The widespread adoption of drug-eluting stents into routine practice was associated with a decline in the need for repeat revascularization procedures and had similar 2-year risks for death or ST-elevation myocardial infarction to bare-metal stents. “
Drug-Coated Stents May Not Be Riskier
Drug-eluting compared with bare-metal coronary stents among elderly patients. (J Am Coll Cardiol. 2008)
Comparative safety and efficacy of a sirolimus-eluting versus paclitaxel-eluting stent: a meta-analysis. (Am Heart J. 2008)
Medtronic stent may hike risk of fatal aneurysm "Patients treated with a Medtronic stent to prevent aneurysms appear more likely to die than those who undergo surgery, the Food and Drug Administration said Tuesday. The FDA said new data on the company's AneuRx stent showed patients with the device were increasingly likely to die of an aneurysm. FDA issued similar alerts in 2001 and 2003, but the agency said the new data shows risks continue rising five years after the device is implanted. "
Drug Side-Effects and Interactions
One in 10 Stops Taking Clopidogrel Because of "Nuisance Bleeding"
Warfarin use leads to larger intracerebral hematomas (NEUROLOGY 2008)
Simvastatin Used With Amiodarone “[Posted 08/08/2008] FDA notified healthcare professionals of the risk of muscle injury, rhabdomyolysis, which can lead to kidney failure or death, when simvastatin is used with amiodarone.”
Characteristics of the Amiodarone-Warfarin Interaction During Long-term Follow-Up (Am J Health-Syst Pharm. 2008)
Drug Tied to China Had Contaminant, F.D.A. Says "Federal drug regulators said Wednesday that a critical blood thinner that had been linked to at least 19 deaths and whose raw components were produced in China contained a possibly counterfeit ingredient that mimicked the real drug."
Management of warfarin-related intracerebral hemorrhage. (Expert Rev Neurother. 2008) "Warfarin-related intracerebral hemorrhage (WICH) is a medical and neurosurgical emergency with a 1-month mortality of approximately 50%. Warfarin is commonly is used in patients with atrial fibrillation to prevent ischemic stroke and to prevent progression of deep vein thrombosis to pulmonary embolism."
Drugs
Generic Drugs in CVD: Just as Effective as Brand-Name Pills
Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein. (N Engl J Med. 2008) “Conclusions In this trial of apparently healthy persons without hyperlipidemia but with elevated high-sensitivity C-reactive protein levels, rosuvastatin significantly reduced the incidence of major cardiovascular events.”
Anticoagulation intensity and outcomes among patients prescribed oral anticoagulant therapy: a systematic review and meta-analysis (CMAJ 2008) “Conclusions: The risks of hemorrhage and thromboemboli are minimized at international normalized ratios of 2–3. Ratios that are moderately higher than this therapeutic range appear safe and more effective than subtherapeutic ratios.”
[Amiodarone--still a useful antiarrhythmic drug] (Tidsskr Nor Laegeforen. 2008)
Blood Pressure Drugs Lower Heart Risk
Daily aspirin therapy: Understand the benefits and risks
Outcomes Associated with Combined Antiplatelet and Anticoagulant Therapy. (Chest. 2008) "Conclusions At the population level, the hemorrhagic risk associated with warfarin therapy combined with antiplatelet therapy appears to outweigh the benefits. These findings suggest that clinicians should carefully consider risks and benefits when recommending combined antiplatelet therapy for patients on warfarin who do not meet evidence-based criteria for such therapy."
Aspirin + clopidogrel therapy: How does your care compare to the evidence? (J Fam Pract. 2008)
Exercise
General Information
Aspirin administered to women at 100 mg every other day produces less platelet inhibition than aspirin administered at 81 mg per day: implications for interpreting the women's health study. (J Thromb Thrombolysis. 2008) “We observed that the degree of platelet inhibition was significantly less with aspirin 100 mg every other day compared with aspirin 81 mg daily, suggesting that results of the Women's Health Study may have underestimated both the efficacy and toxicity of aspirin as it is commonly administered. These data need to be considered when developing recommendations about the use of aspirin in the primary prevention of cardiovascular disease in women.”
Self-management of anticoagulation (Expert Review of Cardiovascular Therapy 2008) “Treatment with vitamin K antagonists (i.e., warfarin or coumadin derivatives) requires repeated monitoring of the intensity of anticoagulation and regular dose adjustment. Nevertheless, many patients are not in the therapeutic target range for a considerable proportion (30–50%) of the time. In addition, repeated laboratory checks and visits to the (anticoagulation) clinic or office are time-consuming and may have a negative impact on patient satisfaction.”
Indications of combined vitamin K antagonists and aspirin therapy. (J Thromb Thrombolysis. 2008)
Many Stroke, Heart Attack Patients May Not Benefit From Aspirin, Study Suggests "Up to 20 percent of patients taking aspirin to lower the risk of suffering a second cerebrovascular event do not have an antiplatelet response from aspirin, the effect thought to produce the protective effect, researchers at the University at Buffalo have shown."
Risk of Thromboembolism With Short-term Interruption of Warfarin Therapy (Arch Intern Med. 2008) "Conclusions For many patients receiving long-term anticoagulation who need to undergo a minor outpatient intervention, a brief ( 5 days) periprocedural interruption of warfarin therapy is associated with a low risk of thromboembolism. The risk of clinically significant bleeding, even among outpatients undergoing minor procedures, should be weighed against the thromboembolic risk of an individual patient before the administration of bridging anticoagulant therapy."
Guidelines
AHRQ - Your Guide to Coumadin®/Warfarin Therapy
Cardiologists Issue Guidelines for Stent Use
NGC - Anticoagulation - warfarin. (2007)
Immunotherapy
Internet Sites
Treatment Information
Drug-Food-Supplement Information
DrugDigest (drug interactions)
FDA - Drug Interactions: What You Should Know
NIH - Botanical Dietary Supplements: Background Information
NIH - Drug, Supplements, and Herbal Information
NIH - Herbal Supplements: Consider Safety, Too
NIH - Vitamin and Mineral Supplement Fact Sheets
Nutrition
Other
Other Treatments
Experimental
Radiotherapy
Supplements-Vitamins-CAM
Effect of Folic Acid and B Vitamins on Risk of Cardiovascular Events and Total Mortality Among Women at High Risk for Cardiovascular Disease (JAMA 2008) “Conclusion After 7.3 years of treatment and follow-up, a combination pill of folic acid, vitamin B6, and vitamin B12 did not reduce a combined end point of total cardiovascular events among high-risk women, despite significant homocysteine lowering.”
Surgery
Age, Race Are Among Factors That Influence Carotid-surgery Success “The NYCAS study found that the overall risk of death or stroke in the first 30 days after surgery varied greatly according to a patient's age, race, number of serious medical conditions, severity of carotid disease and acuity of neurological symptoms. The statistical findings included: • Advanced age (defined in the NYCAS study as 80 years or older) increased the risk-adjusted odds of death or stroke by 30 percent; • Non-white patients were 83 percent more likely to have a negative outcome within 30 days; • Having coronary artery disease increased the odds of death or stroke by 51 percent; and • Having diabetes treated with insulin increased the odds of death or stroke by 55 percent. In addition, the more serious the neurological symptoms a patient had from the blockage of the carotid artery, the higher the risk of negative outcomes. Patients who suffered a stroke or temporary stroke in the year before carotid surgery also had increased risks.”
Transplantation
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