Keeping you up to date on recent headlines in cardiovascular healthcare:
Pork heart system expedites R&D work ....A machine developed at North Carolina State University (Raleigh) makes an animal heart, after removal from the body, pump much like a live heart, potentially speeding the development of heart surgery techniques, such as valve replacement. The machine could be used before live animal trials to test experimental surgical technologies more quickly and less expensively. "Researchers can obtain pig hearts from a pork processing facility and use the system to test their prototypes or practice new surgical procedures," said Andrew Richards, a mechanical engineering PhD student at who designed the heart machine. Greg Buckner, PhD, who directed the work, said the system enables "'proof of concept' before operating on live animals."
Study: AF more difficult to identify in blacks .... Population-based studies have shown that atrial fibrillation (AF) is less common among blacks than whites, perhaps the result of limitations in standard diagnostic methods, according to a new study. Blacks have a higher rate of stroke than whites, but a lower prevalence with AF a major risk factor for stroke – which is highly contradictory. Researchers at Wake Forest University School of Medicine (Winston-Salem, North Carolina) used ECG to study 15,429 participants (27% black) and found that AF was significantly less common among blacks than whites (.24% compared with 0.95%), but blacks had significantly higher and more abnormal values for AF predictors, and AF was intermittent and more difficult to identify in blacks – indicating that physicians should put AF predictors above ECG findings.
Call for more patients for PFO trials .... The American Heart Association (Dallas) and the American College of Cardiology (Washington) are pushing for enrollment of more patients in clinical trials for catheter-based closure of patent foramen ovale (PFO), an opening between the two chambers of the heart which fails to close at birth. The associations say that there is a lack of conclusive research on managing PFO after stroke or transient ischemic attack, thus no clearly established treatment. The "call to action" advisory is published in Circulation: Journal of the American Heart Association and the Journal of the American College of Cardiology and cites research that shows PFO present in 33.8% to 43.9% of patients with cryptogenic stroke.
(http://americanheart.mediaroom.com/index.php?s=43&item=734 and http://content.onlinejacc.org/cgi/content/full/j.jacc.2009.04.001)
Aspirin may reduce stroke in those with PAD .... Aspirin, with or without dipyridamole, may reduce the risk of stroke in patients with peripheral artery disease (PAD), according to a meta-analysis. Among 18 randomized trials, aspirin therapy yielded a non-significant decrease in the risk of myocardial infarction, stroke, or cardiovascular death, according to researchers at the University of Colorado at Denver and colleagues. There was, however, a statistically significant decrease in the secondary endpoint of non-fatal stroke alone, they report in the May 13 issue of the Journal of the American Medical Association. Beyond perceived cardiovascular benefits, several studies have shown that aspirin "delays the rate of PAD progression, reduces the need for lower extremity revascularization, and reduces graft failure in patients who have undergone lower extremity revascularization procedures," the researchers said.
SCAAR registry: reassurance on DES safety .... A new study analyzes the outcomes of 47,967 patients entered in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) between 2003 and 2006, finding no increased risk of death between groups receiving bare metal stents (BMS) and drug-eluting stents (DES). An initial SCAARS study showed that patients receiving DES in Sweden between 2003 and 2004 had increased late mortality over those receiving BMS, suppressing subsequent use of DES. Professor Eric Eeckhout, speaking for the European Society of Cardiology (Sophia Antipolis, France), said the difference in the conclusions likely reflects "the way in which cardiology practice has evolved over time, leading to greater optimization of the results of stenting. Significant changes include use of higher balloon pressures and the increased use of dual anti-platelet therapy." The study appears in the May 7 issue of The New England Journal of Medicine.
Use of Carillon device shows early positive results .... A device that acts like a belt to reshape an enlarged, leaky heart valve is providing a minimally invasive treatment option for patients who are too sick for open-heart surgery. Data from the Annuloplasty Device European Union Study (AMADEUS), presented at the scientific sessions of the Society for Cardiovascular Angiography and Interventions (SCAD; Washington), showed that the Carillon Mitral Contour System safely treated leaky mitral valves, even in patients with moderate-to-severe heart failure. AMADEUS, enrolling 48 patients, was funded by Cardiac Dimensions (Seattle), manufacturer of the Carillon, which was recently granted the CE Mark. (www.cardiacdimensions.com/usa/press-release-5-4-09.html)
First Test My Heart Tour of England .... A campaign to reduce the number of undiagnosed heart conditions, using a mobile unit donated by Philips (Amsterdam, the Netherlands) equipped with Philips' ECG and ECHO equipment – will visit 12 locations in England in May and June. Sponsors said the CRY Philips Test My Heart Tour 09 is the first free tour of its kind in England, made possible by Philips, the CRY (Cardiac Risk in the Young; Surrey, UK) charity and the Gwyneth Forrester Trust (Kent, UK). The tour aims to test over 3,000 people, ages 14-35, to identify heart conditions which could prove fatal if not treated. Every week, 12 young people die as the result of sudden cardiac death in the UK, according to CRY. (http://testmyheart.org/)
Study: financial impact of stroke in China .... A study of almost 5,000 stroke patients across 62 hospitals in China finds that more than 70% of these stroke survivors experience a catastrophic impact on their finances due to lost income and the costs of their care. Extrapolating, more than one-third of stroke patients in China are pushed below the poverty line due to out-of-pocket expenses for care. The study was conducted by Australian and Chinese researchers. The Chinese government reportedly is launching health reform intended to achieve various improvements by 2020. The findings were published in Stroke. (PDF at http://researchaustralia.org/RA/Media/MemberMediaReleases/2009/May-June2009.aspx)
Females do less well than men undergoing PCI for heart attack .... Women who undergo percutaneous coronary intervention (PCI) for heart attack often fare less well than men, according to studies presented at the annual scientific sessions of the Society for Cardiovascular Angiography and Interventions (SCAI; ). The studies found that women undergoing angioplasty for heart attack are often older (average, nine years), are in poorer condition and that they and caregivers are slower to recognize symptoms. Then, women are less likely to develop brisk blood flow through the treated artery after PCI. Women thus face twice the risk of procedural failure and an increased risk of death. (www.scai.org/)
— Compiled by Don Long, MDD National Editor