Keeping you up to date on recent headlines in cardiovascular healthcare:


U.S. Heart treatment costs: $78 billion annually .... Opening blocked arteries, trying to keep heart attack victims alive, fixing defective heart valves, and the full range of heart treatments cost the U.S. $78 billion in 2006 roughly 8% of the more than $1 trillion spent on all medical care in America, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (Washington). The statistics reviewed by AHRQ reflect costs for hospital admissions, emergency department visits, visits to doctors' offices and hospital outpatient departments, home healthcare, and prescription drug spending.

(www.meps.ahrq.gov/mepsweb/data_stats/quick_tables_results.jsp?component=1&subcomponent=0&year=1&tableSeries=2&searchText=&searchMethod=1&Action=Search: go to table 3)

ACC/AHA updates heart failure guidelines .... The American College of Cardiology (Washington) and the American Heart Association (Dallas), in collaboration with the International Society for Heart and Lung Transplantation (Addison, Texas) have updated guidelines, released in 2005, for the diagnosis and management of heart failure. The new document ranges from management of heart failure patients to new medication regimens to "streamlined" information concerning the use of ICDs. (http://americanheart.mediaroom.com/index.php?s=43&item=699)

Nile Therapeutics heart failure clinical trial put on hold .... Nile Therapeutics (San Francisco) last week reported that the FDA has put on hold its Phase IIb clinical trial using its drug CD-NP, a chimeric natriuretic peptide used to treat acute heart failure. The FDA requested additional data from the recently completed Phase IIa clinical trial and modifications to CD-NP's Investigator Brochure. The company said it is working diligently to respond in a timely manner to respond to the FDA's (www.nilethera.com/pr090327.html)

No added benefit for reshaping ventricle over bypass surgery .... A type of surgery which reshapes the scarred left ventricle, often done in conjunction with heart bypass, not only failed to reduce deaths and hospitalizations in heart failure patients but also did not improve patients' quality of life compared to bypass alone after four years of follow-up, according to the results of a large international clinical trial funded by the National Heart, Lung, and Blood Institute of the NIH. These results, from the Surgical Treatment for Ischemic Heart Failure Trial (STICH), were presented at the ACC's Annual Scientific Session in Orlando. Although both types of surgeries improved symptoms such as angina and ability to exercise, after 4 years of follow-up, there were no significant differences between the two groups in combined rates of death and heart-related hospitalizations. Results from a second STICH trial, which is comparing the benefits and risks of bypass surgery with medical therapy alone, are to be reported in 2011. (http://public.nhlbi.nih.gov/newsroom/home/GetPressRelease.aspx?id=2633)

Improved predictive value of heart failure biomarkers reported .... Reports in the April issue of the European Journal of Heart Failure suggest two more efficient applications of biomarkers. One report indicates improved prognostic information for the biomarker N-terminal pro-B-type natriuretic peptide (NT-proBNP) 354 patients with chronic heart failure treated in a community-based heart failure program. A study from Sweden indicated usefulness in the combination of time serum measurements with measurements of NT-proBNP for mortality risk assessment.

(www.escardio.org/about/press/press-releases/pr-09/Pages/Stent-4-Life.aspx)

AHRQ study: lower risk of heart attack, death with DES vs. BMS .... Heart disease patients 65 and older who receive drug-eluting stents (DES) are more likely to survive and less likely to suffer a heart attack than those receiving bare metal stents (BMS), according to a new study supported by the Agency for Healthcare Research and Quality and the American College of Cardiology's National Cardiovascular Data Registry. AHRQ said that the study of 262,700 stent-implanted Medicare patients is the largest ever to compare DES with BMS. The report was presented on Saturday at the ACC's Scientific Session. (www.ahrq.gov/news/press/pr2009/stentspr.htm)

Study: Individualized CBT stroke treatment under-utilized .... A study published in Catheterization and Cardiovascular Interventions, the official journal of The Society for Cardiovascular Angiography and Interventions (SCAI), supports the effectiveness of catheter-based therapy (CBT) to remove blood clots in stroke patients. It is estimated that less than 5% of patients eligible for thrombolysis drug treatment receive it, prompting interest in alternative therapies such as CBT, according to researchers from the Ochsner Heart and Vascular Institute (New Orleans). (www.seconds-count.org)

American Association Of Heart Failure Nurses Annual Meeting .... The Annual Meeting of The American Association of Heart Failure Nurses (AAHFN; Mount Laurel, New Jersey) Annual Meeting will be held June 24-27, 2009, at the Hyatt Regency Minneapolis (Minneapolis, Minnesota). Topics of interest will range from assessment and treatment of heart failure to the use of implantable device therapies. (www.aahfnannualmeeting.com)

Kaiser Permanente pilot reduces cardiac deaths by 73% .... Kaiser Permanente (Oakland, California) reported that it has substantially improved the heart attack survival rate for its members in Colorado through a program that links coronary artery disease patients, and teams of pharmacists, nurses, primary care doctors and cardiologists, with an electronic health record and advanced clinical care registry. The results of this pilot, the Collaborative Cardiac Care Service, were demonstrated at the Washington briefing, "Reforming the Health Care Delivery System: A Team Approach." Among the results: Patients have an 88% reduced risk of dying of a cardiac-related cause when enrolled within 90 days of a heart attack, compared to those not in the program; the number of patients meeting their cholesterol goal increased from 26% to 73%; and the patients screened for cholesterol increased from 55% to 97%.

(http://xnet.kp.org/newscenter/pressreleases/nat/2009/032709ahrstudy.html)

Cholesterol crystals linked to cardiovascular attacks .... For the first time ever, a researcher at Michigan State University (MSU; Lansing, Michigan) has shown cholesterol crystals can disrupt plaque in a patient's cardiovascular system, causing a heart attack or stroke. As reported in the April issue of the American Journal of Cardiology, as cholesterol builds up along the wall of an artery, it crystallizes from a liquid to a solid state, expands and work their way into the bloodstream. In separate research published in the March edition of Atherosclerosis, the same MSU researchers reported that physical conditions such as temperature can play a role in how quickly cholesterol crystallizes and potentially causes a rupture. (http://news.msu.edu/story/6099/)

A possible risk group for statin use .... In a patient study of more than 1,000 individuals with coronary artery disease (CAD), researchers have found that high levels of an enzyme called PLTP significantly increased the risk of heart attack in the subset of patients taking statins. While follow-up studies will be needed to tease out the exact connection between PLTP and statins, this connection does suggest levels of PLTP in the blood should be a consideration for potential statin treatment.

(www.jlr.org/cgi/content/abstract/M800414-JLR200v1)

— Compiled by Don Long, MDD National Editor

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