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

HRS applauds AF resolution .... The Heart Rhythm Society (HRS; Washington) has issued a statement praising the introduction of House Resolution 255 calling for a National Atrial Fibrillation (AF) Awareness Month in September, introduced by Representative C.A. "Dutch" Ruppersberger (D-Maryland). "[L]ess than 30% of AF patients receive the recommended treatment," HRS said. "Therefore, an AF Awareness Month will play an important role in not only raising awareness but also improving patient care and ultimately saving lives." (See www.HRSonline.org)

Study: One in 100 blacks suffers early heart failure .... According to one of the first long-term studies to look at the life-threatening condition in younger adults has found that one in 100 black men and women develop heart failure before age 50. The study, appearing in yesterday's issue of the New England Journal of Medicine, looked at data from more than 5,100 blacks and whites in Chicago; Minneapolis; Birmingham, Alabama, and Oakland, California. The participants were ages 18 to 30 at the time they joined the study more than 20 years ago, and since than 27 people developed heart failure by age 50; all but one were black. Five died, all black.

The elderly with co-morbidities may not benefit from defibrillators .... Older people with co-morbidities or with multiple hospital admissions related to heart failure are unlikely to receive meaningful survival benefit from implanted defibrillators, according to a study by researchers from Brigham and Women's Hospital and Harvard Medical School (both Boston). This contrast with data registries indicating that implantable defibrillators are frequently implanted in older patients with heart failure: 61% of patients were 65 or older, and 15% were 80 or older.
(www.cmaj.ca/press/pg611.pdf)

Timely access to critical care unavailable for one in four Americans .... A new study by the University of Pennsylvania School of Medicine (Philadelphia), published in the journal Annals of Emergency Medicine, shows that 71% of Americans have access to an emergency department of some kind within 30 minutes, and 98 percent can reach one within an hour. But on a state-by-state basis, the findings suggest that many of those nearby facilities may not be able to provide care for the most emergent conditions. (www.emnet-usa.org)

Recommended following severe stroke: 'aggressive' brain surgery .... Aggressive brain surgery after suffering a severe stroke generally improves the patients' lives and allows them to live longer, according to research by neurologists at the University of Rochester Medical Center (Rochester, New York). The researchers made three separate analyses of patients who had had a serious type of stroke known as a malignant middle cerebral artery infarction, in which blood flow to a large part of the brain is cut off. Patients who didn't have the surgery were about three times more likely to die within a year than patients who did have the surgery, though many of the surgical patients were left with considerable disability. (www.rochester.edu/pr/news/story.cfm?id=2407)

New study of anergia fatigue in older heart failure patients .... Doctors and researchers at Columbia University Medical Center (New York) have focused on syndrome affecting and estimated 40% of older adults with heart failure: anergia, or lack of energy, a newly delineated, criterion-based geriatric syndrome. In a nine-month study, heart failure patients were provided an actigraph — a device worn on like a watch and used to assesses physical activity, energy expenditures and sleep by measuring limb movement. Significant discrepancies between self-reported fatigue and actigraphy readings suggest that the readings provide complementary and important information about the link between heart failure, sleep disorders and impairments in health-related quality of life that may be operative through anergia. (http://cumc.columbia.edu/news/press_releases/091003MaurerAnergia.html)

Miami stem cell trial completes safety phase .... Cardiologists at the University of Miami Health System (UHealth) reported completing the early safety phase of a trial involving first use in the U.S. of a unique injection catheter to deliver stem cells. The study, the Transendocardial Autologous Cells in Ischemic Heart Failure Trial (TAC-HFT), uses the Helical Infusion catheter system developed by BioCardia (San Carlos, California). The first four patients in the early phase received 10 injections each, with .25 ml of bone marrow stem cells, not a placebo. One group of patients in the randomized trial will get bone marrow cells, another group will get mesenchymal cells, and a third group will get a placebo. The goal is to test the ability of mesenchymal stem cells to enable the generation of new cardiomyocytes. (www.med.miami.edu/medicine/x784.xml)

Aspirin improves survival in women with stable heart disease .... New results from the Women's Health Initiative (WHI) Observational Study provide more evidence that aspirin may reduce the risk of death in post-menopausal women who have heart disease or who have had a stroke. Regular aspirin users had a 25% lower risk of death from cardiovascular disease and a 14% lower risk of death from any cause, compared to those women saying they had not taken aspirin. Overall, aspirin use did not significantly decrease the risk of heart attack, stroke or other cardiovascular events, except among women in their 70s. (Women's Health Initiative, www.nhlbi.nih.gov/whi/index.html)

New target for heart failure therapy found .... A novel signaling pathway plays a significant role in the production of aldosterone, a hormone that promotes heart failure after a myocardial infarction, according to a study conducted by researchers at Thomas Jefferson University (Philadelphia). The findings, published online this week in Proceedings of the National Academy of Sciences, show that aldosterone levels are elevated in chronic heart failure, its presence contributing to heart failure progression and diminished cardiac function after myocardial infarction. (www.tju.edu)

Those waking with stroke: candidates for clot-busters .... Giving clot-busting drugs to patients who wake up with stroke symptoms appears to be as safe as giving it to those in the recommended three-hour window, according to researchers at the University of Texas Medical School (Houston). "Thrombolytic Therapy for Patients Who Wake Up With Stroke" study results appear in the March issue of Stroke. (http://publicaffairs.uth.tmc.edu/media/newsreleases/nr2009/stroke_patients.htm)

Heart Rhythm Society meetings .... The Heart Rhythm Society, the Drug Information Association (Horsham, Pennsylvania), and the FDA will host a meeting, Cardiovascular Safety and QT/Arrhythmia Assessment in Drug Development: Optimizing Drug Development, April 29 to May 1 in Bethesda, Maryland. Discussions will include the collection and interpretation of clinical ECG data, including study design; strategies to design a program for QT assessment; and conducting and interpreting data from a thorough QT/QTc study. For information: Joe Krasowski at Joe.Krasowski@diahome.org.

HRS will hold an update on managing patients with atrial fibrillation (AF). Part of the society's AF 360° Initiative, March 28, at the Orange County Convention Center in Orlando, from 12 noon to 4 p.m. Topics will include anticoagulation and stroke prevention (including new devices and cardioversion), heart failure in AF, appropriate selection and endpoints for antiarrhythmic drug therapy, and patient selection and techniques surrounding catheter ablation to cure AF.

— Compiled by Don Long, MDD National Editor

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