Topic Overviews

• CME/CE Highlights of the American Heart Association (AHA) 2007 Scientific Sessions
  Physicians - maximum of 1.5 AMA PRA Category 1 credit(s)™
  Nurses - 1.5 nursing contact hours (1.5 of these credits are in the area of pharmacology)
  Pharmacists - 1.5 ACPE continuing education credits for pharmacists (0.15 CEUs)
  • The Ongoing Search to Lower LDL-Cholesterol: Targeting Squalene Synthase
    Michael H. Davidson, MD, FACC; Linda Brookes, MSc
  • Extended-Release Niacin and Statins in Mixed Dyslipidemia
    Michael H. Davidson, MD, FACC; Linda Brookes, MSc
  • Vasodilatory Beta-Blockade in Hypertension and Heart Failure
    Michael A. Weber, MD; Linda Brookes, MSc

Conference Coverage

• The Failure of Torcetrapib -- The Search for the Reason WhyWhy did torcetrapib fail? Was it the blood pressure? The electrolytes? New data from ILLUMINATE and ILLUSTRATE, and new CETP inhibitors suggest answers.
• The COURAGE Trial: The Controversy ContinuesA closer examination of the COURAGE trial results suggest PCI may in fact be a good strategy in patients with stable angina…or does it only confuse things more?
• Why Patients Stop Taking Statins and What Can Be Done About ItCoronary heart disease is almost an epidemic, but fortunately statin therapy is largely very effective and safe -- except that many patients stop taking their prescribed statin. Who and why?
• Adjunctive Therapy in ACS Patients: TRITON-TIMI 38, EVA-AMI, and BRIEF-PCIPrasugrel vs clopidogrel, eptifibatide vs abciximab in primary PCI, and brief vs standard infusions of GP IIb/IIIa inhibition after nonemergent PCI in ACS patients are described.

Expert Interviews

• Role of Newer Beta-blockers in Blood Pressure Control and Heart Failure: An Expert Interview With Alan H. Gradman, MDAHA 2007: A leading authority discusses whether the ability of the newer generation of beta-blockers to increase NO confers additional benefits for treatment of hypertension and heart failure.
• Lowering LDL Cholesterol: Beyond the Statins: An Expert Interview With Frank M. Sacks, MDAHA 2007: Physicians are increasingly aware that optimal statin therapy still leaves 50% "residual risk" -- here a well-known authority discusses present and future alternative LDL-C therapies.

Conference News

• CME DASH-Style Diet May Reduce Risk for CHD and StrokeThe Dietary Approaches to Stop Hypertension eating pattern has been shown to lower blood pressure, and this dietary pattern may translate into reductions in coronary heart disease and stroke events.
  Medscape Medical News, November 26, 2007
• DES Feasible and Safe for Cerebrovascular DiseaseA first look at just under 100 patients who received drug-eluting stents for significant intracranial stenosis shows that their use appears to be feasible in this indication, and they seem to be safe and produce more favorable outcomes than medical therapy or bare metal stents. However, further randomized trials are needed, say the researchers.
  Heartwire, November 21, 2007
• Vernakalant Bests Placebo for Converting AF Patients to Sinus Rhythm After Cardiothoracic SurgeryResults of the ACT II study suggest that the investigational antiarrhythmic may help almost half of all patients who develop atrial fibrillation or flutter after CABG or valve surgery.
  Heartwire, November 16, 2007
• Can Folic Acid Help Prevent Congenital Heart Disease?Public-health measures to increase folic-acid intake in Canada were followed by a decrease in the prevalence of severe congenital heart disease at birth, supporting the hypothesis that folic acid has a preventive effect on this outcome, researchers say.
  Heartwire, November 16, 2007
• CME Regular Fasting May Improve CVD RiskAn observational study of Latter-day Saints Mormons suggests that fasting may be a key driver of reduced cardiovascular disease in this group.
  Heartwire, November 14, 2007
• CME Oral Contraceptives Increase Risk of PlaquesOtherwise healthy young women who are past users of oral contraceptives have a 20% to 30% increased risk for carotid or femoral atherosclerosis vs women who have never used the pill.
  Heartwire, November 14, 2007
• Patients Treated With Percutaneous Aortic Valve Show Device Durability, Symptom ReliefThe series points to the steep learning curve with the Edwards Sapien valve and lower-than-expected mortality rates.
  Heartwire, November 14, 2007
• Nicotine Vaccine: Another Option for Smoking Cessation?A phase 2 study of a nicotine vaccine has shown that the highest dose tested produced antibodies against nicotine and was associated with a higher rate of smoking cessation than placebo.
  Heartwire, November 13, 2007
• MASCOT: Anti-AF Pacing Not Routinely Needed During HF Resynchronization TherapyThe incidence of new chronic atrial fibrillation was low in the trial and was the same whether or not the CRT device's AF-suppression function was activated.
  Heartwire, November 13, 2007
• RACE: A Herculean Attempt to Improve STEMI CareResearchers in North Carolina have instituted one of the largest and most extensive programs in the US to improve the treatment of STEMI, demonstrating significant improvements in quality of care. But there is still much work to be done.
  Heartwire, November 12, 2007
• CME POISEd to Change the Guidelines on Perioperative Use of Beta Blockers?Hailed as a landmark, the POISE trial has nevertheless generated mixed results, with no clear indication as to who will benefit and who will be harmed by the perioperative use of beta-blockers.
  Heartwire, November 9, 2007
• CME No Clinical Gain From Subbing ARB for ACE Inhibitor for BP-Lowering in CAD PopulationA randomized trial from Japan suggests that some populations might fare better from a multidrug strategy based on an angiotensin receptor blocker for lowering blood pressure.
  Heartwire, November 9, 2007
• Enrollment of Women in NIH-Funded CVD Trials No Better Now Than One Decade AgoInvestigators say the paucity of women in trials means not only missing information but potentially putting women at risk.
  Heartwire, November 9, 2007
• CME Simvastatin, but Not Pravastatin, May Reduce Sleep QualityResults of a randomized trial show that simvastatin, but not pravastatin, appears to interfere with sleep quality and increase sleep problems as assessed by patients.
  Medscape Medical News, November 8, 2007
• CME AF/CHF Trial: Rate as Good as Rhythm Control for AF in Heart FailureThe simpler strategy of controlling ventricular rate and allowing atrial fibrillation to persist was probably better than the more complex rhythm control.
  Heartwire, November 7, 2007
• Think Resynchronization Therapy for Heart Failure Benefits "Narrow-QRS" Patients? RethinQCardiac resynchronization therapy didn't improve functional outcomes among patients with a QRS duration <130 msec in the small randomized trial.
  Heartwire, November 7, 2007
• MASTER I: Disappointment for T-Wave Alternans TestingThe test did not predict life-threatening ventricular tachyarrhythmic events in patients with MADIT-2 criteria for ICD implantation and therefore should not be used to stratify ICD use in this group, researchers said.
  Heartwire, November 7, 2007
• Cardiac Stem-Cell Results Highlight Need for Standardization and Collaboration for the Field to Move ForwardResults from three new studies offer a glimpse of progress, but experts say the field needs to retrace its steps; understand the fundamental biology; and reach some consensus about what cells to use, how they're delivered, and when they should be used.
  Heartwire, November 7, 2007
• Genetic Guidance of Warfarin Dosing Shows PromiseUsing genetic tests improved the accuracy and efficiency of warfarin dose initiation in the Couma-Gen study, but the primary end point of a reduction in out-of-range INRs was not significantly changed.
  Heartwire, November 7, 2007
• Hypertension Vaccine Safe, Well-Tolerated in Phase 2a StudyResults of a phase 2a study suggest that an investigational vaccine against angiotensin II was safe and well-tolerated in patients with mild to moderate hypertension. Preliminary data also indicate good blood pressure control with the vaccine for up to 4 months.
  Medscape Medical News, November 6, 2007
• CME TRITON-TIMI 38: Prasugrel Lowers Events but Ups Bleeding vs ClopidogrelPrasugrel reduced ischemic events vs clopidogrel, but increased major (and fatal) bleeding in patients with acute coronary syndromes scheduled for percutaneous coronary intervention.
  Heartwire, November 6, 2007
• CME CORONA: Little Clinical Benefit Seen in First Major Statin Trial in Heart FailureStatins may not improve heart failure clinical outcomes, as expected, but there were some secondary signals suggesting some clinical benefit in patients with systolic heart failure of ischemic origin.
  Heartwire, November 6, 2007
• AED Use by Bystanders Improves Survival After Out-of-Hospital Cardiac ArrestA review of out of hospital cardiac arrests in 11 cities in the United States and Canada shows an impressive increase in survivors with the public availability of automated external defibrillators.
  Medscape Medical News, November 6, 2007
• New Torcetrapib Data Rejuvenate Interest in Other CETP InhibitorsNew data from the ILLUMINATE and ILLUSTRATE trials have shown that torcetrapib stimulates aldosterone, which possibly accounts for its adverse outcomes. In addition, both studies showed that patients with the largest HDL increases with the drug showed benefits, suggesting that the HDL produced was functional.
  Heartwire, November 6, 2007
• TRITON-TIMI 38: What Role for Prasugrel in ACS?The predominant view on the trial appears to be that prasugrel probably does have a role in clinical practice, as long as care is taken in certain patient groups at high risk of bleeding.
  Heartwire, November 6, 2007
• A Moratorium on CT Angiography? Not With Results Like CORE 64, Investigators SayDr Michael Lauer is calling for a moratorium on CT angiography pending outcomes studies. But investigators for the CORE 64 trial say studies demonstrating diagnostic capabilities of CTA are important baby steps toward slashing unnecessary, invasive tests.
  Heartwire, November 6, 2007
• The Nuclear Option: COURAGE Substudy Supports PCI for Ischemia Relief in Stable CADIt's old school, and yet. . . . A substudy of the trial that sparked a reevaluation of PCI for patients with stable coronary disease confirmed what has been long observed, that PCI on top of medical therapy is better than meds alone at reducing myocardial ischemia. Whether better ischemia relief means better clinical outcomes is still up in the air.
  Heartwire, November 5, 2007
• EVA-AMI: Eptifibatide Equal to Abciximab for STEMI Patients Undergoing PCIThe results will be reassuring to cath labs already substituting the cheaper GP IIb/IIIa inhibitor in STEMI patients, but at least one expert believes proof of equivalence for two GP IIb/IIIa inhibitors does not answer the question of whether these agents should be widely in use for STEMI patients.
  Heartwire, November 5, 2007
• Largest US Registry Study Supports Two-Year Safety, Reduced Revascularizations, for DESAt two years, DES were associated with comparable MI rates but statistically significant reductions in mortality and revascularizations. Investigators say they will continue to track the 17 000+ patients for at least five years, but for now the findings are "reassuring."
  Heartwire, November 5, 2007
• BRIEF-PCI: Infusion of Eptifibatide Can Be ShortenedA shortened, two-hour infusion of the GP IIb/IIIa inhibitor eptifibatide following nonemergency PCI is just as effective as the standard 18-hour infusion of the drug and is probably safer, according to a new study.
  Heartwire, November 5, 2007
• Quality-of-Life and Economic Data From OAT Support Original FindingsFurther quality-of-life and economic analysis of the Occluded Artery Trial support and reinforce the original conclusions of the study--that it is best to treat stable post-MI patients with optimal medical therapy alone rather than PCI.
  Heartwire, November 5, 2007