Medscape Conference Coverage, based on selected sessions at the:

American Heart Association 2006 Scientific Sessions

November 12 - 15, 2006; Chicago, Illinois

This activity is not sanctioned by, nor a part of, the American Heart Association.

Conference News

Raloxifene May Increase Fatal Stroke Risk in Postmenopausal Women

[Medscape Medical News]
Secondary analysis from the RUTH trial suggests a small potential increase in the risk for fatal strokes, although not in the overall stroke risk, in postmenopausal women at risk for coronary heart disease.
Evidence Lacking for Most Nutraceuticals

[Heartwire]
Despite the myriad of cardiovascular health claims made by manufacturers of nutritional supplements, only a few substances can boast hard scientific evidence to support these assertions.
Statins Help, Low Cholesterol Hurts Survival in Acute HF

[Heartwire]
The drugs probably benefit patients with HF through non-lipid-lowering effects, but whether those with initially low total cholesterol levels should receive the drugs remains unsettled, according to investigators.
New Anticoagulant With an "On-Off" Switch

[Heartwire]
A novel anticoagulant using RNA aptamer technology in early development is hoped to overcome many of the limitations of current agents, in that it is selective, has a rapid onset of action, can be easily titrated, and is fully reversible with the use of an antidote.
Insights Into Marathoners' Hearts: Don't Believe the Hypertrophy

[Heartwire]
New findings from screening tests of marathon runners over age 50 suggest that while traditional Framingham risk scores are low, coronary artery calcium scans and MRI point to subclinical atherosclerosis and increased LV mass that may not merely be adaptation to endurance exercise.
Late Symptomatic Recurrence Observed in AF Patients "Cured" With Pulmonary-Vein Isolation

[Heartwire]
A small observational study suggests there is a risk of late AF recurrence among patients free of the arrhythmia at one year with pulmonary-vein isolation. These findings stress the importance of long-term follow-up and raise issues about anticoagulation strategies in AF patients undergoing pulmonary-vein isolation, say investigators.
Hypertension in Pregnancy Linked to Increased Risk for CVD, Microalbuminuria

[Medscape Medical News]
A new study by Mayo researchers suggests that women who develop hypertension during pregnancy face a higher risk for stroke, CHD, hypertension, and microalbuminuria later in life.
Glycemia Levels Prognostic in Nondiabetics With Heart Failure: A New HF Treatment Target?

[Heartwire]
They don't show cause and effect, but two recent studies suggest that heart-failure outcomes in nondiabetics slide with rising degrees of glycemia.
Anger Is a Trigger for VT/VF in ICD Patients

[Heartwire]
Getting mad never does much good, but now doctors can tell their ICD patients that getting angry increases the risk of getting zapped by their defibrillator. In this new study, acute episodes of moderate anger were associated with a significantly greater risk of ICD discharge.
Universal Donor Cells Suitable for Any Patient Who Needs Myocardial Repair

[Medscape Medical News]
"Off-the-shelf" stem cells for repairing heart damage may be a reality soon.
Smoking in Pregnancy Causes Congenital Heart Defects

[Heartwire]
Women who smoke during the first trimester of pregnancy are 60% more likely to have a child with congenital heart disease than women who don't smoke, according to a new case-control study. Specifically, smoking during this period increases the risk of right-sided obstructed heart and septal defects, the lead researcher explained.
Fat May Be a Safe Source of Stem Cells in the Elderly

[Medscape Medical News]
Adipose tissue appears to be a fertile source of autologous stem cells for the repair of vascular tissue in older cardiac patients.
Chocolate Has Antithrombotic Effects Similar to Aspirin

[Medscape Medical News]
In an unplanned subanalysis of GeneSTAR, chocolate lowered the risk of platelet aggregability and cardiovascular disease.
Amniotic Fluid-Derived Stem Cells Grown Into Functional Heart Valves

[Medscape Medical News]
Stem cells extracted from amniotic fluid can be induced to grow on a polymer scaffold into a fully functional human heart valve that will open and close like a native valve, Swiss researchers report. The process may find application in neonatal valvulopathy.
Migraine Linked to Increased CVD Risk in Men

[Medscape Medical News]
A new report from the Physicians' Health Study suggests that, as in women, men with migraine face a higher risk for cardiovascular disease, particularly myocardial infarction, over time.
Pilot Study Shows Ablation Is Superior to Biventricular Pacing for Treatment of AF in CHF Patients

[Heartwire]
Pulmonary vein isolation is superior to biventricular pacing for the treatment of atrial fibrillation in chronic heart failure patients, a new study shows. Although the procedure is technically demanding, one expert suggests that curative ablation could become the standard of care for the treatment of atrial fibrillation in this patient population.
Canadian Study Indicates BNP Test for Suspected Heart Failure is Cost-Effective

[Heartwire]
A new Canadian study looking at the use of BNP testing in patients with shortness of breath attending the emergency room has found that the assay saved almost $1,000 per patient, by helping doctors better decide who had, and who did not have, heart failure. Although BNP testing is widely used in the US and some other countries, Canada's publicly funded healthcare system has yet to embrace it, says the investigator.
Noninvasive Microvolt T-Wave Alternans Test for Selective Targeting of Primary-Prevention ICDs Gets More Trial Support

[Medscape Medical News]
The ECG-like test can help target the devices to patients most likely to need them, confirms a study that also supports a possible complementary but selective screening role for traditional electrophysiologic testing, according to some experts.
Arm Exercise May Reduce Leg Pain Caused by Peripheral Arterial Disease

[Medscape Medical News]
A potential systemic effect from arm exercise may help the elderly and disabled unable to perform leg exercises.
Death Is an Option: The Benefit of ICDs Is "Not as Big as We Think"

[Heartwire]
Patients and doctors grossly overestimate the benefits of implantable cardiac defibrillators, new studies show. Physicians must have candid discussions with their patients to quantify the true benefits of these devices, to explain that most people will still die from heart failure in the long run, and to raise the issue of advance directives, the researchers say.
PCI No Better Than Optimal Medical Therapy in Persistent Total Occlusions Three to 28 Days Post-MI: OAT and TOSCA-2

[Heartwire]
Late angioplasty for occluded infarct-related arteries is no better than medical management in reducing rates of death, reinfarction, or heart failure and may even increase reinfarction rates, despite the presence of patent arteries and less left ventricular enlargement. The findings are a reproof to clinicians who prematurely decided, long before the results were in, that PCI would be superior.
SALT 1 and 2: Tolvaptan Shows Promise in Hyponatremia

[Medscape Medical News]
Results of 2 trials of an oral vasopressin V2-receptor antagonist show that treatment effectively increased serum sodium concentrations in patients with euvolemic or hypervolemic hyponatremia.
Cognition Impaired After Bypass Surgery in Smokers

[Medscape Medical News]
A history of smoking more than doubled the risk for cognitive decline above normal baseline levels.
ACC/AHA Launch D2B Initiative; New Study Highlights Key Ingredients for Closing the Gaps

[Heartwire]
As previously reported by heartwire, the D2B initiative is a Guidelines Applied in Practice program that aims to increase the percentage of AMI patients who receive primary angioplasty within 90 minutes of hospital presentation to 75%; currently, only 35% of patients are treated within the recommended 90-minute window.
Study Confirms Folic Acid, B Vitamins Do Not Prevent Cardiovascular Events

[Heartwire]
Yet another study has shown no benefit of folic acid and B vitamins in the secondary prevention of cardiovascular events, leading researchers to conclude that there is no reason for anyone to take these supplements for the prevention of heart disease. The trial also showed that the fortification of food with folic acid in the US does not explain the negative findings.
FAME: Pharmacy-Care Program Improves Medication Adherence, as Well as BP and LDL-Cholesterol Levels

[Heartwire]
A new study has shown that a comprehensive-care program, one that involves pharmacists and focuses on patient education, dramatically improves drug adherence. It is also associated with improvements in blood pressure and LDL-cholesterol levels.
CHICAGO: Pioglitazone Slows Progression of Carotid Atherosclerosis vs Glimepiride

[Medscape Medical News]
Results of a head-to-head comparison of 2 antidiabetes drugs have shown an advantage for pioglitazone over glimepiride in reducing progression of carotid intima-media thickness in patients with type 2 diabetes.
Selective TZD Use Won't Exacerbate HF Symptoms in Diabetics With Heart Failure, Says Analysis

[Heartwire]
Many diabetics with established heart failure can apparently take thiazolidinediones safely, as long as they are carefully followed for signs of HF exacerbation, according to investigators.
Presence of Calcium Leads to Improved Use of Statins, Aspirin in Asymptomatic Men

[Heartwire]
Researchers say their study is the first to show that a calcium score, above and beyond presence of traditional risk factors, influences physician management decisions. One can "reasonably infer" that patient outcomes would also improve.

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The materials presented here were prepared by independent authors under the editorial supervision of Medscape and do not represent a publication of the American Heart Association. These materials and the related activity are not sanctioned by the American Heart Association or the commercial supporter of the conference and do not constitute an official part of that conference.