Getting the Ejection Fraction Right: Reducing Interobserver Variability

In one echocardiography laboratory, a formal teaching intervention significantly improved an important measure of quality.

An Implantable Device for Resistant Hypertension Performs Well in a Randomized Trial

Baroreflex activation therapy safely lowered systolic blood pressure in patients who had hypertension despite taking an average of five antihypertensive drugs.

In phase I and II trials, a cardiac myosin activator safely improved systolic function without increasing myocardial oxygen consumption.

It seems intuitive that agents that improve cardiac contractility would help patients with systolic dysfunction. Unfortunately, existing agents — including dobutamine (an adrenergic stimulant), milrinone (a phosphodiesterase inhibitor), and levosimendan (a calcium sensitizer unavailable in the U.S.) — are associated with morbidity and mortality that outweigh their benefits. Two manufacturer-sponsored studies now provide early insights into the possible use of omecamtiv mecarbil, a novel selective cardiac myosin activator that, in animal models, increases cardiac contractility without increasing intracellular calcium.

Delays in Treatment for STEMI Increase Risk for Heart Failure

Findings from a population-based observational study suggest that reducing time from EMS call to PCI could improve morbidity as well as mortality.

Time in Therapeutic Range for Warfarin — A European Success Story

A Swedish registry and quality-improvement program resulted in a mean TTR of more than 75%.

Focused Update: ACC/AHA Guidelines on Peripheral Arterial Disease

Revised recommendations emphasize early detection of PAD, prevention of cardiovascular events, and the equivalence of surgical and endovascular revascularization.

Sponsoring Organizations: American College of Cardiology, American Heart Association, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society for Vascular Medicine, Society for Vascular Surgery

Background and Purpose: Changes to recommendations for the management of lower-extremity arterial and abdominal aortic disease reflect clinical-study evidence published since completion of the 2005 guidelines. The 2005 recommendations regarding renal and mesenteric arterial disease remain unchanged in the absence of new pivotal studies of disease in these segments.

Clopidogrel Dosing Based on Genotype: What Difference Does It Make?

In patients heterozygous for the CYP2C19*2 allele, higher doses significantly reduced platelet reactivity, but whether genotype-guided dosing improves outcomes remains unknown.

Evacetrapib Raises HDL and Lowers LDL — but Then What?

The cholesterol ester transfer protein inhibitor evacetrapib had very favorable lipid effects, but the trial was small and lasted only 12 weeks.

Compared with other smoking-cessation treatments, the risk for suicidal behavior or depression was markedly increased with varenicline.

Even with Anticoagulation Therapy, Higher CHADS2 Scores Predict Worse Outcomes

In a RE-LY substudy, the correlation was present and similar in all treatment arms.