Added On : 30th July 2011Registry data show that the rate of late PCI on completely occluded arteries did not decline after the OAT findings prompted guideline recommendations against it.
The 2006 Occluded Artery Trial (OAT) demonstrated no benefit of percutaneous coronary intervention (PCI) to treat completely occluded culprit arteries >24 hours after acute myocardial infarction (MI; JW Cardiol Nov 14 2006).
Consequently, the 2007 American College of Cardiology/American Heart Association guidelines for ST-segment-elevation MI (STEMI), non-STEMI, and PCI include class III recommendations against such treatment. To what extent have the OAT results and the guideline recommendations been incorporated into practice?
Added On : 12th August 2011Ticagrelor Trumps Clopidogrel in ACS Patients Slated for Noninvasive Management
The results of yet another prespecified subgroup analysis mimic those of the larger trial.
Note: Ticagrelor has now been approved by the FDA for marketing in the U.S. For a discussion of the response to this approval in the cardiology community, see the recent Voices blog on CardioExchange, an online forum for cardiology news and discussion.
Added On : 24th September 2011In 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.
Added On : 5th November 2011Focused 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.