Distinguished Cardiologists and Scientists Honored with 2008 International Academy of Cardiology Awards
A world-renowned panel of 130 cardiologists and scientists, members of the Faculty of the International Academy of Cardiology (IAC) announced the 2008 International Academy of Cardiology Awards during the 14th World Congress on Heart Disease held in Toronto, ON, Canada. Recipients include: Professor Harisios Boudoulas, M.D.; Professor Robert Roberts, M.D.; Professor Philip R. Liebson, M.D.; Professor Sherif F. Nagueh, M.D.; and Professor Udho Thadani, M.D. Three faculty, Professor Martin Alpert, M.D.; Professor Naranjan S. Dhalla, PhD, M.D. (Hon) and Professor John A. Elefteriades, M.D. were also honored with the Distinguished Fellowship Award. Professor Asher Kimchi, M.D., Founder and Chairman of the IAC, said, "In the past 19 years the IAC has grown from a prestigious academy to one of the world's preeminent forum for top Cardiologists and Scientists. These Professors are the best of the best. We are proud to honor them with these well-deserved awards." MORE»

Merck/Schering-Plough Pharmaceuticals Provides Results of the ENHANCE Trial
Merck/Schering-Plough Pharmaceuticals announced the primary endpoint and other results of the ENHANCE (Effect of Combination Ezetimibe and High-Dose Simvastatin vs. Simvastatin Alone on the Atherosclerotic Process in Patients with Heterozygous Familial Hypercholesterolemia) trial. ENHANCE was a surrogate endpoint trial conducted in 720 patients with Heterozygous Familial Hypercholesterolemia (HeFH). The primary endpoint was the mean change in the intima-media thickness (IMT) measured at three sites in the carotid arteries (the right and left common carotid, internal carotid and carotid bulb) between patients treated with ezetimibe/simvastatin 10/80 mg versus patients treated with simvastatin 80 mg alone over a two year period. There was no statistically significant difference between treatment groups on the primary endpoint. The change from baseline in the mean carotid IMT was 0.0111 mm for the ezetimibe/simvastatin 10/80 mg group versus 0.0058 mm for the simvastatin 80 mg group (p =0.29). At baseline, the mean carotid IMT measurement for ezetimibe/simvastatin was 0.68 mm and for simvastatin 80 mg was 0.69 mm. There was also no statistically significant difference between the treatment groups for each of the components of the primary endpoint, including the common carotid artery. Key secondary imaging endpoints showed no statistical difference between treatment groups. MORE»

Blocking Early Steps in Platelet Aggregation Reduces Stroke Infarct Size Without Increasing Intracerebral Hemorrhage (ICH)
Ischemic stroke is the third leading cause of death and permanent disability in industrialized countries. Currently, the anticoagulant therapies available to treat ischemic stroke offer moderate benefit on stroke progression and recurrence, but this is outweighed by a significant increase in the rate of ICH. During ischemia, platelets can adhere to hypoxic endothelial cells by binding of their glycoprotein (GP) Ib receptor to von Willebrand factor (vWF) on the endothelial surface. Additionally, subendothelial matrix proteins are exposed, allowing firm attachment of platelets to the vessel by binding of collagens to their GPVI receptor. These processes lead to activation of platelet GPIIb/IIIa and platelet aggregation. Christoph Kleinschnitz, MD et al from the University of Würzburg in Würzburg, Germany tested the hypothesis that blocking platelet aggregation and activation at various steps in these pathways may reduce infarct size following ischemic stroke. Their results, published in the May 1, 2007 issue of Circulation, showed that targeting platelet GPIb or GPVI receptors protects mice from ischemic brain injury in an experimental stroke model without increasing bleeding complications. In contrast, blockade of the final common pathway of platelet aggregation with anti-GPIIb/IIIa antibodies had no positive effect on stroke outcome and dose-dependently raised the incidence of ICH and mortality. MORE»

Intravenous Hydrocortisone Reduces the Incidence of Atrial Fibrillation (AF) after Cardiac Surgery
The incidence of AF has been reported to be 20-40% after coronary bypass graft (CABG) surgery, and is even higher after valve and combined valve and bypass surgery. A potential mechanism for the AF is an exaggerated inflammatory response, demonstrated by increased levels of complement, C-reactive protein complex, and number of white blood cells in patients who develop AF. Jari Halonen, MD et al from Kuopio University Hospital in Kuopio, Finland investigated whether intravenous corticosteroids administered after cardiac surgery prevents AF after cardiac surgery. Their results, published in the April 11, 2007 issue of the Journal of the American Medical Association concluded that intravenous hydrocortisone reduced the incidence of AF after cardiac surgery. MORE»

Elastin Stabilization is an Effective and Safe Treatment for Abdominal Aortic Aneurysms (AAAs) in a Rat Model
Currently, a pharmacologic treatment for AAAs does not exist. Present treatment options include endovascular stents or open surgery, but these procedures are not appropriate for all patients and there are risks involved. One of the characteristic features of AAAs is matrix metalloproteinase (MMP) mediated loss of elastin. However, elastin can be rendered resistant to enzymatic degradation when bound by tannins. Jason C. Isenburg, PhD and Dan T. Simonescu, PhD et al from the Department of Bioengineering at Clemson University in Clemson, SC explored the effects of polyphenolic tannins, specifically petagalloly glucose (PGG), on AAA development. The results of their study, published in the April 3, 2007 issue of Circulation, concluded that acute localized periadventitial delivery of noncytotoxic concentrations of PGG inhibits elastin degradation, attenuates aneurysmal diameter expansion, and hinders development of AAA in an established animal model. MORE»

Pulse Pressure is a Risk Factor for New-Onset Atrial Fibrillation (AF)
Atrial fibrillation is associated with an increased risk of mortality and stroke, and every one in four people will develop AF at some point in their lifetime. Already recognized clinical risk factors for AF include advancing age, increased systolic blood pressure, diabetes, hypertension, heart failure, valvular disease, myocardial infarction, and obesity. Echocardiographic risk factors for AF include left atrial enlargement, increased left ventricular wall thickness, and impaired left ventricular systolic function. Gary F. Mitchell, MD et al from the Cardiovascular Engineering Inc. in Waltham, MA investigated whether pulse pressure, a reflection of aortic stiffness, could be a potentially easily modifiable risk factor for AF. Their study, published in the February 21, 2007 issue of The Journal of the American Medical Association, found that pulse pressure is in fact an important risk factor for incident AF in a community-based sample. MORE»

Intensive Treatment with Atorvastatin in Patients with Stable Coronary Artery Disease Significantly Reduces Hospitalizations for Heart Failure (HF)
Statins are known to reduce the rate of major cardiovascular events through their lipid lowering effects, but their potential benefit as treatment for HF is largely unexplored. Kiran K. Khush et al from University of California, San Francisco School of Medicine compared the effects of two doses of the same statin formulation to determine their impact on the incidence of hospitalization for HF among the two treatment arms. This study, which was published in the February 6, 2007 issue of Circulation, found that intensive treatment with atorvastatin in patients with stable coronary artery disease significantly reduces subsequent hospitalizations for HF compared with low-dose therapy. This benefit was most pronounced in patients with a history of HF. MORE»

Alleles for Long –QT Syndrome are More Often Transmitted to Daughters Than to Sons 
Congenital long-QT syndrome is a rare cardiac disorder in which patients present with a prolongation of the QT interval of the heart rate. The patients are at risk for ventricular arrhythmias, which could lead to syncope and death. Inheritance of long-QT syndrome is autosomal dominant but can also be recessive. Mutations in the potassium-channel genes, KCNQ1 and KCNH2, cause type 1 and type 2 forms of the disease, respectively.  A female predominance has often been observed and has been attributed to an increased susceptibility to cardiac arrhythmias. Pascale Guicheney, PhD et al from the INSERM in Paris, France investigated the possibility of an unbalanced transmission of the deleterious trait to women. Their results showed a skewed segregation of the mutations from mothers to their daughters and explained how it contributes to the female predominance in long-QT syndrome. The study was published in the December 28, 2006 issue of The New England Journal of Medicine. MORE»

Decontamination of Nasopharynx and Oropharynx with Chlorhexidine Gluconate Appears to Reduce Nosocomial Infection After Cardiac Surgery
Nosocomial infections after open-heart surgery are recognized as an important cause of complications and mortality. Patrique Segers, MD et al from the University of Amsterdam set out to determine the efficacy of perioperative decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate for reduction of nosocomial infection after cardiac surgery. Their study, published in the November 22/29 issue of the Journal of the American Medical Association found that decontamination with chlorhexidine gluconate appears to be an effective method to reduce nosocomial infection after cardiac surgery. MORE»

Percutaneous Coronary Intervention Did Not Reduce the Occurrence of Death, Reinfarction, or Heart Failure in Patients with Occlusion of the Infarct-Related Artery 3 to 28 Days after Myocardial Infarction
Current treatment of acute myocardial infarction (MI) with ST-segment elevation includes early reperfusion with primary percutaneous coronary intervention (PCI. For patients with persistent total occlusion of the infarct-related artery who have been identified after the currently accepted period during which reperfusion is administered, the best strategy for care has been unclear until now.  Judith Hochman M.D., et al from the New York University School of Medicine, conducted a 4 year study showing that PCI did not reduce the occurrence of death, reinfarction or heart failure in patients with occlusion of the infarct-related artery 3 to 28 days after myocardial infarction. The article was published in the November 14, 2006 issue of The New England Journal of Medicine. MORE»

Radiofrequency Catheter Ablation Should Be Considered a First-Line Therapy After the First Episode of Symptomatic Atrial Flutter
Until now, there have been no studies comparing amiodarone therapy and radiofrequency catheter ablation (RFA) for patients who have had one episode of atrial flutter (AFL). Antoine Da Costa, MD, PhD et al from the University Jean Monnet in Saint-Etienne, France did a study comparing the efficacy and safety of first-line RFA versus AFL therapy. The study found that RFA should be considered a first-line therapy even after the first episode of symptomatic AFL due to better long-term success rate, the same risk of subsequent AF and fewer secondary effects. The study was published in the October 17, 2006 issue of Circulation. MORE»

Intracoronary Injection of Mononuclear Bone Marrow Cells in Acute Myocardial Infarction Found No Effects on Global Left Ventricular Function
The net loss of cardiomyocytes during myocardial infarction is a key factor in the impairment of cardiac-pump function. The bone marrow contains stem cells that have shown promising results in solid-organ repair and regeneration.  Ketil Lunde M.D. et al from the Rikshospitalet University Hospital in Oslo, Norway designed a randomized, controlled trial to investigate the effects of intracoronary injection of autologous cells from bone marrow (BMC) in the acute phase of myocardial infarction. They investigated whether there was any improvement in left ventricular function after the treatment. The study, published in the September 21, 2006 issue of The New England Journal of Medicine, found no effects of intracoronary injection of autologous mononuclear BMC on global left ventricular function. MORE»

Sirolimus-Eluting Stents Reduce the Rate of Target-Vessel Revascularization Among Patients with Acute Myocardial Infarction
While it has been known that Sirolimus-eluting stents reduce the rates of restenosis and reintervention, the safety and efficacy of such stents in primary percutaneous coronary intervention (PCI) for acute myocardial infarction was not studied as extensively. Christian Spaulding, M.D. et al from the Cochin Hospital in Paris, France performed a single-blind, multicenter, randomized trial to compare sirolimus-eluting stents with uncoated stents in primary PCI for patients with acute myocardial infarction with ST-segment elevation. Their study, published in the September 14, 2006 issue of The New England Journal of Medicine, found among selected patients with acute myocardial infarction, the use of sirolimus-eluting stents significantly reduced the rate of target-vessel revascularization at 1 year. MORE»

Daptomycin may be an Alternative to Standard Therapy for Bacteremia and Endocarditis Caused by Staphylococcus aureus
Staphylococcus Aureus is a leading cause of bacteremia and endocarditis. Gentamicin plus penicillin or vancomycin is standard therapy for S. Aureus bacteremia. Vancomycin is the standard therapy for blood-stream infections attributable to methicillin-resistant S. aureus (MRSA). The standard therapy has been associated with suboptimal outcomes. Vance G. Fowler, Jr., MD, MHS, et al from Duke University Medical Center set out to establish whether daptomycin is an effective and safe treatment for S. aureus bacteremia and endocarditis. The study, published in the August 17, 2006 issue of The New England Journal of Medicine found that Daptomycin (6 mg per kilogram daily) is not inferior to standard therapy for S. aureus bacteremia and right-sided endocarditis. MORE»

Mediterranean Diets Supplemented With Olive Oil or Nuts Have Beneficial Effects on Cardiovascular Risk Factors
The low incidence of coronary artery disease in Mediterranean countries has been attributed to the dietary habits of the people of that region. A multi-center, randomized study by Ramon Estruch, MD, PhD et al from the Hospital Clinic in Spain compared the short-term effects of two Mediterranean diets versus those of a low-fat diet on intermediate markers of cardiovascular risk. The findings, published in the July 4, 2006 issue of Annals of Internal Medicine, found that compared to low-fat diets, Mediterranean diets supplemented with olive oil or nuts have beneficial effects on cardiovascular risk factors. MORE»

N-Acetylcysteine may Prevent Contrast-Medium Induced Nephropathy in Patients Treated With Primary Angioplasty
Patients with acute myocardial infarction undergoing primary angioplasty are at high risk for contrast-medium-induced nephropathy. Giancarlo Marenzi M.D. et al from the Institute of Cardiology at the University of Milan investigated the use of N-acetylcysteine for the prevention of contrast-medium-induced nephropathy in patients undergoing primary angioplasty. The study, published in the June 29,2006 issue of The New England Journal of Medicine, concluded that intravenous and oral N-acetylcysteine may prevent contrast-medium-induced nephropathy with a dose-dependent effect in patients treated with primary angioplasty and may improve hospital outcome. MORE»

Mutations in the Connexin 40 Gene, GJA5, Predisposes Patients to Idiopathic Atrial Fibrillation
Atrial Fibrillation is the most common type of cardiac arrhythmia characterized by erratic electrical activation of the atrial myocardium, resulting in loss of effective contractility and an increase in clot formation. Michael H. Gollob et al from the University of Ottawa Heart Institute studied the genetic basis of atrial fibrillation as it relates to mutations in the connexin 40 gene, GJA5. Their results, published in the June 22, 2006 issue of The New England Journal of Medicine, found that mutations in GJA5 may predispose patients to idiopathic atrial fibrillation by impairing gap-junction assembly or electrical coupling. MORE»

In Pediatric Patients With Cardiac Arrest, Survival Outcomes Were Higher Among Patients in Whom Ventricular Fibrillation or Tachycardia was Present Initially Than Among Those in Whom it Developed Subsequently
In children, cardiac
arrests are typically presented secondary to a progressive respiratory failure or shock, rather than as a primary arrhythmogenic event as seen in adults.
Ventricular fibrillation or tachycardia can also occur
during cardiopulmonary resuscitation (CPR) for asystole or pulseless electrical activity as a reperfusion
arrhythmia. A study by Robert A. Berg M.D et al, from
the Steele Children’s Research Center in Arizona, showed that a presentation of ventricular fibrillation or
tachycardia at the beginning of cardiac arrest results
in a better survival outcome than if the ventricular
fibrillation presented subsequently during CPR. The
study was published in the June 1, 2006 issue of The New England Journal of Medicine. MORE»

High-Dose Atorvastatin Reduces the Overall Incidence of Stroke or Transient Ischemic Attack
It has become evident that patients who take statins have a decreased incidence of stroke and cardiovascular risks. It has been, however, unknown whether patients with previous strokes or transient ischemic attacks (TIA) would benefit from taking statins. A study led by The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators showed that in patients with recent stroke or TIA and without known coronary heart disease, 80 mg of atorvastatin per day reduced the overall incidence of strokes and of cardiovascular events. This study was published in the August 10, 2006 issue of The New England Journal of Medicine. MORE»