The Biggest Opportunities for Cost Savings in Cardiology: Take II

Harlan M. Krumholz, MD, SM
Voices
2 Feb 2012 - 

Let’s build on the suggestions that the community has made. How do we actually deliver on some on reducing these tests and procedures? What are we still missing?

Guiding TAVR into Clinical Practice

Steven Bailey, MD, Richard A. Lange, MD, MBA, and L. David Hillis, MD
The Expert Is In
31 Jan 2012 - 

The ACC, AATS, SCAI, and STS have issued a critical consensus document to guide the use of transcatheter aortic valve replacement (TAVR) as it enters clinical practice in the U.S. (see also our CardioExchange news coverage here). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to writing committee member Steven R Bailey, the Janey Briscoe Distinguished Professor of…

Selections from Richard Lehman’s Weekly Review: Week of January 30th

Richard Lehman, BM, BCh, MRCGP
Voices
30 Jan 2012 - 

This week’s topics include lifetime cardiovascular risks, anticoagulation self-monitoring, opting for thrombolytics over late transfer for PCI, exercise’s antidepressant effect, and the worry that statins can induce diabetes.

27 Jan Indu Poornima, MD wrote a post
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Plaque Rupture with Thrombosis, After Shooting Hoops

A 22-year-old white man presented to the ER with acute non-ST-segment-elevation MI, after playing basketball. He had experienced chest pain on and off for more than 10 hours before presentation. His initial EKG showed T-wave inversions in leads III and avF (see image), and his troponin T level was 1.2 ng/mL. The patient’s initial pain…

26 Jan William Kent Cornwell, MD, Kathryn Jesseca Lindley, MD, Aaron Earles, DO, MS, and Erica Sarah Spatz, MD, MHS wrote a post
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Follow the Fellows: Turning Points

The fellows describe the challenging moments that brought them to select cardiology as their specialty.

26 Jan John E Brush, MD wrote a post
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Sizing Up Clinical Trials — Quickly and Intuitively

A pharmaceutical sales rep comes to your office bringing lunch. He shows you a graphic stating that Multaq (dronedarone) reduced the primary endpoint in the ATHENA trial by 24%. The fine print shows an impressive P value: <0.0001. You come away satisfied that this drug looks good. You may not realize it, but you also…

25 Jan Richard A. Lange, MD, MBA and L. David Hillis, MD wrote a post
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Heads Up (Lesions Down) on a New Embolic Protection Device for Carotid Arterial Stenting

The current standard of care for individuals undergoing carotid arterial stenting (CAS) entails the use of an embolic protection device (EPD) to minimize the risk for embolic stroke. At present, the only FDA-approved EPD is a filter that is placed distal to the stenosis (i.e., it is advanced across the lesion) before stenting. In a recently completed randomized trial, a proximal balloon occlusion device…

23 Jan Richard Lehman, BM, BCh, MRCGP wrote a post

Selections from Richard Lehman’s Weekly Review: Week of January 23rd

This week’s topics include bridging antiplatelet therapy in patients undergoing CABG, cognitive and neurologic outcomes after CABG, using IV beta-adrenergic agonists
during acute respiratory distress syndrome, and pulmonary embolism risk in those admitted to the hospital for an auto-immune disorder.

23 Jan David Cohen, MD MSc wrote a post
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Drug-Eluting vs. Bare-Metal Stents, Using Instrumental Variable Analysis

David J. Cohen, the principal investigator of an observational PCI registry study of drug-eluting versus bare-metal stents, sheds light on a risk-adjustment technique called “instrumental variable analysis.” CardioExchange welcomes your thoughts on the value of this method and on the study it was used to elucidate. The Study Using data from a prospective observational PCI…

20 Jan Daniela J Lamas, MD and Gervasio Antonio Lamas, MD wrote a post
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Subclinical Atrial Fibrillation and the Risk of Stroke: An Interview

A NEJM editorial fellow interviews a NEJM editorialist about subclinical AF and the risk of stroke.