In a recent Viewpoint in JACC: Cardiovascular Interventions, Marso and colleagues expressed grave reservations about the application of appropriate use criteria for PCI in a controversial study published last year in JAMA by Chan and colleagues, which found that only half of PCIs performed for nonacute indications were classified as appropriate. Interventional cardiology editors Rick Lange and David Hillis asked CardioExchange…

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At the recent meeting of the Society of Thoracic Surgeons (STS), Fred Edwards presented the high-risk subset of ASCERT (ACCF-STS Database Collaboration on the Comparative Effectiveness of Revascularization Strategies). CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis posed the following questions to Edwards and Christopher White, the president of the Society for Cardiovascular Angiography and Interventions (SCAI). Rick Lange and…

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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…

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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…

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

There is a problem so grave that it threatens the very validity of what we learn from the medical literature. Bad data? Not exactly. Actually, it’s missing data — information, relevant to the risks and benefits of treatments, that is simply not published. In some cases, these data would make a critical difference in the…

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Jersey Chen answers questions about his recent study in JAMA documenting that heart failure hospitalization rates declined nearly 30% between 1998 and 2008.

In an elegant study that will resonate with the anecdotal experience of many consulting cardiologists, Jaffe and colleagues provide strongly suggestive evidence that elevations in “cardiac” troponin T may not be quite as specific for cardiac muscle injury as has been claimed (see CardioExchange News blog). Among patients with skeletal myopathies who had elevations in…

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In an observational study involving Medicare patients undergoing carotid stenting between 2005 and 2007, Dr. Brahmajee Nallamothu and colleagues showed that low annual operator volume and early experience are associated with increased 30-day mortality. CardioExchange Interventional Cardiology moderators Rick Lange and David Hillis have posed the following questions to Dr. Nallamothu: RL and DH: Did…

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Several important questions about the relative safety and efficacy of apixaban versus warfarin in patients with nonvalvular atrial fibrillation have been answered.