The HCPLive Cardiology condition center page is a comprehensive resource for clinical news and insights on cardiovascular and cardiometabolic diseases. This page consists of interviews, articles, podcasts, and videos on the research, treatment and development of therapies for heart disease and cardiovascular events, as well as associated diabetes, renal failure, and more...
October 25th 2024
New research indicates semaglutide reduced albuminuria and body weight in CKD patients without diabetes, highlighting its potential renal benefits.
Elevating Care for PAH: Applying Recommended Management Approaches to Maximize Outcomes
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‘REEL’ Time Patient Counseling™: Navigating the Complex Journey of Diagnosing and Managing Fabry Disease
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Expert Illustrations & Commentaries™: Envisioning Novel Therapeutic Approaches to Managing ANCA-associated Vasculitis
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Fundamentals of clinical research: Causal inference, surrogate measures, and intention to treat
The previous installment of this series on clinical research highlighted some important fundamentals in cohort studies and randomized controlled trials (RCTs). In this article, additional issues that are critical to the understanding of RCTs are discussed, including causal inference, the use of surrogate measures, and the principle of intention to treat (ITT).
It takes a gutsy person to sign up for a plenary session with that title. From the moment she took the podium, Grace Anne Dorney Koppel captivated a small audience with her moving story of her struggle with chronic obstructive pulmonary disease (COPD) and its many co-morbidities. With steely resolve, she challenged the physicians in the audience to step up their efforts to diagnose and treat a disease that currently affects more than 24 million Americans.
Undiagnosed diabetes mellitus in coronary artery bypass graft surgery
September 19th 2008We examined the prevalence and risks associated with undiagnosed diabetes mellitus among more than 7000 patients who had undergone coronary artery bypass graft surgery. At the perioperative and postoperative stages, patients with undiagnosed diabetes showed a significantly higher morbidity and mortality rate.
Untreated diabetes mellitus in coronary artery by pass graft surgery
Lauruschkat and colleagues entitled their article "Undiagnosed diabetes mellitus in coronary artery bypass graft surgery."
Elevated high-density lipoprotein cholesterol and carotid atherosclerosis
September 19th 2008We assessed the relationship between high-density lipoprotein (HDL) cholesterol level and carotid plaque progression in 1952 men and women with preexisting carotid atherosclerosis over a period of 7 years. The HDL cholesterol level was inversely related to plaque growth. The plaques that became more echogenic during follow-up had a lower growth rate compared with those that became more echolucent. These findings suggest that HDL cholesterol stabilizes plaques and counteracts their growth by reducing their lipid content and inflammation.
Initiating treatment for chronic heart failure
Standard congestive heart failure treatment begins with an angiotensin-converting enzyme (ACE) inhibitor to which a beta-blocker is added once the target dose of the ACE inhibitor has been reached. We compared morbidity and mortality between standard treatment and treatment using the reverse sequence, that is, the beta-blocker bisoprolol was given to patients first, followed by the ACE inhibitor enalapril. Results showed that both sequence strategies were safe and effective, with a survival trend in favor of the bisoprolol-first strategy.
The clinical ramifications of CIBIS III: Does the sequence of medication initiation really matter?
September 19th 2008The development of new and innovative mechanical and pharmacologic therapies for the broad spectrum of cardiovascular disease has led to dramatic changes in the makeup of clinical practice.
Obesity and cardiovascular risk in hypertensive patients with left ventricular hypertrophy
The observed relationship linking obesity, severity of hypertension, and increase in cardiovascular risk was traditionally thought to emanate from the increase in circulatory volume, persistently increased systemic resistance from obesity, and clustering of major cardiovascular risk factors (eg, hypercholesterolemia and diabetes mellitus) among obese patients.
Laboratory monitoring for spironolactone in congestive heart failure
September 19th 2008We evaluated how well patients taking spironolactone were monitored for hyperkalemia, as well as the association between spironolactone and hyperkalemia. Only two thirds of patients received testing for serum potassium and creatinine levels, and higher baseline serum creatinine levels predicted a high risk of hyperkalemia. These results indicate that appropriate patient selection and close monitoring are essential, especially for patients with renal impairment.
Spironolactone and hyperkalemia in congestive heart failure
In 1999 Pitt and colleagues published the results of the RALES trial, an important study showing that the addition of a relatively small dose of the aldosterone antagonist spironolactone to a regimen that included angiotensin-converting enzyme (ACE) inhibitors for patients with severe congestive heart failure (NYHA Class III-IV) had a striking benefit on mortality
Transcatheter occlusion of the left atrial appendage to prevent stroke in atrial fibrillation
September 19th 2008We conducted 2 feasibility studies to assess the performance and safety of the percutaneous left atrial appendage (LAA) transcatheter occlusion system for the prevention of stroke in high-risk patients with nonrheumatic atrial fibrillation. Results showed that percutaneous LAA occlusion can be performed using the device at acceptable risk. This procedure may be particularly useful for patients at increased risk of ischemic stroke with a contraindication to anticoagulation therapy.
Transcatheter occlusion of the left atrial appendage
Atrial fibrillation commonly affects millions of patients, and often causes the disabling complication of cardioembolic stroke.
Ultrafiltration for heart failure
September 17th 2008We compared the use of early, minimally invasive ultrafiltration with usual care in patients with acute decompensated heart failure in a randomized controlled trial. Ultrafiltration therapy resulted in greater fluid removal than standard therapy and was shown to be a safe and effective alternative to loop diuretics for sodium and fluid homeostasis in patients with heart failure. More research is needed to identify those patients most likely to benefit from this approach.
High-resolution spiral computed tomography coronary angiography
September 17th 2008We evaluated the performance of the 64-slice spiral computed tomography coronary angiography scanner in 52 symptomatic patients with stable sinus rhythm and found that it was highly reliable in ruling out the presence of a significant coronary stenosis. This technique may be regarded as a suitable alternative to invasive coronary angiography.