Clinical Cardiology Alert – October 1, 2004

October 1, 2004

• Prevention of Atrial Fibrillation After Cardioversion

  The Prevention of Atrial Fibrillation After Cardioversion Trial was a placebo-controlled study comparing sotalol and a quinidine/verapamil combination in patients with persistent atrial fibrillation after cardioversion.

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• Warfarin vs Aspirin for Bioprosthetic Aortic Valve Replacement

  Low-dose aspirin is as effective as warfarin for preventing cerebral thromboembolic events after bioprosthetic aortic valve replacement.

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• Public-Access Defibrillation

  The use of automatic external defibrillators by trained volunteers is safe and effective, particularly in public locations where there is at least a moderate likelihood that an out-of-hospital cardiac arrest will be witnessed.

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• Relationship Between Calcium Scans and Stress Myocardial Perfusion

  A calcium score < 100 eliminates the need for myocardial perfusion scans (MPS), but patients with a negative MPS often have coronary calcium. These findings imply a potential role for applying coronary artery calcium screening after MPS among patients manifesting normal MPS.

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• Cardiovascular Disease Trends: United States and Worldwide

  The developing world is experiencing an epidemic of CAD which expects to continue to increase in the foreseeable future.

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• Correction

  Issues July, August, and September 2004 were printed as Volume 21. They should read Volume 23.

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• Pharmacology Watch: Linking COX-2 Inhibitors and Cardiovascular Event Risk

  A new, and as of yet unpublished study, has raised increased concern about the relationship between rofecoxib (Vioxx), Mercks blockbuster COX-2 inhibitor, and cardiovascular events. The study, which was presented at a meeting in Bordeaux France, was financed by the FDA in collaboration with Californias HMO giant Kaiser Permanente.

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• Clinical Briefs in Primary Care Supplement

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