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The sudden cardiac death in heart failure trial (SCD-HeFT) was a study involving patients with ischemic and non-ischemic cardiomyopathy and a left ventricular ejection fraction < 35% and class II or III heart failure that tested the value of ICD therapy for the primary prevention of sudden cardiac death.
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The relationship between physical activity and atrial fibrillation has been controversial. Lone atrial fibrillation is relatively common in young, competitive athletes, and it is uncertain whether routine physical activity is protective or harmful in elderly populations where atrial fibrillation is more common.
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In patients with elevated triglycerides, other atherogenic particles may be as important as LDL-cholesterol (C). These particles and LDL-C are measured as non-HDL-C, and are considered a secondary target of therapy.
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The management of anticoagulation in patients requiring long-term warfarin therapy is often problematic when they need cardiac catheterization.
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Diabetic patients are at higher risk for in-stent restenosis and stent thrombosis than their non-diabetic counterparts.
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This second publication from the COURAGE investigators reports on multiple assessments of quality of life, particularly angina presence and severity, between the two groups over the study observation.
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Although the ECG is key in the triage of suspected ST wave elevation myocardial infarction (STEMI), it is imperfect.
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Blockage of the harmful effects of tissue plasminogen activator by imatinib (Gleevec) might improve ischemic stroke outcomes.
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The optimal duration of oral anticoagulation therapy after an initial symptomatic deep venous thrombosis remains unknown. Siragusa et al assessed patients by ultrasonography for the presence of residual vein thrombosis (RVT) after three months of anticoagulation for a DVT. Those with RVT were randomized to 9 additional months of anticoagulation versus discontinuation. Among the 70% with RVT, prolonged anticoagulation showed only a non-significant trend for reducing recurrent DVT. For the 30% without RVT, all of whom stopped anticoagulation after three months, only one of 78 patients (1.3%) developed a recurrent DVT. For select patients, the lack of RVT after initial anticoagulation identifies patients in whom anticoagulation may be safely discontinued. The optimal duration of anticoagulation for higher risk patients, including those with RVT, remains undefined.
