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Audio Journal of Cardiovascular Medicine

Reporting from ACC 2007

Fewer Major Bleeding Events with Bivalirudin For Patients with Acute Coronary Syndromes: The ACUITY Study

REFERENCE: ACUITY Trial, ACC.07 Scientific Session and i2 Innovations Summit. Presentation Number: 2414-5

Patients with acute coronary syndromes who take bivalirudin have fewer major bleeding events and a lower incidence of late stent thrombosis’ compared with those who receive standard heparin therapy. This is the finding of one year results from the ACUITY Study announced by Gregg Stone of Columbia University, New York during the American College of Cardiology annual meeting that took place in New Orleans. Sarah Maxwell asked Harvey White at the Auckland City Hospital in New Zealand to comment about the ACUITY investigation.

Audio Journal of Global Health Issues

reporting from American College of Physicians Annual Meeting: Internal Medicine 2007; San Diego April 19-21

Drug Eluting Stents, PFO Closure: Indications Not Obvious

REFERENCE: ABSTRACT ACP Internal Medicine 2007, ERA 002

MARK REISMAN, Swedish Medical Center, Seattle

Drug eluting stents may not always be the automatic choice over the bare metal variety for patients requiring intervention, despite the important clinical advantages that have been emerging from their introduction recently. This is according to Mark Reisman who gave the Internal Medicine 2007 conference in San Diego his latest insights from the rapidly changing world of interventional cardiology. At this (recently renamed) annual meeting of the American College of Physicians he also discussed the difficult question of which patients are candidates for PFO closure, and what the clinical objectives of this might be: including the possible reduction of migraine headaches. After his session he talked with Peter Goodwin.

Audio Journal of Global Health Issues

reporting from American College of Physicians Annual Meeting: Internal Medicine 2007; San Diego April 19-21

Patient Power Best to Manage Diabetes

REFERENCE: ABSTRACT Press Release, San Diego ACP 2007

HILARY SELIGMAN, University of California, San Francisco

Doctors can best help their patients with diabetes by taking particular care to put management into the hands of the patients themselves, rather than asking them to slavishly follow the doctors' instructions, conference-goers in San Diego heard. A new ACP guide booklet for diabetes management called "Living with Diabetes", designed to be used by patients in consultation with their doctors, has made concrete improvements in diabetic management, according to results from a study released during the American College of Physicians annual meeting. Peter Goodwin talked with one of the authors of the new initiative, Hilary Seligman.

Audio Journal of Global Health Issues

reporting from American College of Physicians Annual Meeting: Internal Medicine 2007; San Diego April 19-21

Study on Longevity Genes And Aging Raises Prospects for Therapy

REFERENCE: ABSTRACT ERA 001 ACP 2007, San Diego

NIR BARZILAI, Albert Einstein College of Medicine, New York

The prospect of modulating the activity of "longevity genes" to extend life was held out at a special session of the ACP Internal Medicine annual meeting in San Diego. Nir Barzilai, Director of the Institute for Aging Research in New York, presented data from his group's study of patients up to 100 years old and over which have shown that specific genes are related to longevity and freedom from physical illness. Afterwards he talked about his findings and the clinical opportunities they present with Peter Goodwin.

Audio Journal of Global Health Issues

Rural to Urban Migration: Cardiovascular Health Risks Assessed in Lima, Peru

JAIME MIRANDA, London School of Hygiene and Tropical Medicine, Peru

The consequences of migration from rural to urban areas in Peru has provided an opportunity for studying the impact of a radically altered lifestyle and diet upon health. Jaime Miranda is investigating the disease patterns among migrants from the Andes Mountains and the Amazon Jungle regions of Peru in the capital, Lima. He discussed his group's investigation with Peter Goodwin.

Audio Journal of Global Health Issues

Once-And-For-All TB Assay Brings Cheap, Sensitive, Specific, Seven-Day Diagnosis and Drug-Susceptibility Testing

REFERENCE: N Engl J Med 355: 1539-50

DAVID MOORE, Imperial College, London and Lima

A new test for TB, trialled in Peru, has proved more powerful and yet faster and cheaper than alternatives, making it especially suitable for use in resource-limited settings where tuberculosis is becoming more rampant, partly through the world-wide advance of HIV. David Moore and his colleagues have published results in the New England Journal of Medicine of a massive investigation conducted in Lima with nearly 4 000 samples of the sputum test called: Microscopic-Observation Drug-Susceptibility (MODS) Assay. Their findings promise not only to improve diagnosis and save lives in developing countries and other settings with limited health-care resources, but also out-perform costly gold-standard technology-intensive TB diagnosis methods currently used where cash is not a problem. The MODS test, David Moore told Peter Goodwin during a visit to Peru, gives sensitive and specific diagnosis in as little as seven days, and concurrently yields drug susceptibility data which helps combat multi-drug resistant TB.

Audio Journal of Cardiovascular Medicine

Reporting from American College of Cardiology, New Orleans, March 24-27, 2007

"COURAGE" Trial Assessed: New Guidelines for Patients with Stable Coronary Disease?

REFERENCE: ACC 2007 & N Engl J Med 356: March 2007

HARVEY WHITE, Auckland City Hospital

The finding from the COURAGE trial: that angioplasty adds no benefits to optimal medical therapy alone for patients with stable coronary disease, should give pause for thought among clinicians all over the world, according to Harvey White, who discussed the new data with Peter Goodwin.

Audio Journal of Cardiovascular Medicine

“EXACT” Study: Carotid Stenting Benefits Are Maintained in the Real World

REFERENCE: Abstract 2409-5, American College of Cardiology New Orleans

WILLIAM GRAY, Columbia University, New York

The benefits of carotid stenting as compared with surgery have been maintained in real-world settings since USA-approval of the technique in 2004, according to William Gray who reported findings from the EXACT study of 1500 patients to the annual meeting of the American College of Cardiology. He discussed his conclusions and recommendations with Peter Goodwin.

Audio Journal of Cardiovascular Medicine

Direct Renin Inhibitor Combined with Angiotensin Receptor Blockade Gives Additional Blood Pressure Lowering

REFERENCE: Abstract 405-12, American College of Cardiology New Orleans

SUZANNE OPARIL, University of Alabama, Birmingham

A combination of two antihypertensive agents has given improved blood pressure control in a study with nearly 2000 patients reported to the ACC meeting in New Orleans by a group from the University of Alabama at Birmingham. Suzanne Oparil presented findings on the use of the direct rennin inhibitor, aliskiren, combined with the angiotensin receptor blocker, valsartan. She explained to Peter Goodwin how this “dual renin system blockade” gave enhanced blood pressure lowering in patients with mild to moderate hypertension who were followed with ambulatory monitoring.

Audio Journal of Cardiovascular Medicine

"RADIANCE-1" Study: Cholesteryl Ester Transfer Protein Inhibitor Fails to Benefit Patients with Familial Hypercholesterolemia

REFERENCE: Abstract 407-7, American College of Cardiology New Orleans

JOHN KASTELEIN, Academic Medical Center, Amsterdam

A drug which raises HDL and reduces circulating levels of LDL has nevertheless failed to reduce atherosclerotic progression in patients with familial hypercholesterolemia. This disappointing outcome of a study using the cholesteryl ester transfer protein inhibitor (CETP), torcetrapib, was announced at the American College of Cardiology meeting in New Orleans. John Kastelein discussed the findings, and their implications for therapies targeting HDL, with Peter Goodwin.