theheart.org - ACS newsletter

Tuesday, May 20, 2008

High-risk ACS section: Elevating your knowledge on STEMI
Stay abreast with the latest information dedicated to the diagnosis and treatment of STEMI. The High-risk ACS section includes news, thought leader-driven discussions, slides, and more. There is always something new here. With High-risk ACS steering committee: Drs Bates, Hamm, Steg and Teirstein. Supported by an independent educational grant from The Medicines Company.

Optimizing outcomes in STEMI patients
The volume of recently released - and sometimes conflicting - clinical trial data surrounding the treatment of patients with ACS has led to confusion as to what is the best therapeutic option for a given patient. Join Dr Bates and panelists Drs Berger and Stone as they discuss applicability to clinical practice. CME provider: Medscape, LLC. Supported by an independent educational grant from The Medicines Company.

H E A R T W I R E > A C S - L A S T 30 D A Y S

Acute coronary syndromes
Generic enoxaparin in the US?
The US Court of Appeals has upheld a ruling made last year that the patents on Sanofi-Aventis's Lovenox are unenforceable. [16 May]

Acute coronary syndromes
"Delipidated" HDL: A new, autologous option for plaque regression?
Very preliminary data from a pilot study indicates that stripping a patient's own HDL of its lipid content, then reinfusing it, is feasible and safe and may even offer a novel means of stabilizing atherosclerotic plaques. (EuroPCR 2008.) [16 May]

Acute coronary syndromes
Discrepancies in US/European guidelines on antithrombotics for ACS
UPDATED WITH INTERVIEWS // Discrepancies in the European and US guidelines on recommendations for the use of enoxaparin and fondaparinux in the treatment of ACS is causing confusion, some clinicians have suggested. (Eikelboom J et al. Lancet 2008; 371:1559-1561.) [15 May]

Acute coronary syndromes
Which MI patients have the longest delays in hospital presentation?
MI patients who are older, female, Hispanic, or black or who have diabetes appear to wait the longest before seeking medical attention, a new study shows. (Ting HH et al. Arch Intern Med 2008; 168:959-968.) [15 May]

Acute coronary syndromes
Generic clopidogrel imminent, this time in Europe
A generic version of clopidogrel is expected to be available soon in Germany and then other European countries, according to an announcement from Swiss pharmaceutical company Schweizerhall. [9 May]

Acute coronary syndromes
ACUITY: Bivalirudin beneficial in patients switched from heparin/enoxaparin
But no overall net clinical benefit was seen in patients naive to antithrombin therapy at randomization. (White HD et al. J Am Coll Cardiol 2008; 51:1734-1741.) [9 May]

Acute coronary syndromes
Managed-care data suggest high frequency of GI events from clopidogrel
Investigators report that 6.2% of patients prescribed clopidogrel filed at least one insurance claim for ulcer or gastrointestinal bleeding. One expert, however, says the finding is simply hypothesis generating at this point. (International Society for Pharmacoeconomics and Outcomes Research 2008 International Meeting.) [7 May]

Acute coronary syndromes
Intracoronary spectroscopy catheter gets FDA approval
The device can map the location of coronary plaques that contain a lipid core and may be vulnerable to rupture; it can, in theory, be used to guide preventive interventions. [1 May]

Acute coronary syndromes
Heparin contamination was deliberate act to cut costs?
A US Congressional hearing on the heparin contamination has suggested that the counterfeit product was introduced in China on purpose to increase profits. Investigators said the tragedy had highlighted "both the best and the worst of the FDA's performance." [30 Apr]

Acute coronary syndromes
Enoxaparin now affected by heparin contaminant
Some countries have recalled affected batches, although no increase in adverse reactions has been seen. [25 Apr]

Acute coronary syndromes
ACS patients in India: Younger, poorer, sicker, and dying
A new registry analysis of almost 21 000 STEMI and non-STEMI patients admitted to Indian hospitals suggests that the country, along with other developing nations, is in dire need of better emergency services, healthcare insurance, and public-education campaigns if any dint is to be made in the global CVD epidemic. (Xavier D et al. Lancet 2008; 371:1435-1442.) [24 Apr]

Acute coronary syndromes
Heparin contaminant and mechanism of adverse events published
More details about oversulfated chondroitin sulfate and the mechanism by which it is believed to bring about adverse events have now been published in two separate papers. (Guerrini M et al. Nat Biotechnol; published online before print April 23, 2008. Kishimoto TK et al. New Engl J Med; published online before print April 23, 2008.) [24 Apr]

Acute coronary syndromes
Possible mechanism behind heparin adverse events identified
But there is disagreement between US and Chinese regulators about whether the contaminant found in supplies of heparin is responsible. [22 Apr]

Acute coronary syndromes
ACUITY: Diabetic subgroup shows bivalirudin benefit
The diabetic subgroup showed the same results as the overall trial, with bivalirudin monotherapy associated with a similar rate of adverse clinical outcomes but reduced bleeding compared with heparin plus a GP IIb/IIIa blocker. Diabetic patients had higher event and bleeding rates than nondiabetic patients. (Feit et al. J Am Coll Cardiol 2008; 51:1645-1652.) [21 Apr]

Acute coronary syndromes
No increased in-hospital mortality in AMI patients arriving during "off" hours
AMI patients arriving at US hospitals on weeknights, holidays, or weekends were more likely to receive fibrinolysis and less likely to undergo PCI, but they were no more likely to die in the hospital than patients coming in on weekdays. (Jneid H et al. Circulation; published online before print April 21, 2008.) [21 Apr]

H E L P

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