Cath Lab Digest - January 2008 - (Page 55)

55 Top Research Advances Include Studies on Genetics and Stem Cell Research, Stents American Heart Association 2007 year-end report S everal new studies on genetics and stem cell research, along with studies that continue to debate the use of stents to clear coronary artery blockages, are among the top research advances in heart disease and stroke for 2007, said Daniel W. Jones, MD, president of the American Heart Association. Other major milestones include a study that may change how lives are saved using a new method of cardiopulmonary resuscitation. The American Heart Association in 1996 began compiling an annual list of the top 10 major advances in heart disease and stroke research and continues to highlight influential research annually. Achievements in 2007 include: Funding: Grants from the Wellcome Trust, the National Genome Research Network 2 of the German Federal Ministry of Education and Research and the Cardiogenics project of the European Union supported this study. 3. Cardiopulmonary resuscitation by bystanders with chest compression only (SOS-Kanto): An observational study This work represents the first meaningful chance to improve cardiopulmonary resuscitation (CPR) in more than 50 years. Results indicate chest compression-only resuscitation by bystanders may be the preferable approach to resuscitation for adult patients with witnessed out-of-hospital cardiac arrest, especially those with apnea, shockable rhythm or short periods of untreated arrest. Source: The Lancet, March 17, 2007. The Lancet 2007; 369:920-926; www.thelancet.com. Funding: Grants from the Laerdal Foundation of Acute Medicine, Norway and the Ministry for Health, Labour and Welfare, Japan, supported this study. 4. Implementation of a statewide system for coronary reperfusion This study found that a statewide program focused on regional systems for quickly treating ST-elevation myocardial infarctions (STEMI) can significantly improve quality of care. The research sets the stage for collaborative, non-competitive care for patients of a region, expanding door-toballoon initiatives into the community for a systems approach. The American Heart Association’s Mission: Lifeline program, created to establish systems to provide emergency care for STEMI patients, promotes this strategy for improving patient care. Source: Journal of the American Medical Association, Nov. 28, 2007; JAMA 2007; 298(20);2371-23809; www.jama.org. This study was also presented at the American Heart Association Scientific Sessions 2007. Funding: Blue Cross and Blue Shield of North Carolina supported this study. 5. Long-term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP) This is the first major trial to document that a reduced sodium intake lowers the risk of clinical cardiovascular disease outcomes, not just blood pressure. Source: British Medical Journal, April 20, 2007; BMJ 2007;334;885; www.bjm.com. Funding: The National Heart, Lung and Blood Institute, National Institutes of Health supported this study. 6. Optimal medical therapy with or without PCI for stable coronary artery disease (COURAGE) This study compared the initial management strategy of percutaneous coronary intervention (PCI) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) vs. optimal medical therapy alone in reducing the risk of cardiovascular events. The authors concluded that, as an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction or other major cardiovascular events when added to optimal medical therapy. Source: New England Journal of Medicine, April 12, 2007; N Engl J Med 2007; 35;(15);1503-16; www.nejm.org. Funding: The U.S. Department of Veterans Affairs Office of Research and Development provided support for this study. 7. The generation of functional cardiomyocytes from adult mouse spermatogonial stem cells This study analyzed the complex functional properties of cardiomyocytes (heart muscle cells) derived from maGSCs in vitro and the behavior of undifferentiated maGSCs in normal hearts of mice in vivo after transplantation. The authors conclude that maGSCs provide a new source of distinct types of cardiomyocytes for basic research/potential therapeutic application. Source: Circulation Research, June 8, 2007; Circ Res 07 Jun 8;100(11):1615-25; www.ahajournals.org. Funding: A grant from the Georg-AugustUniversity of Go¨ttingen supported this study. 8. HORIZONS: Harmonizing Outcomes with RevascularIZatiON and Stents This large study examined the safety and effectiveness of anticoagulation medications and drugeluting stents in patients experiencing a STEMI, without significantly increasing the rate of death or recurrent heart attacks among these patients. Source: Late-breaking trial at the Transcatheter Cardiovascular Therapeutics TCT 2007; www.tct2007.com. Funding: The Cardiovascular Research Foundation supported this study. 9. Effectiveness and safety of drug-eluting stents in Ontario 1. Genome-wide association study of 14,000 cases of seven common diseases and 3,000 shared controls Genome-wide association studies identify genes (strands of DNA) that may cause specific diseases and represent a powerful approach in identifying genes involved in common human diseases. This large-scale genome-wide association (GWA) study found consistent and replicable genetic markers of several complex diseases of adulthood, including atherosclerotic heart disease. Study authors said their analysis of some 17,000 people for seven common familial diseases (bipolar disorder, coronary artery disease, Crohn’s disease, hypertension, rheumatoid arthritis, type 1 diabetes and type 2 diabetes) confirms previously identified loci (DNA closely linked to genes that may identify a trait of a particular disease) and provides strong evidence for many novel disease susceptibility genes. Source: Nature, June 7, 2007; Nature 2007. 447:661-78;www.nature.com. Funding: Wellcome Trust was the principle funding source of this study. 2. Genome-wide association analysis of coronary artery disease This study included a joint analysis of two genome-wide association studies of coronary artery disease. Researchers used the genetic patterns of the persons (cases) with coronary artery disease (CAD) from the Wellcome Trust Case Control Consortium study (described above) and tried to replicate the genetic patterning for CAD in another genome-wide association study — the German MI [Myocardial Infarction] Family Study. Results identified several genetic loci that, individually and in aggregate, substantially affect the risk of developing coronary artery disease. Source: New England Journal of Medicine, Aug. 2, 2007; N Engl J Med 2007;357:443-453; www.nejm.org. Continued on next page http://www.thelancet.com http://www.nejm.org http://www.ahajournals.org http://www.nature.com http://www.ahajournals.org http://www.jama.org http://www.tct2007.com http://www.bjm.com http://www.nejm.org

Table of Contents Feed for the Digital Edition of Cath Lab Digest - January 2008

Cath Lab Digest - January 2008 Central Baptist Hospital Contrast Media Use in High-Risk Patients An Ergonomic Survey of Cath Lab Repetitive Stress Injuries Contents Clinical Editor’s Corner Takotsubo Cardiomyopathy, a.k.a., Transient Left Ventricular Apical Ballooning Syndrome: An Acute Coronary Syndrome Imposter Searching for the Key to D2B STEMI Intervention News STEMI Interventions: Commentary The Massachusetts Stent Study The Value of Educating Staff Ask the Clinical Instructor: A Q&A Column for Those New to the Cath Lab SICP* Chapter Updates The Society of Invasive Cardiovascular Professionals Holds an RCIS Review Course at New Cardiovascular Horizons 18:20 To Denver — One Student’s First Clinical Experience CEU Education Center Meetings Calendar What Do You Think? Clinical & Industry News Classifieds The Ten-Minute Interview with…Heather Vardon, RN Advertisers Index

Cath Lab Digest - January 2008

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