Cardiovascular Business - January/February 2009 - (Page 27)

Clinical Study Digest Xience V drug-eluting stent. source: abbott Vascular was increased with greater numbers of arteries bypassed. The authors said that if patients wish to maximize their chance of a better short-term result with fewer in-hospital risks, they may choose DES. On the other hand, some patients may choose to maximize their long-term survival while risking higher inhospital complications and worse short-term survival. RSNA: Stress CT perfusion imaging compares well to MRI to detect ischemia Adenosine stress multidetector CT myocardial perfusion imaging can be successfully performed in patients with coronary artery disease (CAD), proving to have good agreement with stress myocardial perfusion MRI, according to research presented at the 2008 Radiological Society of North America meeting in Chicago. Shingo Kato, MD, and colleagues from the National Institute of Radiological Sciences in Chiba, Japan, performed retrospectively gated cardiac CT in 13 patients during continuous injection of adenosine. Radiation dose was less than 20 mSv. Perfusion abnormality during stress was observed in 57 of 144 segments by CT and in 55 of 144 segments by MRI. The sensitivity, specificity and accuracy of perfusion CT imaging were 88 percent, 80 percent and 85 percent, respectively, compared with MRI. “The ability of CT to perform both stress perfusion imaging and coronary angiography will significantly enhance the value of cardiac MDCT in the diagnosis and treatment of patients with CAD,” Kato said. “We knew going into this study that there was an association between thiazolidinediones and fracture risk, however the magnitude of risk had not been evaluated,” said Sonal Singh, MD, coauthor of the study published in the Jan. 6 issue of the Canadian Medical Association Journal. In absolute terms, if thiazolidinediones (TZDs) are used by elderly, postmenopausal women (around 70 years) with type 2 diabetes for one year, one additional fracture would occur among every 21 women. Among younger women (around 56 years), use of the drugs for one year or longer would result in one additional fracture for every 55 women, Singh said. The two currently available TZDs are rosiglitazone (Avandia) and pioglitazone (Actos). For the study, researchers reviewed 10 previously completed trials that lasted at least one year. Nearly 14,000 participants were included in the studies. Overall, the studies showed a consistent decline in bone mineral density at the lumbar spine and the hip in women, but not for men. AIM: Women with valve disease receive inferior treatment compared to men Evidence of higher mortality and lower surgery rates in women versus men with mitral valve prolapse and regurgitation may be related to the complexity of evaluating the condition’s severity in women. Jean-François Avierinos, MD, and colleagues at several institutions retrospectively examined more than 8,000 patients (4,461 women and 3,768 men)—all patients at the Mayo Clinic diagnosed by echocardiography with mitral valve prolapse over a 10-year period (1989 to 1998). The study found that one of the most powerful known reasons to recommend surgery—left ventricular size—was poorly estimated in women because their cardiac size appeared smaller than that in men. When their smaller body size was taken into account, cardiac enlargement was at least as serious, according to the study (Annals 2008;149:787-794). Researchers concluded that such underestimation of cardiac enlargement may have been the main reason that women with moderate or severe regurgitation were less likely than men to undergo mitral valve surgery. CMAJ: Popular class of diabetes drugs doubles risk of fractures in women Long-term use of thiazolidinediones, a class of oral medication for type 2 diabetes, has been found to double the risk of fractures in women. CardiovascularBusiness.com Cardiovascular Business 27 http://www.CardiovascularBusiness.com

Table of Contents Feed for the Digital Edition of Cardiovascular Business - January/February 2009

Cardiovascular Business - January/February 2009 Contents First Word Electrophysiology Roundtable Forum: A Candid Conversation about Profits, Procedures and Patients Heart Failure Care Gets Boost from Technology Emerging Technologies in Peripheral Vascular Interventions Stent vs. Graft: Choosing the Best Path for the Diabetic Patient with Multivessel Disease Cardiology Groups and Hospitals Strive to ‘Connect’ Seamlessly CT Beyond 64 Slices Clinical Study Digest: Kidney Disease & PCI; Women and Valve Disease Compact Echo Systems Come Up Big in Cardiac Care News & Views Reader Resources The ACC Corner

Cardiovascular Business - January/February 2009

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.