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Cross blogged from our Emergency Cardiology Site…

The Emergency Cardiology Group

There has been lots of media interest in our paper ‘Validation of high-sensitivity troponin I in a 2-h diagnostic strategy to assess 30-day outcomes in emergency-department patients with possible acute coronary syndrome‘ that went online in in the Journal of the American College of Cardiology in the last few days.

Those in Queensland may have heard reference to the study on the ABC Radio news this morning and Louise Cullen has been interviewed today by ABC Radio National and Channel Nine.

We may have lost out to Black Caviar on the Channel Nine News though…

A copy of the press release from the Queensland Government is available here: RBWH media release – improved testing for potential heart attack patient.

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This sort of thing has been bugging me for ages…

Old CardioBrief

Don’t believe the the hype! That’s the cardinal rule to obey when reading health news. “Breakthroughs” and “cures” are rare, and should always be viewed with caution and skepticism.

This week was a great example. Last Sunday, the New York Times, the major networks, and a host of other media outlets (including this one) reported on a paper in  Nature Medicine about the discovery of a novel and potentially significant pathway linking red meat to heart disease. Briefly, the research suggested that carnitine, which is found naturally in high concentrations in red meat, can lead to atherosclerosis when it is converted by gut bacteria to a chemical called TMAO. Almost immediately I received a lot of comment from experts who raised serious questions about the research. Then today, a separate study was published with an entirely different perspective on carnitine. Although the two studies don’t directly contradict each other, they…

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Things don’t always get the attention they deserve…

Duchamp's FountainOne of the triumphs of the recent ACC 2013 meeting was the the host city of San Francisco and the meeting venue, the Moscone Centre, which is central to downtown San Francisco and it’s associated attractions. One of the notable attractions is the San Francisco Museum of Modern Art (MoMA) right next door to Moscone. In a spare couple of hours during the meeting it was great to be able to call in there for some diversion.

There I was delighted to find one of the replicas of Duchamp’s 1917 work ‘Fountain’ pictured above. If it looks like a urinal that’s because that is what it was. This is no ordinary urinal but one that in 2004 was voted one of the most influential modern art works of all time (and therefore possibly one of the most important works in the MoMA). Duchamp’s 1917 original was lost but celebrated by a series of replicas – this one, in the MoMA quietly celebrating the 50th anniversary of its creation in 1963. Unceremoniously placed on a non-descript, plain white plinth garners a level of inattention that I am sure the artist would perhaps have appreciated. I took the short movie below to illustrate this (you can see ‘Fountain’ centre frame on the white box).

It was in no way my intention, but a matter of fact, that I didn’t attend any of the late breaking clinical trial sessions at the recent ACC meeting. In fact, I admit to taking at least 24 hours to figure out what an LBCT actually was (a new mode of cardiac imaging that had passed me by?).

I enjoyed blogging some of the less travelled sessions of the meeting (Day 1, Day 2, Day 3). So I feel I did my bit for some of the things that don’t get the attention they deserve but for those in need of a good summary of the headline trials, that did garner most of the attention, here are a few suggestions.

Here is perhaps the definitive video summary of the key trials from the heart.org’s Cardiology Show

...and here a more personal view from Melissa Walton-Shirleys “Heartfelt’ blog, also on the heart.org

…and in a slightly different format a slideshow of the key findings of the major trials that were presented at the meeting.

Plenty to be getting on with there…

An interesting view of events around the last minute ‘pull’ of the PREVAIL study from the ACC program last weekend.

Old CardioBrief

SPIN
The biggest story at the American College of Cardiology meeting last week was the missing story. As reported here and just about everywhere else, the PREVAIL trial, probably the most-anticipated late-breaker of the meeting, was pulled from the program at the last minute by the ACC leadership after Boston Scientific broke the embargo by issuing a press release several hours before the scheduled presentation.

To understand this event we first need to know what happened in the week before the ACC. And there’s a major gap in the story that has not come out before that I think holds the key to a full understanding of the story.

More than a week before the scheduled presentation I received an email invitation from a PR firm representing Boston Scientific:

“If you have any interest in speaking about the trial under embargo with Dr. Ken Stein, chief medical officer, Cardiac Rhythm Management, Boston…

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This is a post from CardioBrief – Important with respect to maternal heart disease. See this post 

Old CardioBrief

Hospitals are treating increasing numbers of adults with congenital heart disease, thanks to tremendous progress in treatment for this condition in recent decades. A clear picture of this dramatic change emerges in a new study, presented at the ACC in San Francisco and published simultaneously in JAMA.

Jared O’Leary and colleagues analyzed data from the Nationwide Inpatient Sample and compared congenital heart disease hospital admissions from 1998 through June 30, 2004, with those from July 1, 2004, through 2010. From the first period to the second, adult admissions grew much more rapidly than pediatric admissions.

  • Adult admissions increased by 87.8%, from 331,162 in the first half to 622,084 in the second half.
  • Pediatric admissions increased by 32.8%, from 815,471 to 1,082,540.

Adults constituted a growing percentage — from 28.9% to 36.5% — of congenital heart disease admissions.

The authors wrote that the “observed trend is likely due to a number…

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