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The Emergency Cardiology Group

The ACRE project was featured on the ABC radio AM news and current affairs programme this morning.

You can listen to the story featuring interviews with Will Parsonage and Terry George from Nambour Hospital here.

Nambour was where the ACRE project pilot was rolled out and the results of the pilot project have been published here.

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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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It seems I only ever get time to really work on my blog when I get away to a conference.

So here I am in wonderful San Francisco ready to soak up all that the American College of Cardiology meeting has to offer in 2013. The theme is ‘Discovery to Delivery’ although many of the subjects of the ‘late breaking’ sessions involve decidedly old drugs in refined applications – think tenecteplase in PE, viagra in diastolic heart failure, digoxin in the elderly…

Non-pharma interventions will feature heavily with more on TAVI, atrial appendage occluders and another ‘old’ idea; off-pump bypass surgery.

You can find a good summary of the things that might attract attention here, courtesy of the heart.org.

We’re here to present some new data on high sensitivity troponin in a session of moderated posters on Monday, but I will post separately on that. For starters the abstracts are all now online and you can check out the session here.

The plan is to try and do a daily post at least with lots of tweeting on the #ACC13 hashtag, so we’ll see how it goes. It’s going to be a busy few days.