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Newsletters January 2011 - Jefferson Cardiology Happenings

What's in this Newsletter:

Top Cardiology Stories of 2010

The editors of Journal Watch, published by the New England Journal of Medicine, have selected the top cardiology stories of 2010. A summary of some of these studies follows. Some of these studies have been described in Hap-penings during the past year in greater detail.

A major study, TAVI, demonstrated hope for patients with se-vere aortic stenosis, severe narrowing of the valve through which blood leaves the heart. In this study, patients judged to be at too high risk for surgical aortic replacement had their valves replaced by a catheterization technique avoiding high risk surgery. When compared with similar high risk patients watched with medical treatment, there was a significant survival benefit with the catheterization technique for aortic valve replacement.

Another major study, the ACCORD lipid study, demonstrated that the drug fenofibrate, Tricor, lowered triglycerides in diabetics but had no survival benefit. A study about the new anticoagulant dabigatran, Pradaxa, had greater protective effects in preventing dissemination of blood clots when compared to Coumadin when there was suboptimal control of the INR, the test used to determine adequate levels of Cou-madin effects.

More bad news accumulated about the diabetic drug rosiglitazone, Avandia, with increased evidence of cardiovascular risk. Because of this risk, the FDA is try-ing to restrict the drug’s usage.

A study evaluating bystander CPR, or CPR initiated by random laypersons, showed no benefit of using mouth-to- mouth breathing and chest compressions when compared to chest compressions alone.
A study evaluating the effective-ness of statin therapy for high cholesterol compared two strategies. One group of patients, tailored therapy, was treated with intensity dependant on risk of a future coronary event. Those with a 5-year risk of coronary event under 15% were treated less intensively than those with a greater than 15% risk. The other group was aggressively treated to reduce LDL cho-lesterol to levels deemed appropriate by national guidelines. Results were better in the tailored therapy group compared to more intensive therapy. This study did not include persons over age 75. It remains to be seen how this study will affect the new U.S. guidelines for cholesterol manage-ment that may come out later this year.

Patients with acute coronary syndromes treated with stents receive combination drug therapy to prevent clots within the stent. One of these drugs has been aspirin and the other is a drug called Plavix.
A study called PLATO compared Plavix and a new drug, Effient. It had previously been noted that up to 30% of people may be resistant to Plavix. In the study these persons treated with Effient did better than those treated with Plavix.

There has been concern in recent years that blood pressure in diabetics should be kept lower than in other persons. The ACCORD study demonstrated that lowering diabetic patients systolic blood pressure had no incremental benefit. Another study demonstrated lack of benefit in lowering systolic blood pressure below 130/80 in patients with diabetes or coronary disease.

A study evaluating the benefit of omega 3 fatty acids, from plants or fish, showed no evidence of prevention of atrial fibrillation. Another study involving atrial fibrillation demonstrated that patients with less stringent heart rate control do just as well as those with tighter heart rate con-trol.

Staff News

We would like to wish a very Happy Birthday to Nancy Carlin and Chrissy Falk. Hope you all enjoy your special day!

Happy New Year!!

All of us here at Jefferson Cardiology would like to wish all of you and your families a very happy, safe and prosperous new year.

Linguine with Peppery Shrimp

Ingredients:

2 pounds large shrimp, peeled and deveined 1 lemon
3 tablespoons butter 8 oz uncooked linguine
1 tablespoon chopped fresh thyme, divided Kosher Salt and Pepper

Directions:

Combine ½ teaspoon kosher salt, 1 ½ teaspoons freshly ground black pepper, and shrimp, tossing to coat shrimp. Heat a large nonstick skillet over medium-high heat. Coat pan with cooking spray. Add shrimp; sauté 4 minutes or until shrimp are done. Grate lemon rind to measure ½ teaspoon; juice lemon to measure 3 tablespoons. Combine rind and juice in a small saucepan over medium heat; add 2 teaspoons thyme. Bring to boil; add butter, stirring constantly with a whisk until butter melts. Bring 6 quarts water to a boil; stir in 1 tablespoon kosher salt. Add pasta; cook 10 minutes or until al dente. Drain, reserving 2 tablespoons pasta water. Add shrimp, butter mixture, reserve pasta water, and ½ teaspoon kosher salt to pasta, tossing to coat. Sprinkle with remaining 1 teaspoon thyme.

A publication of Jefferson Cardiology Association
Alan D. Bramowitz, M.D. | Michael S. Nathanson, M.D. | Gennady Geskin, M.D.

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