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A cousin to the inflammatory biomarker C-reactive protein may zero in on coronary lesion characteristics that portend bad outcomes. Also, MRI identifies cardiomyopathy patients who won't benefit from an implantable device.
Biomarker May Signal Vulnerable Plaque
Japanese researchers appear to have found a noninvasive way to potentially identify soft coronary lesions that could easily rupture and cause an acute heart attack.
Blood levels of the novel inflammatory biomarker pentraxin 3 (PTX3), which is related to C-reactive protein, were significantly higher in patients with than in those without such lesions, wrote Seiji Koga, MD, of Nagasaki in Nagasaki, Japan, and colleagues.
The researchers used optical coherence tomography and intravascular ultrasound to evaluate lesions. Of the 75 patients, 47 had stable angina and 28 had acute coronary syndrome. The mean age of those with and without thin caps was 66, and 69, respectively, according to the study published online in the JACC: Cardiovascular Interventions.
Previous investigators have suggested that PTX3 might play a causal role in the progression of atherosclerotic lesions, but the current study cannot demonstrate such a relationship.
MRI May Triage Risk of Enlarged Heart
Baseline MRI scans without late gadolinium enhancement appeared to identify patients with idiopathic dilated who would not need an implanted device, a small study suggested.
All 56 patients at baseline had increased left ventricular volume and reduced ejection fraction, but the 30 patients without baseline late gadolinium enhancement (LGE) on MRI remained free of LGE at 2 years follow-up.
The LGE correlated with positive structural and functional outcomes including reductions in left ventricular mass with a concurrent increase in stroke-volume and ejection fraction, according to Pier Giorgio Masci, MD, of Fondazione Toscana Gabriele Monasterio in Pisa, Italy, and colleagues.
Patients with LGE at baseline had LGE at follow-up, which correlated with worse structural and functional outcomes, they reported in the study published online in .
The overall mean age of patients was 55, two-thirds were women, and one-quarter had previously been hospitalized for heart failure.
FDA Considers Combo Drug for HTN
The FDA has accepted the new drug application for Exforge (amlodipine besylate/valsartan) for review as a new treatment option for people with high blood pressure, according to maker Novartis.
The two components of the drug -- amlodipine, a calcium channel blocker, and valsartan (Diovan), an angiotensin receptor blocker -- are the No. 1 prescribed branded medications in their respective classes, according to the company statement.
The drug, which is intended to help patients control their hypertension, was tested in more than 5,000 hypertensive patients in the U.S. The single daily dose of Exforge provided clinically significant blood pressure reductions and was well tolerated.
Exforge HCT -- a triple combination of amlodipine, valsartan, and the diuretic hydrochlorothiazide -- was approved by the FDA for initial hypertension therapy on May 1, 2009.
In October 2010, Novartis paid hundreds of millions of dollars in fines in response to criminal charges of paying illegal kickbacks to physicians for prescribing valsartan, Exforge, and several other drugs.
Stratifying Risk in ACS: There's an App for That
A new app called GRACE 2.0 will help physicians calculate the long-term risk stratification (1 to 3 years after hospital admission) in patients with acute coronary syndrome (ACS).
GRACE 2.0, which will be available soon, is an improvement over the original GRACE app, which calculates the 6-month risk. The original app is available and for the .
is an international observational database of outcomes for patients with ACS. It includes 100 hospitals in 14 countries that will enroll a total of 10,000 patients per year.
The GRACE risk score has been validated and is recommended widely by ESC Guidelines for acute management of ACS.
Development team leader , a professor of cardiology at the University of Edinburgh in Scotland and chair of the European Society of Cardiology's (ESC) Scientific and Clinical Program, will have a presentation based on the app as part of the Hot Line Session at the upcoming ESC meeting.
AstraZeneca supported the app's development.
Carotid Thickness Gauges STEMI Risk
Calculating a patient's vascular age from carotid intima-media thickness (CIMT) and adding that to the Framingham risk score (FRS) may be a good formula for identifying those at risk of a severe heart attack, a pilot study suggested.
The mean age of the 26 patients who presented with ST-segment elevation myocardial infarction (STEMI) was 52, but the CMIT-calculated vascular age added an average of 26 years to the chronological age, reported Ash Kabra, MD, of the , Pa., and colleagues.
Use of vascular age to stratify risk significantly raised the mean FRS from 12.1% to 16.6% and the corresponding mean 10-year event rate from 10.2% to 17.2%, they reported in the journal Echocardiography.