Providing discharge supplies of antiplatelet medication post-PCI resulted in lower overall costs for insurers, according to a study in the December 2011 issue of the American Journal of Managed Care.

Targeted strategies based on screening risk factors for stroke and cognitive decline in patients referred for coronary artery bypass graft (CABG) surgery may help reduce adverse neurologic outcomes, authors of a review article in the Jan. 19 issue of the New England Journal of Medicine proposed. But to date, such procedures are not a standard of care.

he SYNTAX trial cracked open the door for the use of PCI as a treatment option for select patients with complex coronary artery disease. Since the trials enrollment closed, refinements in technologies and techniques continue to nudge the door wider for PCI at the same time that longer-term data from SYNTAX shine favorably on CABG for higher-risk patients. But the verdict is still out on how best to treat patients with multivessel or left main disease if they are not clear-cut candidates for either procedure.

If a hospital or practices priority is to make money, then it may want to think twice about instituting a transradial PCI program. But if it wants to lower costs, free up resources and be positioned for a shift in reimbursement toward outpatient care and quality incentives, then developing expertise in transradial access will pay dividends, proponents of the procedure say.

While it is no surprise that obesity is associated with an increased risk of cardiovascular morbidity and mortality, patients who undergo bariatric surgery may lose some of this risk, according to a study published Jan. 4 in the Journal of the American Medical Association. The study showed that patients who underwent this weight-loss surgery saw a decreased incidence of cardiovascular death and events. However, while bariatric surgery does help with weight-loss, its benefits and mechanisms remain unknown.

The Maryland Chapter of the American College of Cardiology (ACC) and the Society for Cardiovascular Angiography and Interventions (SCAI) have reiterated their call for the state of Maryland to require rigorous internal and external review of stenting practices in hospitals in the state after an advisory group recommended a lower standard. Simultaneously, a report has emerged of a new case of improper stenting in the state.

The physician performing an index catheterization and the treating hospital were strong independent predictors of revascularization treatment, according to a study published online Dec. 12 in the Canadian Medical Association Journal. In an accompanying editorial, the authors suggested that patient preference also may influence the three-fold variation found in the ratio of PCI and CABG.

New-onset atrial fibrillation (AF) occurred in one-third of patients undergoing transcatheter arotic valve implantation (TAVI) with no previous history of AF, according to a single center study published Dec. 14 in the Journal of the American College of Cardiology. However, authors of an accompanying editorial wrote that the results should be interpreted with "caution," and that the correlation pinpoints the need for improvement in the identification of patients at risk.