Coronary artery disease (CAD) is the leading cause of death in women. Yet, imaging remains inconsistent from the treatment of their male counterparts. Understanding gender differences in the physiology, symptoms and risk factors may help to reduce the gender gap and improve care.

The FDAs decision to expand coronary artery stenting (CAS) indications to include patients both at high risk and standard risk of stroke has increased the use of CAS to treat carotid stenosis. An editorial published Nov. 14 in Archives of Internal Medicine questioned the increased use of CAS, particularly due to the rather inconclusive data, and concluded that CAS should get a less is more designation for asymptomatic patients because of the definite harms and unclear benefits.

ORLANDO, Fla.CLEVER, a late-breaking clinical trial presented at this years American Heart Association (AHA) scientific sessions, found that for patients with peripheral artery disease (PAD), supervised exercise and stenting showed equivalent improvement in walking distance compared with optimal medical care, with the supervised exercise group arm walking the farthest at six months. Study investigator Emile R, Mohler, III, MD explained the results and implications to Cardiovascular Business.

ORLANDO, Fla.Samuel Z. Goldhaber, MD, principal investigator of ADOPT, discussed the design and negative findings of the trial, which compared an extended course of thromboprophylaxis with apixaban (Eliquis, Bristol-Myers Squibb) with enoxaparin (Lovenox, Sanofi-Aventis) for medically ill patients with venous thromboembolism with Cardiovascular Business.

SAN FRANCISCOUsing a proximal balloon protection device significantly decreased cerebral embolization during carotid artery stenting (CAS) procedures compared with filter protection devices, according to the results of the PROFI trial presented Nov. 11 at the 23rd annual Transcatheter Cardiovascular Therapeutics (TCT) conference.

A large registry-based study that compared clipping with coiling of patients hospitalized with aneurysmal subarachnoid hemorrhage found that clipping increases the risk of in-hospital complications, which results in a longer length of stay and worse functional outcomes. Patients who are suitable for either procedure should receive endovascular treatment, the authors recommended in their study in the November issue of Stroke.

Stroke ranks as the third leading cause of death and the leading cause of serious long-term disabilities in the U.S., according to the American Heart Association (AHA). Direct and indirect costs of stroke were $40.9 billion in 2007, with ischemic stroke having an individual lifetime cost of about $140,000. With the development of acute stroke centers, outcomes are improving for patients. By monitoring for stroke risk factors, such as atrial fibrillation, neurologists now can intervene before a second stroke occurs.

Cook Medicals Zilver PTX drug-eluting stent, a device used to treat peripheral artery disease (PAD) in the superficial femoral artery, has received a unanimous recommendation from the FDAs Circulatory System Devices Panel of the Medical Devices Advisory Committee.