News and views

We continue our series in which Consultant Interventionist Dr Michael Norell takes a sideways look at life in the cath lab… and beyond. In this column, he considers ‘non-expert’ opinion....

The National Institute for Health and Clinical Excellence (NICE) has recommended that drug-eluting stents can continue to be used in patients who have a higher risk of needing further stents if a conventional bare-metal stent were used instead. It has set a limit for the price differential between drug-eluting and bare-metal stents of £300....

The results of two major trials of intensive glucose lowering in patients with type 2 diabetes appear to have reached different conclusions....

In contrast, the ADVANCE study, has not shown any harm in its intensive treatment arm. In this trial, 11,140 high-risk patients with type 2 diabetes, were randomised to intensive (aiming for an HbA1C A1C level below 6.5) versus standard glucose lowering treatment. Patients in the intensive group started treatment with the sulphonylurea drug, gliclazide modified release, and then other drugs could be added....

A new study has highlighted a changing pattern of cardiovascular mortality within Europe, and shows that while cardiovascular mortality rates are decreasing in general, Eastern and Middle European countries have the highest mortality....

There is a need  to meet the demand, led by primary care, for the appropriate assessment and management of patients with heart failure. Standard 11 (heart failure) of the National Service Framework (NSF) for Coronary Heart Disease (CHD)1 has been paid much less attention within primary care than other NSF standards with a much greater emphasis on and investment in services for secondary prevention of CHD. The current changes in primary care, particularly those relating to practice-based commissioning, will inevitably lead to a review of all services, including those for heart failure, with cost-effectiveness being one important consideration. The evaluation of an urban heart failure service by Patel et al. (see pages 35–9)2 in this issue supports the use of open access echocardiography/heart failure services for patients with suspected heart failure. One might argue that, from a number of different perspectives, such services may be better delivered from a primary care base. Given the less than favourable financial circumstances of many primary care organisations at the present time, however, ongoing and additional investment in primary care-based heart failure services may be under threat unless we can provide more robust3 data in areas such as quality of service and cost-effectiveness....

As part of a larger focus on prevention of disease in the NHS, Prime Minister Gordon Brown has announced that new screening programmes for early signs of heart disease, stroke and kidney disease will be introduced in the UK....

The first clinical trials with the new cholesteryl ester transfer protein (CETP) inhibitor, anacetrapib, have raised hopes that this agent may not be affected by the toxicity seen with the first drug in this class – torcetrapib....

As well as causing musculoskeletal problems, vitamin D deficiency may also increase the risk of heart disease, a new study suggests....

Anatomy software developer, Primal Pictures, has been awarded government grants to develop two new computer simulations which should improve training procedures for cardiologists and keyhole surgeons....