Meta-analysis: increased mortality in cancer patients treated with epoetin and darbepoetin

Cancer patients who take erythropoiesis-stimulating agents (ESAs) have a higher risk of death, according to a new meta-analysis published in the Lancet. European researchers analyzed 53 cancer trials including nearly 14,000 patients and found that those taking epoetin or darbepoetin had a 17% increase in mortality compared to control patients. There were no differences in…

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On the radar: BARI 2D could be the next COURAGE

The BARI 2D trial, which will be presented on June 7th at the scientific sessions of the American Diabetes Association, may have an outcome similar to the COURAGE trial, but its impact probably won’t be as big, according to one knowledgeable Wall Street analyst. The BARI 2D trial is comparing revascularization with either CABG or…

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Dronedarone debut: will it be successful?

In the wake of dronedarone’s successful but controversial advisory panel meeting in March, a perspective in the New England Journal of Medicine by Peter Zimetbaum reviews the complicated history of the drug and makes a cautious forecast that the drug may be accepted into clinical practice when and if it gains FDA approval: “So where…

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New imaging technique may help monitor vulnerable plaque

A new imaging technique may be helpful in assessing the efficacy of anti-inflammatory therapy in vulnerable plaque, according to a new study published online in the Journal of the American College of Cardiology. The ATHEROMA (Atorvastatin Therapy: Effects on Reduction of Macrophage Activity) Study used ultrasmall superparamagnetic iron oxide-enhanced magnetic resonance imaging to compare the…

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Pfizer reports drop in Lipitor sales

Sales of atorvastatin (Lipitor) dropped 13% in the first quarter to (only) $2.72 billion, according to Pfizer’s quarterly report. Jacob Goldstein, writing in the Wall Street Journal Health Blog, notes, with perhaps only slight hyperbole, that Lipitor is “the biggest blockbuster in the history of the universe.” Although the drug has more than two years…

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Conflicts of interest threaten public’s trust in medicine: IOM report

“Conflicts of interest threaten the integrity of scientific investigations, the objectivity of medical education, the quality of patient care, and the public’s trust in medicine,” according to a new report issued today by the Institute of Medicine. [Here is a link to a free PDF of the Executive Summary.] The report calls for “all academic…

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Dual antiplatelet therapy linked to more post-CABG infections

The increased bleeding risk in CABG patients who are on dual antiplatelet therapy  is well known. Now a raised risk of post-surgical infection may be an additional concern, according to a new study appearing in the Archives of Internal Medicine. Researchers at Johns Hopkins retrospecitvely 1677 CABG patients. At 30 days the rate of infection…

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Good kitty ROMICAT: CT to rule out MI

CT angiography (CTA) may help rule out MI in the emergency department in chest pain patients at low to intermediate risk, according to results of the ROMICAT study published in the Journal of the American College of Cardiology. Study investigators observed 368 patients admitted for rule out MI and found that half of these patients…

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Statins linked to reduced incidence of prostate cancer

The use of statins has been linked to a reduced incidence of prostate cancer, according to the findings of a large observational study of 2,447 men from Olmstead County. Researchers from the Mayo Clinic presented the results on Sunday at the annual meeting of the American Urological Association meeting in Chicago. After more than 15…

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Football moms go red

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It seems unlikely but this is our second football-related post in less than a week. Last week we enjoyed reporting that the Stanford cardiology fellows had challenged the San Francisco 49ers to a push-up contest. Now we are pleased to report that the Professional Football Players Mothers’ Association (PFPMA) has joined the American Heart Associations’s…

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Is the party over? PhRMA publishes new guidelines on clinical trials

No more meetings at fancy resorts and no more ghost writers. The life of clinical trialists will be a bit more drab and constrained, as the pharmaceutical industry’s revised  Principles on Conduct of Clinical Trials and Communication of Clinical Trial Results take effect later this year. The document is a reflection of the ongoing efforts…

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FDA panel gives cautious nod to the Watchman

The FDA’s Circulatory System Devices Panel voted 7-5 in favor of the Watchman, an implantable device that blocks the left atrial appendage with a fabric-covered expandable nitinol cage. It is designed to help patients with nonvalvular AF avoid warfarin therapy. You can read a Heartwire story, a MedPage story, or a Reuters story. You can…

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Two radically different approaches to financial incentives

We stumbled across two entirely different approaches to financial incentives today: The first approach was discussed in an intriguing story by Andrew Pollack in today’s New York Times. In this story, drug makers change “what they charge for their drugs, based on how well the medicines improve patients’ health.” The article discusses a new agreement…

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FDA extends review of saxagliptin until July 30

Despite a positive 10-2  vote in favor of saxagliptin earlier this month by the FDA’s Endocrinologic and Metabolic Advisory Committee (as we reported here), the FDA has extended its review of the drug until July 30. The previous deadline had been April 30….

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FDA: is it time for the Watchman?

Following its promising debut in the PROTECT-AF trial a few weeks ago at the ACC, the Watchman device appears likely to receive a somewhat less ecstatic response when it appears before the FDA’s Circulatory System Devices Panel on Thursday. The Watchman is an implantable device that blocks the left atrial appendage with a fabric-covered expandable…

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ACC defends partnership with industry group to separate clinical and cost effectiveness studies

The ACC has taken a firm position against yoking clinical effectiveness studies and cost effectiveness studies, and has joined an industry-supported group that supports a similar agenda. The issue has bubbled to the surface lately in response to a proposed Obama administration initiative that would support cost effectiveness measures based on comparative efficacy studies. A…

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Electricians do it better

Electrophysiologists do it better— at least when it comes to implanting ICDs, according to a large registry report published in JAMA. 71% of implantations were performed by electrophysiologists, according to the study of more than 111,000 procedures reported to the ICD Registry. There were more complications and lower likelihood of receiving a CRT-D device when…

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Bring it on! Stanford cardiology fellows challenge 49ers to push-up contest

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We couldn’t overlook a recent Stanford University Medical Center press release. In what may be the ultimate geek versus jock competition, the Stanford cardiology fellows have challenged the San Francisco 49ers to a push-up contest to help raise money for hypertrophic cardiomyopathy. We have been unable to confirm rumors that television executives are already planning…

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STEMI networks key to rapid reperfusion

The best way to consistently deliver rapid primary PCI is through organized regional networks combining paramedics, emergency departments and cardiology teams, according to a new study published in the Journal of the American College of Cardiology: Cardiovascular Interventions. “Whether it was big cities like Los Angeles or smaller towns like Medford, Oregon, the creation of…

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JACC white paper clarifies role of cardiovascular MR in myocarditis

Cardiovascular magnetic resonance (CMR) may have an important role to play in the diagnosis of myocarditis, according to a white paper published in the Journal of the American College of Cardiology. The  International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis writes in their conclusion: “The use of CMR appears suitable to identify patients with…

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JAMA imbroglio: the shrink strikes back

Robert Robinson is the psychiatrist who failed to disclose a conflict of interest in a JAMA article and thereby sparked an imbroglio that quickly expanded beyond the initial subject. The story’s focus soon shifted to the JAMA editors for their ham-fisted handling of the episode, especially after they had a series of contentious conversations with…

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COURAGE & OAT: persistent doubts among interventionalists

It will come as little surprise to readers of this blog that the COURAGE and OAT trials were not exactly welcomed with open arms by the interventional community. An innovative study published in the American Heart Journal helps quantify and characterize this dissent by analyzing articles that cited the studies. The details of their methods…

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MR angiography continues to advance, but still limited

Coronary magnetic resonance angiography (CMRA) continues to make broad advances but is still not ready for routine clinical usage, according to a new study published online in the Journal of the American College of Cardiology. The new study reports on the single-center experience with a new 3.0 tesla contrast MRA in 96 patients scheduled for…

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GISSI-AF: valsartan fails to prevent AF recurrence

The angiotensin II-receptor blocker (ARB) valsartan failed to prevent the recurrence of atrial fibrillation in 1,442 patients enrolled in the GISSI-AF study. “Our findings do not support the original hypothesis of a beneficial role of blockers of the renin–angiotensin–aldosterone system in the prevention of recurrent atrial fibrillation,” wrote the GISSI investigators. The results of GISSI-AF…

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Francis Collins reported to be next NIH director

The In Vivo blog is reporting that Francis Collins will be nominated to be the next director of the NIH. Cardiologist Elizabeth Nabel, director of the NHLBI, had been rumored to be one of the candidates for the position….

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