New Yorker: “We took a wrong turn when doctors stopped being doctors and became businessmen…”

Why is McAllen, a poor town near the border of Mexico, the second most expensive health care market in the US? Although income in McAllen is only $12,000 per capita, Medicare spent 15,000 for each of its members in 2006,  about twice the national average. To find out more, Atul Gawande, a surgeon at Brigham…

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Study finds no benefit in routine ECG screening for young athletes

Routine ECG screening for young athletes doesn’t save lives, according to a new study by Maron et al published online in the American Journal of Cardiology. Barry Maron and colleagues compared cardiovascular-related mortality rates in athletes from the Veneto region in Italy, where 12 lead ECGs have been utilized in athletic screening programs for 25…

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Antithrombotic Trialists’ Collaboration questions value of aspirin in primary prevention

Aspirin for primary prevention has “uncertain net value” according to the latest report from the Antithrombotic Trialists’ (ATT) Collaboration in the Lancet. The new meta-analysis includes data from 95,000 primary prevention patients and 17,000 secondary prevention patients. Previous attempts to analyze existing studies did not include patient-level data, so were unable to assess the risk…

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Explosive increase in type 1 diabetes predicted

The overall incidence  of type 1 diabetes in Europe will undergo explosive growth over the next decade, with the biggest increases occurring in children under 5 years of age, according to data from the EURODIAB  study published online in the Lancet. Researchers found an overall 3.9% per year increase in the incidence of type 1…

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Arterial damage found in teens and young adults with obesity or type 2 diabetes

It shouldn’t come as a big surprise to our readers, but a study from Cincinnati shows that teenagers and young adults who are obese or who have type 2 diabetes are already developing atherosclerotic changes that do not bode well for their future cardiovascular health. The study by Urbina et al appears in Circulation as…

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Is bigger really better? Study compares NFL players to the rest of us

Despite mounting concerns in recent years about their increasing size, NFL players have a cardiovascular risk profile similar to the rest of the population, according to a new study by Tucker et al in the Journal of the American Medical Association. The researchers compared data from 504 active NFL players with men of the same…

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Study raises concerns about coronary aneurysms after DES implantation

A new study from Spain is raising concerns about the possible dangers of coronary aneurysms following DES implantation. The study by Alfonso et al is published in the Journal of the American College of Cariology. In the study,  nearly 1,200 consecutive patients underwent late angiographic evaluation after DES implantation. Coronary aneurysms were found in 15…

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Robert Furchgott, Nobel winner for NO, dead at 92

Robert Furchgott, the Brooklyn-based researcher who shared a Nobel Prize for his research that led to the recognition of nitric oxide as a key signaling factor in blood vessels, has died at the age of 92. In 1980 Furchgott first reported on endothelium-derived relaxing factor (EDRF), which after a long and intense search by researchers…

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The Super Bowl really does mean life or death

Sports fans often act as if the outcome of a big sporting event is a matter of life and death. They just may be right, according to an article in press published online in the American Journal of Cardiology. Kloner and colleagues studied total and cardiovascular mortality in Los Angeles in 1980 and 1984. In…

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Lancet meta-analysis revives hope for coronary benefits of intensive glucose control in type 2 diabetics

A meta-analysis of 5 large studies of intensive glucose control of type 2 diabetes  may help revive the hope that this treatment strategy can help fight coronary heart disease. The individual studies (UKPDS, PROactive, ADVANCE, VADT, and ACCORD)  failed to provide reliable evidence for intensive glucose control in this population.  The meta-analysis, and an accompanying…

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FIELD: fenofibrates cuts amputation in type 2 diabetics

Fenofibrate reduces the rate of amputation in type 2 diabetics by 36%, according to a prespecified analysis of the FIELD trial published today in the Lancet. In its original presentation FIELD failed to find a benefit for fenofibrate therapy in the primary endpoint of reduction of cardiovascular death or MI in diabetic patients, but did…

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Zipes testifies in Australian Vioxx trial

US cardiologist Douglas Zipes said that Vioxx played a “substantial contributing role” in the MI of a plaintiff who is suing  Merck in Australia, according to a news report in the Australian. Four cardiologists— two on each side— faced off against each other in the trial. Zipes and Richard Harper, a Melbourne cardiologist, said that…

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TIMACS: early and late intervention for ACS evaluated

Early intervention is no better than delayed intervention in ACS patients in reducing the rate of death, MI, or stroke at 6 months, according to results of  the Timing of Intervention in Acute Coronary Syndromes (TIMACS) trial published today in the New England Journal of Medicine. However, early intervention did reduce the incidence of recurrent…

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Renaissance man Eric Topol: rock star, model, wireless expert, skit subject

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We doubt Eric Topol has his own personal publicist, but if he does that person deserves a raise. Topol, who has long been a rock star equivalent in the relatively quiet world of cardiology, is now breaking out into noisier areas, including music, fashion, and wireless technology. To start, Topol appears in a photograph in…

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JAMA this week: bone marrow cell therapy; cardiorespiratory fitness

Two studies in JAMA this week are likely to be of interest to many readers. 1) After a great deal of hype earlier in the decade, stem cell therapy is no longer attracting a great deal of attention in the cardiology world. Now a new study in JAMA may help revive interest. Bone marrow cell…

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Ohio cardiologist sues Heart Center, alleging abuse of patients and Medicare fraud

An Ohio cardiologist is suing his former employer, the North Ohio Heart Center, after being punished for raising questions about the center’s treatment of its patients. The North Ohio Heart Center, in Elyria, Ohio, was the subject of a 2006 New York Times story by Reed Abelson after a Dartmouth study  found that heart patients…

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Obesity paradox: more CV disease but better outcome

Cardiovascular researchers have long observed a puzzling paradox: obese people are more likely to develop cardiovascular disease than their skinnier counterparts, but once they do develop cardiovascular disease obese people actually have a better prognosis. The implications of the obesity paradox are discussed in a review article by Carl Lavie and colleagues in JACC. Lavie…

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JACC publishes revised appropriate use criteria for radionuclide imaging

A task force of cardiology and radiology organizations has published revised appropriate use criteria for radionuclide imaging (RNI) in JACC. RNI was deemed appropriate as a test for possible ACS, but inappropriate for definite ACS. In chest pain patients, RNI was deemed appropriate for those with an intermediate or high probability of coronary disease or…

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ICDs in the real world: good survival but many shocks

In the real world patients with ICDs live longer than their counterparts in randomized studies, but they also have a higher than anticipated rate of inappropriate shocks. The results of the ALTITUDE prospective observational study of more than 85,000 ICD and CRT-D patients were presented by Leslie Saxon at the  annual meeting of the Heart…

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MADIT II at 8 years: 1 life saved for every six patients

Eight year followup of the MADIT II trial provides the first substantial evidence for the long term mortality benefits of ICDs. Mortality at 8 years was 45% in the ICD group compared to 61% in controls. The mortality difference was statistically significant in the first 4 years of the study and also in the last…

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Psychotropic drugs increase risk of sudden death in ACS

Patients who are taking psychotropic drugs such as antipsychotics, antidepressants and benzodiazepines are at increased risk of sudden death during ACS, according to a new case-control study from Finland presented today at the annual meeting of the Heart Rhythm Society. Comparing  321 sudden cardiac death victims to 609 MI survivors, Jussi Honkola found significantly higher…

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Both high and low estradiol levels linked to higher mortality in men with HF

Men with heart failure who have either high or low levels of estradiol are more likely to die than heart failure patients with normal levels, according to a new study published in JAMA. Researchers in Poland studied 501 men with heart failure. 171 patients died during the 3-year followup. Compared to patients with estradiol levels…

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The Medicines Company discontinues phase 3 CHAMPION clinical trial program of Cangrelor

(from WikiDoc— by C. Michael Gibson, M.S., M.D. Dr. Gibson served as a member of the Executive and Steering Committees for the CHAMPION trial) The phase 3 CHAMPION clinical trial program of the investigational agent cangrelor was discontinued today. The intravenous agent was being evaluated in patients undergoing percutaneous coronary intervention (PCI). The announcement was…

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ACC takes firm stand against lanyards and tote bags

If the ACC Scientific Sessions in Orlando seemed a little less colorful this year, that may be due to the decision by the ACC leadership to avoid the “Nascar effect.” ACC CEO Jack Lewin spoke to Tradeshow Week and explained that the ACC gave up half a million dollars in sponsorship by not selling sponsorships…

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Your mother was wrong: don’t take vitamins (before exercise)

Contrary to the ardent belief of supplement supporters and mothers, vitamins may not always be good for you. A new study in the Proceedings of the National Academy of Sciences raises the intriguing possibility that the antioxidant vitamins C and E may actually prevent the healthful benefits of exercise in humans. German researchers evaluated insulin…

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