JAMA studies raise questions about CRP and other biomarkers

Two large new studies published in JAMA shed important new light on CRP and other biomarkers, but are unlikely to result in significant changes in clinical practice. In the first report, a large genome-wide association and replication study, followed by a mendelian randomization study, failed to find a causal role for CRP in coronary heart…

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JACC White Paper urges cautious approach to triple antithrombotic therapy

Many patients receiving dual antiplatelet therapy for ACS or after receiving a stent may also require anticoagulant therapy for stroke prevention, leading to increased usage of triple antithrombotic therapy (clopidogrel, aspirin, and warfarin). “But although triple therapy can prevent both thromboembolism and stent thrombosis, it is also associated with significant bleeding hazards,” write David Holmes…

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Michael Jackson’s doctor: cardiologist or not?

Although he is being called a “cardiologist” in the mainstream media, Michael Jackson’s personal physician was not a board-certified cardiologist. Near the epicenter of the Michael Jackson media storm is Dr. Conrad Murray, a Las Vegas physician. Murray was with Jackson in his last hours and apparently attempted to revive him with CPR, according to…

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Takeda’s alogliptin delayed for at least 2 years

Takeda announced today that approval for its DPP-4 inhibitor alogliptin will be delayed. At the request of the FDA the company will perform a cardiovascular safety trial. The drug will be delayed for at least two years. Click here to read a story in the Asian Wall Street Journal….

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EASD raises concerns about possible link between Lantus insulin and cancer

Studies from Europe are raising fears that an insulin analog, insulin glargine (Lantus), may raise the risk of cancer. You can find links to the published papers, a statement from Sanofi-Aventis, information for patients, as well as additional information, on the website of Diabetologia, a journal published by the European Association for the Study of…

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Doug Zipes, AHA on Michael Jackson’s death

We spoke briefly tonight with Doug Zipes about Michael Jackson’s death. Zipes, a former president of the American College of Cardiology, is a leading expert on arrhythmias and sudden death. Zipes acknowledged that drugs may well have played a role in Jackson’s sudden death. If, as widely reported in the media, Jackson died of sudden…

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TRANSFER-AMI: “definitive” endorsement of early PCI after fibrinolysis

Routine early transfer for PCI following fibrinolysis for MI is strongly supported by results of the TRANSFER-AMI trial published in the New England Journal of Medicine….

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Framingham: first degree AV block not benign

First degree AV block (PR interval >200 ms) may not be as benign as commonly believed, according to new data from 7,575 participants in the Framingham Heart Study published in JAMA. The study found that patients with first degree AV block were twice as likely to develop AF and three times as likely to receive…

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New percutaneous mitral repair device appears promising in small study

A new percutaneous device to repair mitral regurgitation may be beneficial in symptomatic heart failure patients with functional MR, according to a new study appearing in in Circulation: Cardiovascular Interventions….

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Boston Scientific says MADIT-CRT meets primary endpoint: CRT-D slows HF progression

Boston Scientific announced today that MADIT-CRT had met its primary endpoint. NYHA Class I and II patients who received CRT-Ds had a significant 29% (p-0.003) reduction in death or heart failure interventions compared to patients who received traditional ICDs. 1,800 patients in 14 countries were enrolled in the trial. Arthur Moss is the PI….

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Texas passes SHAPE bill requiring reimbursement for MI screening

[Updated with comments from George Diamond, Amit Khera, and PK Shah]– The SHAPE-inspired bill requiring reimbursement for MI screening has passed all the stages required to become law in Texas and will go into effect on September 1. The bill was first proposed two years ago, with strong support from the Society for Heart Attack…

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Braunwald, Shah: “tour de force” Japanese CTA study may be future “landmark”

Updated with comments from Roger Blumenthal and Valentin Fuster]– CT angiography may be able to identify atherosclerotic lesions that are likely to develop ACS, according to an intriguing new study from Japan appearing in JACC. “When more effective therapies” for vulnerable plaques become available, the paper will “surely become a landmark in the effort to…

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Europace update: AF in athletes, drivers with ICDs, more…

Europace 2009 is taking place right now in Berlin. Here are some of the interesting noncommercial press releases from the European Society of Cardiology coming out of the meeting: Implanted Defibrillators: New Recommendations for Drivers with ICDs Atrial fibrillation in endurance athletes still poses problems for sports cardiologists “Big disparities in the treatment of arrhythmias…

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FDA official defends integrity of prasugrel review

Responding to criticism, FDA official Tom Marciniak has defended the methodology used in his review of prasugrel for the Cardiorenal advisory committee meeting in February. Many CardioBrief readers will be aware of the long and complicated history behind this controversy. (Click here for a detailed chronology.) This latest episode begins with our story last week,…

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No recession in starting salaries for new cardiologists or recruiting bonuses

[Updated]– They may not be at the level of a Samin Sharma or Jeff Moses, but newly minted cardiologists probably won’t have to worry about the recession, according to a survey of new physician salaries by the Medical Group Management Association. The median starting salary for invasive cardiologists in 2008 was $350,000, according to the…

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Court transcripts show cardiologists debating Vioxx in Australian trial

Updated with a comment from Harlan Krumholz– Court transcripts from the ongoing Australian Vioxx trial provide a detailed view of the debate between prominent cardiologists over the issue of whether Vioxx causes heart attacks. As we reported previously, four cardiologists— two on each side— faced off against each other in the trial. US cardiologist Douglas…

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BP: “complex interplay” between genes and environment

When it comes to blood pressure it’s not just genes and it’s not just environmental factors that matter. Instead it’s the “complex interplay between genes and environmental factors” that determines blood pressure regulation, according to a study by Franceschini and colleagues appearing in Circulation: Cardiovascular Genetics. Using data from the 3,600 American Indians taking part…

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Lowering BP: small steps, big results

Small steps to improve blood pressure control can make an enormous difference, according to a new study published in Circulation: Cardiovascular Quality and Outcomes. Researchers at the VA-Tennessee Valley Healthcare System undertook multiple initiatives to improve blood pressure education. Nurses in the study distributed over 30,000 blood pressure wallet cards to track clinic visits, document…

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Rivaroxaban in ACS: more bleeding, no benefit over dual therapy

Following its presentation last November at the AHA, the ATLAS ACS-TIMI 46 trial has been published online in the Lancet, with an accompany editorial by Kim Eagle and Hininder Gurm. ATLAS was a dose-ranging study designed to find the best dose of rivaroxaban in ACS. Nearly 3,500 patients were stratified by the choice of background…

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Triple antiplatelet therapy for primary PCI?

Triple antiplatelet therapy may be superior to dual antiplatelet therapy in primary PCI, according to the findings of a retrospective analysis of over 4,200 STEMI patients enrolled in the Korean Acute Myocardial Infarction Registry (KAMIR) who underwent primary PCI with DES. The study by Chen et al  is published online in Circulation, with an accompanying…

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Study links psoriasis and atherosclerosis

Patients who have psoriasis are more likely to have ischemic heart disease, cerebrovascular disease, and peripheral disease than patients without psoriasis, according to a new study in the Archives of Dermatology. “This result is not surprising, given the systemic nature of atherosclerosis,” the authors write. “It has tremendous and far-reaching clinical implications, as all of…

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Pioglitazone to reduce restenosis: the next frontier?

Pioglitazone after PCI may reduce the rate of target lesion revascularization, according to the results of a small Japanese study published in JACC: Cardiovascular Interventions. 97 type 2 diabetics undergoing PCI with bare metal stents were randomized to pioglitazone or control in the multicenter study. The angiographic restenosis rate was 17% in the pioglitazone group…

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Dr. Obama diagnoses a cardiology syndrome

Barack Obama, cardiologist? Not yet, but he spoke to the AMA today and delved briefly into the world of cardiology. Here is the relevant portion of his speech: “…too many doctors and patients are making decisions without the benefit of the latest research. A recent study, for example, found that only half of all cardiac…

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Lilly responds to Serebruany attack on TRITON-TIMI 38

In response to Victor Serebruany’s editorial in Cardiology criticizing TRITON-TIMI 38 (see our previous post), a Lilly spokesperson sent the following statement to CardioBrief:…

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What do FDA insiders really think of prasugrel?

The benefits of prasugrel in TRITON-TIMI 38 were greatly exaggerated by the “massive inclusion of ‘MIs” unreported by the trial investigators,” according to an editorial in Cardiology by Victor Serebruany. Serebruany’s severe criticism of prasugrel and TRITON will come as no surprise to CardioBrief readers. (See our prasugrel chronology for a detailed history of the…

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