New Performance Measures for Peripheral Artery Disease Issued

Performance measures to improve the diagnosis and treatment of peripheral artery disease (PAD) in adults have been published for the first time. The document was produced by the ACC, the AHA, and several other medical organizations. Here are a few key details of the performance measures:…

Click here to continue reading…

Study Finds No Link Between Cancer and Antihypertensives, Except for ARB-ACE Inhibitor Combo

A new meta-analysis has found no evidence of a large cancer risk for most common antihypertensive agents, but did find strong evidence, largely based on one trial, for at least a 10% increase in cancer risk with the rarely used angiotensin-converting-enzyme (ACE) inhibitor and angiotensin-receptor blocker (ARB) combination. In a paper in the Lancet Oncology, Sripal Bangalore…

Click here to continue reading…

MARINE: New Fish Oil Pill Slashes High Triglycerides

A new prescription-grade formulation of ethyl-EPA, an omega-3 fatty acid, significantly lowers triglycerides but doesn’t increase LDL. These were the top line results of the MARINE trial released on Monday by Amarin Corporation, which is developing the drug, now known as AMR101. MARINE randomized 229 patients with triglyceride levels of 500 mg/dl or greater to…

Click here to continue reading…

Greek Study Offers Reassurance About Statin Usage in Patients with Abnormal Liver Tests

Among the 1600 patients randomized in the GREACE (Greek Atorvastatin and Coronary Heart Disease Evaluation) study, 437 had moderately abnormal liver tests at baseline suggesting non-alcoholic fatty liver disease (NAFLD). In a post-hoc analysis of this subset of patients published in the Lancet, the GREACE Study Collaborative Group reported a dramatic 68% reduction in the rate…

Click here to continue reading…

Guest Post: Of Drug Talks, Deception, and Denial

This guest post by Roy Poses, MD, is reprinted with permission from Health Care Renewal. by Roy M. Poses, MD A month ago, we discussed a series of reports by Pro Publica and multiple other respected news organizations about payments by seven pharmaceutical companies to thousands of doctors.  Industry often claims that they only pay the best and the…

Click here to continue reading…

SHARP: A Tale of Two Press Releases

Two press releases were issued about the SHARP trial : one from Merck, the much-maligned and criticized manufacturer of Vytorin (the combination of ezetimibe and simvastatin), and one from the group running the trial, the highly-respected Clinical Trials Service Unit (CTSU) at Oxford. Here’s the surprise: compared to the Oxford press reelease, the Merck release…

Click here to continue reading…

SHARP Shows Benefit for Vytorin in Chronic Kidney Disease

The long-awaited SHARP study has turned up positive results for Vytorin (ezetimibe and simvastatin) in a population of patients with chronic kidney disease. Results of SHARP (Study of Heart and Renal Protection) were presented on Saturday at the American Society of Nephrology meeting in Denver and were scheduled to be posted online on the trial’s website….

Click here to continue reading…

APPRAISE-2 Apixaban in ACS Study Discontinued Due to Increased Bleeding

Bristol-Myers Squibb announced on Thursday evening the discontinuation of APPRAISE-2 (Apixaban for Prevention of Acute Ischemic Events – 2), a phase 3 trial comparing apixaban to placebo in patients with acute coronary syndrome. The decision was based on a recommendation from the Data Monitoring Committee based on “a clinically important increase in bleeding among patients…

Click here to continue reading…

AHA 2010 Is History

Back Camera

Click here to continue reading…

Will This Be the HDL Decade? REVEAL Revealed, Mixed Results for Apo-A1

For a long time HDL has been called the “good cholesterol.” Are we now entering the HDL decade? Two HDL-related trials were presented today at the AHA, and an array of additional trials are planned or underway, prompting the  lead investigator of one of those trials, Chris Cannon, to speculate that this decade may be…

Click here to continue reading…

Anacetrapib: “knock-your-socks-off effect on HDL and a jaw-dropping effect on LDL”

Following the failure of torcetrapib in 2006 the future of CETP inhibitors appeared quite troubled. Now, with the results of  DEFINE (Determining the Efficacy and Tolerability of CETP Inhibition with Anacetrapib), presented at the AHA in Chicago and published online simultaneously in the New England Journal of Medicine, the future for this novel class of…

Click here to continue reading…

CardioExchange at the AHA: A New Voice Emerges

CX logo

Some of you may be aware that my “day job” for the last year has been with the Massachusetts Medical Society, publishers of NEJM. I’ve been working with the great people at MMS helping develop and publish CardioExchange, a social media website for cardiovascular healthcare professionals. Now that may sound silly to many of you…

Click here to continue reading…

BASKET-PROVE Examines Stents for Large Vessels

The BASKET investigators continue their investigator-led exploration of stents in the real world. In BASKET-PROVE they sought to test the hypothesis derived from observations in earlier trials that drug-eluting stents in large vessles might cause only a marginal reduction in revascularizations and might have an increased risk for late stent thrombosis. The results of BASKET-PROVE…

Click here to continue reading…

GRAVITAS: No Benefit for Clopidogrel Dosing Based on Platelet Function Test

The GRAVITAS (Gauging Responsiveness With A VerifyNow Assay– Impact on Thrombosis and Safety) trial enrolled 2,214 patients with high residual platelet reactivty, as assessed by the VerifyNow P2Y12 Test measured 12 to 24 hours after the procedure. (The manufacturer of the test, Accumetrics, sponsored the trial.) Patients in the trial were randomized to either high dose clopidogrel…

Click here to continue reading…

Blast Off! ROCKET AF Hits Chicago

ROCKET AF hit the AHA on Monday morning. Results of ROCKET AF (Stroke Prevention Using the Oral Direct Factor Xa Inhibitor Rivaroxaban Compared With Warfarin in Patients with Nonvalvular Atrial Fibrillation) had been the topic of intense speculation and interest. The trial showed that the experimental factor Xa inhibitor rivaroxaban was as effective as warfarin…

Click here to continue reading…

Study Closes the Book on PFO Closure

Percutaneous PFO closure was no more effective than standard therapy in the prevention of recurrent stroke, according to results of the CLOSURE I trial presented in Chicago at the American Heart Association….

Click here to continue reading…

Omega-3 Fails to Show Benefits in Atrial Fibrillation

In sharp contrast to earlier studies suggesting a positive effect, a large study of high dose prescription omega-3 fatty acids found no evidence of benefit in treating atrial fibrillation. The trial, called the Efficacy and Safety of Prescription Omega-3 Acid Ethyl Esters (P-OM3) for the Prevention of Recurrent Symptomatic Atrial Fibrillation, included 663 patients with AF…

Click here to continue reading…

Drinking in ASCEND: Is the Cup Half Empty or Half Full?

Generally I’m a half-empty kind of guy. Even if the cup is maybe 60% full I still see it as half empty. But I must say that today I’m actually quite encouraged by ASCEND. Others disagree. NPR health blogger Scott Hensley tweeted this about ASCEND today: As usual, info is yrs too late. And of…

Click here to continue reading…

New LVAD Shows Promise as Bridge-to-Transplant

ADVANCE (Evaluation of the HeartWare HVAD Left Ventricular Assist Device System for the Treatment of Advanced Heart Failure) evaluated the clinical efficacy of a novel small centrifugal flow pump as a bridge-to-transplant. In the trial, 140 patients who received the device were compared to a contemporaneous conrol group of 499 similar patients who had received a commercially…

Click here to continue reading…

Lipstick on a Pig?

Back Camera

No, it’s the Exhibit Hall. Changing the name doesn’t change what it is….

Click here to continue reading…

AHA: ASCEND Trial Finally Resolves the Nesiritide Controversy

In the end everyone was wrong. After many years of controversy, we finally know the truth about nesiritide, and all the experts were wrong. Steve Nissen and Jonathan Sackner-Bernstein, who first raised concerns about the safety of nesiritide in decompensated heart failure, turned out to be wrong. But the defenders of nesiritide, including its manufacturer,…

Click here to continue reading…

Emphatic Support for Eplerenone in NYHA class II HF

Aldosterone antagonists have proven beneficial in heart failure patients with moderate to severe symptoms and in MI patients with LV dysfunction and heart failure. Now the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure) has extended these benefits to patients with systolic heart failure patients and mild symptoms. EMPHASIS HF randomized…

Click here to continue reading…

ICD-CRT Found Beneficial in RAFT

RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure Trial) randomized 1798 patients with NYHA class II or III heart failure, LVEF < 30%, and a wide QRS complex to either an ICD alone or an ICD-CRT. After a mean followup of 40 months, the rate of death or heart failure hospitalization was reduced from 40.3% in the ICD…

Click here to continue reading…

AHA: Study Explores Role of Familial AF in Risk of Developing New AF

Although it is well known that there is a heritable component to atrial fibrillation (AF), the precise clinical significance of familial AF has been unclear. Steven Lubitz and colleagues analyzed data from the Framingham Heart Study to assess the incremental predictive value of familial AF in a risk model for new-onset AF….

Click here to continue reading…

Hypertension and Global Warming Are Not the Same Thing

Back Camera

Headrests on the AHA buses: Bad Pun. Bad Analogy. Bad Taste.   Update: I’ve now taken a second bus trip. The good news is that global warning hasn’t spread to every bus in Chicago.  …

Click here to continue reading…