The Dangers Of Going Too Fast

Updated– According to an editorial published online in the BMJ journal Heart, running too hard, too fast, and for too long can be dangerous. The same holds true in publishing. The editorial was hastily released ahead of its scheduled publication time after portions of it were quoted in a Wall Street Journal article on the dangers of endurance sports….

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Following Earlier Recall, Ranbaxy Halts Manufacturing Atorvastatin

Ranbaxy, the often-troubled manufacturer of generic drugs, will temporarily stop manufacturing generic atorvastatin. On November 9, 2012 the company announced a voluntary recall of some lots of atorvastatin because of possible contamination with glass particles. An FDA statement today said that Ranbaxy will discontinue making the drug “until it has thoroughly investigated the cause of the…

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Statins and Exercise, Independently Beneficial, Even Better In Combination

Photo by T-Rex Runner (click on the the picture for more background)

It’s no secret that statins and exercise are good for people with cholesterol problems. Now a new study published in the Lancet offers fresh evidence that the two appear to be independently beneficial, and that adding the two together may result in greater benefits than either alone. US researchers analyzed data from 10,043 people with dyslipidemia…

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Longer Warfarin Therapy After Bioprosthetic Aortic Valve Replacement May Be Beneficial

Three months of warfarin is the usual standard of care following bioprosthetic aortic valve replacement (AVR),  although the supporting evidence base for this practice is limited. Now a large new registry study published in JAMA suggests that more prolonged warfarin therapy may be beneficial. Danish researchers identified 4,075 patients who underwent bioprosthetic AVR. As expected,…

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The Doctor At The Center Of The Insider Trading Scandal

Gilman Michigan

Last week’s big insider trading case offers fresh evidence that financial interests often clash with medical ethics. Of course, the news stories were all about the juicy details of insider trading at a hedge fund based on information leaked by a key academic investigator. This is an important and shocking story. But there’s another story…

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Model Finds High Cost For ECG Screening Of Athletes

A national program of ECG screening for U.S. athletes would save almost 5,000 lives over 20 years but would cost more than $50 billion dollars, according to a paper published in the Journal of the American College of Cardiology. The advisability of routine ECG screening for athletes has divided the experts: currently the ESC recommends ECG screening…

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Yet Another Look At The Transcendental Meditation Paper

Editor’s note: Below are two responses to Robert Schneider’s defense of his Transcendental Meditation paper, which Schneider wrote in response to my earlier article about the publication of his paper.  In the first part I respond to some of the general issues raised by Schneider. The second part, from Sanjay Kaul, addresses the statistical issues discussed by…

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From Barack To Rupert, A Thanksgiving Message

Sorry for this off-topic post, but I couldn’t resist sharing this email message forwarded from a friend in Washington, DC: Thanksgiving Day, The White House Dear Rupert, I thought on this day in particular it would be appropriate for me to send a brief note expressing my gratitude for all that you did for us over…

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What’s The Best Treatment For Abdominal Aortic Aneurysm?

Endovascular repair of AAA (abdominal aortic aneurysm) gained enthusiastic acceptance after initial results from three trials (EVAR 1, DREAM, and OVER) found an early survival advantage for endovascular repair compared to open repair. Some of the enthusiasm waned, however, after long-term results from the first two trials found no difference in survival between the groups…

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Investigator Defends Controversial Transcendental Meditation Paper

Editor’s Note: Here is a response by Dr. Robert Schneider to my story last week about his controversial paper on Transcendental Meditation that appeared in Circulation: Cardiovascular Quality & Outcomes. I will respond to Dr. Schneider’s post later this week. Response from Dr. Robert Schneider We appreciate the interest in our article published in Circulation: Cardiovascular Outcomes…

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HeartWare LVAD Approved By FDA For Transplant Patients

heartware

The FDA said today that it had granted approval to the HeartWare Ventricular Assist System for use in heart failure patients waiting for a transplant. Approval of the device had been expected after the FDA’s Circulatory System Devices panel recommended approval of the device earlier this year. HeartWare was approved based on data from the pivotal…

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Comprehensive Guidelines for Stable Ischemic Heart Disease Released

New comprehensive guidelines for the diagnosis and treatment of stable ischemic heart disease have been released by the American College of Cardiology (ACC)/American Heart Association (AHA) Task Force on Practice Guidelines, along with the American College of Physicians (ACP), American Association for Thoracic Surgery (AATS), Preventive Cardiovascular Nurses Association (PCNA), Society for Cardiovascular Angiography and…

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FDA Approves Zilver PTX Drug-Eluting Stent For Peripheral Arterial Disease

The FDA today approved Cook Medical’s Zilver PTX stent. It is the first drug-eluting stent (DES) approved for the treatment of peripheral arterial disease (PAD) in the superficial femoral and proximal (i.e., above the knee) popliteal artery. The new stent will provide a new treatment option for treating patients with PAD. Current treatments include exercise,…

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Mysterious Disappearing Paper Finally Reappears In Another Journal

Robert Schneider, M.D., director of the Institute for Natural Medicine and Prevention and dean of Maharishi College of Perfect Health in Fairfield, Iowa. Courtesy MAPI

Updated– Last year, in what may have been an unprecedented action, a paper on the effects of Transcendental Mediation (TM) in African Americans was withdrawn by the editors only 12 minutes before the paper’s scheduled publication in Archives of Internal Medicine. No definitive explanation was ever provided, though the editors and authors said that the action…

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Expert Consensus Document Offers Advice On Troponin Tests

A newly published document provides practical advice on the use of the popular and potent troponin tests. The Expert Consensus Document on Practical Clinical Considerations in the Interpretation of Troponin Elevations was developed by the American College of Cardiology Foundation in collaboration with several other societies to help address the many complex issues raised by the introduction…

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Nonfasting Lipid Testing Gains Growing Acceptance

Although fasting before a lipid test has long been recommended, a new study and accompanying commentaries make the case that nonfasting lipid levels are acceptable and may even be superior to fasting levels for the assessment of cardiovascular risk. Investigators at the University of Calgary analyzed data from laboratory tests obtained from more than 200,000…

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Nine Italian Cardiologists Arrested In Broad Investigation Of Research Fraud And Misconduct

Photo of the arrest of Maria Grazia Modena, from Il Resto Del Carlino

Nine Italian cardiologists have been arrested as part of a broad investigation into serious medical misconduct at Modena Hospital, according to multiple reports in the Italian media. The investigation encompasses at least 67 other individuals and a dozen medical equipment companies, including 6 foreign companies. The charges include conspiracy, fraud, embezzlement, bribery, forgery and performing…

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Statins Use Linked To Reduction In Cancer Mortality

A large new population study rasies the possibility that statin use may lead to a decline in cancer mortality. Researchers in Denmark utilized health data from the entire population of the country and analyzed the information from nearly 300,000 patients who were diagnosed with cancer between 1995 and 2007. The authors note that the relationship is biologically…

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Ultrafiltration Fails To Show Benefit In Acute Heart Failure

Although ultrafiltration (UF) in recent years has become increasingly popular as an alternative to intravenous diuretics for patients with acute decompensated heart failure with acute cardiorenal system (type 1), the first clinical trial to test its value shows that it is inferior to standard drug therapy. The results of CARRESS-HF (Cardiorenal Rescue Study in Acute Decompensated…

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RELAX-AHF Stirs Interest In Novel Drug For Acute Heart Failure

A new drug modelled on a hormone active in pregnancy may prove beneficial to patients with acute decompensated heart failure. Serelaxin is a recombinant form of human relaxin-2, which is known to mediate the hemodynamic changes that occur during pregnancy. The drug is under development by Novartis for use in acute heart failure. In the…

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BLOCK HF: A “Game Changer” For Cardiac Pacing

Editor’s Note: The following guest post is published with the permission of its author,  Edward J. Schloss, MD, (Twitter ID @EJSMD) the medical director of cardiac electrophysiology at Christ Hospital in Cincinnati, OH. Dr. Schloss was an investigator in the BLOCK HF trial. In what has been described as a “game changer” for the field of…

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Early Look: New Methods To Enhance Cholesterol Efflux

Although clinical trials of HDL-boosting CETP inhibitors have so far failed to produce positive results, many other avenues of HDL-related research remain active.  A glimpse at the very early phases of two intriguing lines of research in this area was offered on Monday at the AHA. Apo A-1 is thought to be the key HDL…

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Dalcetrapib: Another HDL-Raising CETP Inhibitor Bites The Dust

Another HDL-raising CETP inhibitor has failed to demonstrate cardiovascular benefit in a large clinical trial. With the presentation of the dal-OUTCOMES trial at the American Heart Association in Los Angeles andsimultaneous publication in the New England Journal of Medicine, dalcetrapib joins torceptrapib on the list of once-promising CETP inhibitors. In dal-OUTCOMES, 15,871 patients with a recent…

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NIH Trial Gives Surprising Boost To Chelation Therapy

With a result that is likely to surprise and baffle much of the mainstream medical community, a large NIH-sponsored trial has turned up the first substantial evidence in support of chelation therapy for patients with coronary disease.  Known as TACT (Trial to Assess Chelation Therapy),  the highly controversial trial was presented today at the AHA by Gervasio…

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ARCTIC Blows A Cold Wind On Platelet Function Tests

The use of platelet-function tests to monitor and guide antiplatelet therapy in PCI patients has sparked heated debate. Cardiologists have sought to reconcile biological plausibility with the absence of clinical evidence. Now the ARCTIC (Assessment by a Double Randomization of a Conventional Antiplatelet Strategy versus a Monitoring-guided Strategy for Drug-Eluting Stent Implantation versus Continuation One…

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