Whistleblower Lawsuit Yields $2.4 Million For New Jersey Cardiologist

A New Jersey cardiologist will receive $2.4 million for his role in a whistleblower lawsuit against Cooper Health System and Cooper University Hospital. Following an investigation by the US Department of Justice and the New Jersey Attorney General’s Office, Cooper agreed last week to pay $12.6 million to settle Medicare and Medicaid fraud allegations. The…

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Small Study Suggests Yoga May Benefit AF Patients

A small study published online in the Journal of the American College of Cardiology suggests that yoga may benefit people who have atrial fibrillation. The study, which the authors describe as “a small, proof-of-concept study,” is the first of its kind. The findings raise the possibility that yoga may reduce AF symptoms and arrhythmia burden. Other…

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FDA Approves Mipomersen For Homozygous Familial Hypercholesterolemia

The FDA said today that it had granted approval to the novel cholesterol-lowering drug mipomersen sodium for use as an adjunct to diet and drug therapy in patients with homozygous hypercholesterolemia. The drug, which was developed by Isis Pharmaceuticals, will be marketed under the brand name of Kynamro by Genzyme. Kynamro was approved as an…

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Popular Antidepressants May Put Patients At Risk For Serious Arrhythmias

In August 2011 the FDA issued a safety communication recommending that the extremely popular antidepressant citalopram (Celexa) not be used at doses greater than 40 mg/day because of a potential increased risk for serious cardiac arrhythmias associated with prolongation of the QT interval. Now a study published in BMJ lends support to this warning and suggests that…

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ESC Gives A Shot In the Arm To Radial Access For PCI Procedures: The New Default?

Radial access is now the preferred approach for percutaneous coronary interventions, according to a consensus document from the European Society of Cardiology and other European organizations and published online in EuroIntervention. However, at least one prominent US interventional cardiologist thinks the “hard benefits” of radial access “are more controversial,” though he supports increased use of…

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Study Warns Against Dual Blockade of Renin-Angiotensin System In Heart Failure And Hypertension

The enormous success of ACE inhibitors in hypertension and heart failure spurred hope that adding a second drug to block the renin-angiotensin system would yield improved outcomes. Although definitive evidence supporting dual blockade of the renin-angiotensin system has never been found, more than 200,000 patients in the US currently receive  this therapy. Now a large…

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The Big Gamble of CETP Inhibitors

Merck has invested a substantial amount of money on the CETP inhibitor anacetrapib. Chemist and veteran pharma blogger Derek Lowe suspects that the company might as well have plunked the money down in a casino. In a provocative new post, Lowe wonders if big pharma, in its desperation, has abandoned rational research in favor of, essentially,…

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The Best Doctor Blog On The Internet

Let me say it right away: the best blog written by a doctor, at least that I’ve ever read, is by a provincial South African general surgeon who calls himself Bongi. He doesn’t write about complex medical policy, and he doesn’t worry too much about appropriate use criteria or whether a patient who needs anticoagulation…

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Renal Denervation: Delineating Its Uses, Misuses, and Possibilities

Over on CardioExchange, Murray Essler, the chief investigator of the  Symplicity HTN-2 trial, answers questions from John Ryan about renal denervation: Non-pharmacologic antihypertensive measures must remain the starting point for patients with hypertension, but will often not be enough. Renal denervation should be reserved for patients in whom behavior modification combined with adequate and skillful antihypertensive…

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Trials Of Niacin And Atrial Fibrillation Device Will Headline American College Of Cardiology Program

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Two big trials will highlight this year’s American College of Cardiology meeting in March in San Francisco. First is the PREVAIL trial testing Boston Scientific‘s long-anticipated Watchman left atrial appendage closure device for stroke prevention in patients with atrial fibrillation. Second is  the detailed presentation of the controversial failed HPS2-THRIVE trial of extended-release niacin and laropiprant. Read my…

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Becoming Your Own Doctor In The Brave New World Of Personalized Medicine

Lately there’s been a lot of talk about personalized medicine. There’s a bold idea going around that people should take control of their own healthcare and manage the flood of new data stemming from a whole bunch of new technologies, including, but hardly limited to, personal genomes, biomarkers, wireless sensors, and iPhone ECGs. … …boutique-style…

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Two Experts Help Sort Out The New Generation Of Anticoagulants

Don’t miss this very practical discussion about the new generation of anticoagulants and the short term loan costs to cover them over on CardioExchange. Here are a few excerpts. Christian Thomas Ruff: I believe the addition of the 3 currently approved novel anticoagulants (dabigatran, rivaroxaban, and apixaban) will eventually translate into a greater proportion of eligible patients…

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Amgen Trial Fails To Show Benefit Of Anemia Drug In Heart Failure Patients

  The bad news continues for Aranesp (darbepoetin alfa), Amgen’s long-acting erythropoietin-stimulating agent. The drug is intended to stimulate red cell blood production in patients with anemia. Amgen today announced the top line results of a large phase 3 heart failure trial of the drug and said  the trial had failed to meet its primary endpoint.   The RED-HF…

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FDA Releases St. Jude Warning Letter

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The FDA on Tuesday released the full text of a warning letter sent last week to St. Jude Medical. The company had previously disclosed the existence of the letter in an SEC filing but did not make clear the full extent of the FDA warning. The letter from the FDA is the latest in a series of…

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Large Meta-Analysis Finds No Harm Associated With Eggs

No food has had more ups and downs over the last century or so than the common egg. Following a long period in which eggs were ubiquitous and highly regarded, eggs fell from favor with the rise of concerns over cholesterol. Currently the American Heart Association recommends that people restrict dietary cholesterol to 300 mg…

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UK Politician Urges More Use Of Ticagrelor To Preserve AstraZeneca Jobs In UK

Use it or lose it. A UK politician is urging the National Health Service (NHS) to increase use of the antiplatelet drug ticagrelor (trade name Brilinta in the US, Brilique and Possia in the EU) in order to prevent the loss of British jobs. Like nearly all the major pharmaceutical companies, AstraZeneca has been fighting…

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Atrial Fibrillation Linked To Increased Risk For Sudden Cardiac Death

Although atrial fibrillation (AF) is well known to be associated with an increase in the risk of stroke and coronary heart disease, a similar association with sudden cardiac death (SCD) has been suspected but not demonstrated in the past. Now a new study examing data from two large population studies offers evidence that AF is…

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Merck Starts To Suspend Worldwide Availability Of Tredaptive

In the wake of the negative HPS2-THRIVE study announced last month, Merck said today that it was beginning to suspend the worldwide availability of Tredaptive, its combination of extended-release niacin and laropiprant. Click here to read the full story on Forbes….

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Acute Kidney Injury Associated With Dual Antihypertensive Therapy And NSAIDs

Adding a non-steroidal anti-inflammatory drug (NSAID) to dual antihypertensive therapy (a diuretic plus either an ACE inhibitor or an angiotensin receptor blocker) is associated with an increase in risk for kidney injury, according to a large new retrospective study published in BMJ. Click here to read the complete story on Forbes.  …

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Should Niacin Still Be Prescribed? William Boden Versus Harlan Krumholz

Harlan Krumholz

In the wake of HPS2-THRIVE many have argued that there is no longer any reason to prescribe niacin. William Boden, the lead investigator of AIM-HIGH and COURAGE, thinks there were enough flaws in the design of the niacin trials to justify the cautious use of niacin in certain circumstances. Says Boden: “There is evidence of…

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Observation Units For Heart Failure Could Reduce Unnecessary Hospitalizations

Two new papers published in the Journal of the American College of Cardiology propose that most heart failure (HF) patients who present to the emergency department (ED) don’t need to be hospitalized and can be safely managed in an observation unit. Currently, the vast majority of HF patients  who show up in the ED are hospitalized…. Click…

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Early Results: Antiplatelet Drug Cangrelor Appears Effective For PCI

The experimental antiplatelet drug cangrelor was superior to traditional clopidogrel in reducing ischemic events at 48 hours in PCI patients, according to the Medicines Company, which is developing the drug. The company today announced positive results from the phase 3 CHAMPION PHOENIX trial, a randomized, double-blind study comparing intravenous cangrelor to oral clopidogrel in PCI patients. The…

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Are Cardiologists Worried About Being Accused Of Unnecessary PCI?

In the last week two cases highlighted, yet again, the continuing shift in standards regarding PCI. In his interventional cardiology blog on CardioExchange, Rick Lange asks cardiologists: Could You Be Accused of Doing Unnecessary PCI? “Public confidence is eroding as the number of reports of physician suspensions and monetary penalties for unnecessary PCIs grow. Accordingly, patients…

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Two Retractions For Embattled Chief Investigator Of Kyoto Heart Study

The editor of Circulation Journal, the official journal of the Japanese Circulation Society (and not to be confused with the American Heart Association’s better known Circulation) has announced the retraction of two substudies from the Kyoto Heart Study. The papers, according to the editor, “contain a number of serious errors in data analysis.” Read my entire…

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Richard Lehman On ICDs In Clinical Practice And Serelaxin For HF

This week in CardioExchange Richard Lehman is not quite as funny as most weeks (perhaps he’s still recovering from New Years’ celebrations?), but he has some interesting and useful comments on a JAMA study comparing real world patients garcinia cambogia plant uses in registries to patients in clinical trials and an impressive Lancet study testing the role of…

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