Interventional Cardiologists Face Major Obstruction In Treatment Of Total Blockages

–Deep divisions over how CTO patients should be treated. In recent years ambitious interventional cardiologists have started to perform PCI on chronic total occlusions (CTOs), though these lesions have long been recognized as among the most difficult to successfully treat. Many other physicians, including some prominent interventional cardiologists, have expressed grave concerns about this expansion…

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Controversial Pharma CEO To Chair AHA Charity Ball

–The Wizard of Oz-themed ball seeks to raise $2 million on the yellow brick road. The American Heart Association’s annual Heart & Stroke Ball will be chaired by John Thero, the CEO of Amarin Corporation, the controversial pharmaceutical company. Amarin manufactures the prescription fish oil product Vascepa for which it is aggressively seeking an expanded indication…

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TV Ads Pushed Inappropriate Use of Testosterone

–Study: prescriptions spiked in direct response to blizzard of ‘Low T’ ads Television ads for testosterone products were highly successful, leading to dramatic increases in the number of men taking testosterone drugs, according to a new study published in the Journal of the American Medical Association. J. Bradley Layton (University of North Carolina, Chapel Hill)…

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Ebbinghaus Study May Help Refute Doctor Google

–No neurocognitive adverse effects linked to very low LDL levels Reaching very low LDL levels with a PCSK9 inhibitor was not associated with any increase in neurocognitive adverse events, according to the largest and most rigorous study to assess the topic to date. Small and preliminary studies have raised concerns over the possibility of the…

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FOURIER Shows New Cholesterol Drugs Work, But Are They Worth It?

–Doctors and patients now must wrestle with a modestly effective but expensive drug. As it turns out the PCSK9 inhibitor saga ends not with a bang but a whimper. The results of the highly anticipated FOURIER trial show that the drugs work, though not as powerfully as many had hoped and expected. The question now…

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Scott Gottlieb’s Sham Ideology Rejects Clinical Trials

Donald Trump has nominated Scott Gottlieb to be the next FDA Commissioner. To his credit, Gottlieb is not certifiably crazy like several of the other candidates who were reported to be under consideration for the job. But he is is a deeply conservative ideologue who is determined to reduce the government’s role in healthcare. On two occasions in…

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For Scott Gottlieb, Business Trumps Health

Donald Trump has nominated Scott Gottlieb to be the next FDA Commissioner. To his credit, Gottlieb is not certifiably crazy like several of the other candidates who were reported to be under consideration for the job. But he is is a deeply conservative ideologue who is determined to reduce the government’s role in healthcare. On two occasions in…

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Has Nutrition Science Been Poisoned?

–The inevitable weaknesses of observational and diet studies “Science is the great antidote to the poison of enthusiasm and superstition,” Adam Smith wrote more than 200 years ago. Unfortunately, it often seems as if the science of nutrition has itself been poisoned. Two recently published papers illustrate this problem. Nutrition and Mortality A good example of…

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Call For More Calcium Screening Gets Pushback

–But a zero calcium score can be useful to avoid statins, some argue Coronary artery calcium (CAC) scans should be widely used in routine clinical practice to improve the detection of coronary disease in people without known disease, according to the authors of a new review in JACC: Cardiovascular Imaging. But many experts urged caution,…

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Top Cardiologist Blasts Nutrition Guidelines

–Salim Yusuf says new evidence fails to support many major diet recommendations. One of the world’s top cardiologists says that many of the major nutrition guidelines have no good basis in science. “I’m not a nutrition scientist and that may be an advantage because every week in the newspaper we read something is good for…

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After Yet Another Failure, Stem Cell Leaders Double Down

–Could repeated doses of stem cells turn the tide of negative trials? Despite an unrelieved history of negative trials, stem cell leaders continue to defend their field. In response to the failure of yet another cardiac stem clinical trial, Roberto Bolli, a prominent leader in the field, argued that it’s time for a “paradigm shift” in…

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International Experts Call Salt Guidelines Far Too Restrictive

A broad group of international experts are recommending a far more modest and less draconian approach to sodium restriction than current U.S. and international guidelines. In a new paper, published online in the European Heart Journal, they also focused on the broad gaps of knowledge in the field and drew attention to the paucity of…

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Enormous Rivaroxaban Study Stopped Early For ‘Overwhelming Efficacy’

(Updated) –Oral anticoagulant reduced CV events in patients with coronary and peripheral disease. The very large COMPASS study has been stopped early for “overwhelming efficacy,” according to a press release issued by Bayer AG and Janssen, manufacturers of rivaroxaban (Xarelto). The phase 3 trial randomized 27,402 patients with coronary artery disease (CAD) and peripheral artery…

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New Questions Raised About SPRINT

More questions are being raised about SPRINT, the enormous NIH-funded blood pressure lowering trial. Two recent developments will likely add more obstacles to the already difficult task of applying the results of the trial in the real world. Even before the full results of the trial were first made public the NIH and the SPRINT…

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27,000 Patient PCSK9 Inhibitor Trial Meets Main Endpoints

(Updated) –Cardiovascular outcomes finally available for PCSK9 inhibitors. Amgen announced on Thursday afternoon that the FOURIER trial had met both its primary composite endpoint (cardiovascular death, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or coronary revascularization) and the even more rigorous key secondary composite endpoint (cardiovascular death, non-fatal MI or non-fatal stroke). The company…

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In Which I Go Under The Knife And Learn About Medicine In The Real World

I’m not a doctor but I thought I knew something about anticoagulation. Over the course of a career covering cardiology I’ve written countless stories about heparin, warfarin, the low molecular weight heparins, and the new oral anticoagulants. So when I had bilateral total knee replacement a few weeks ago I thought I knew what to…

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Long Unsuccessful Heart Failure Drug Once Again At Center Of Controversy

–The long, strange 30-year journey of BiDil. It’s been buried in the avalanche of related news but there’s an interesting and somewhat bizarre cardiology angle to the debate over Trump’s nomination of Tom Price to be the next HHS Secretary. ProPublica reported on Friday that last summer Price went to bat for the makers of…

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Screen-And-Treat to Prevent Diabetes Doomed to Fail

Screening must be supplemented by broader public health approaches. Screen and treat strategies to prevent type 2 diabetes are doomed to failure, according to a large new systematic review and meta-analysis published in The BMJ.  Instead, the authors said and outside experts agreed, any effort to combat the already enormous and still growing problem of type 2…

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2016: Great Year Or Greatest Year Ever?

Editor’s note: Once again Larry was too depressed to write the 2016 yearly review. (Actually, he’s hiding under his bed.) Veteran healthcare journalist and eternal optimist Candide Corn has again kindly agreed to take over the task this year. Candide’s motto is “all is for the best in the best of all possible worlds.” What a great year!…

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More Shots Fired in ‘Sugar War’

–Industry-sponsored study questions current guidelines on dietary sugar. Dietary guidelines relating to sugar— all of which recommend significant reductions in sugar intake— are based on weak evidence and are not trustworthy, according to a systematic review published in Annals of Internal Medicine. But an accompanying editorial points out that the systematic review is itself not…

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Novartis Withdraws Support For Controversial Entresto Contest

(Updated) Novartis will no longer sponsor a contest designed to support the publication of peer review articles about Entresto, the company’s important new heart failure drug. The contest is taking place on Cureus, an open access journal, publishing platform, and vehicle for industry-sponsored content. The contest offered $10,000 in rewards for articles supporting a recent…

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Novartis Contest Rewards Positive Peer Review Articles About Entresto

(See the bottom of the story for updates. Since the original publication of the story the cardiologists on the “peer review panel” have resigned and Novartis has withdrawn its support for the contest.) Despite the fact that it had one of the biggest clinical trial successes in recent years, the Novartis heart failure drug Entresto has…

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Seeking Profit and Investors, Rogue Lab Moves Into Small Hospitals

A controversial new laboratory company specializing in “advanced cardiovascular risk testing” is developing an innovative, highly profitable– and legally dubious– new business model. Details of the scheme are spelled out in a “Management Presentation” slide presentation sent to me by a confidential source. The slide presentation, according to my source, is  being shown by executives at True Health…

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The GiveAway Act

The 21st Century Cures Act should be called the 21st Century GiveAway Act. The Act may not even deliver on its main attraction– the funding of new research– but will instantly definitely give a regulatory boost to a host of special interests, including drug and device makers. As Michael Hiltzik writes in the LA Times,…

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Telling People What They Want To Hear: Alt-Med And Donald Trump

Donald Trump won* the election because he told people what they wanted to hear. Alternative medicine is growing in popularity because it tells people what they want to hear. Of course, there’s a big difference between telling people what they want to hear and actually delivering on those promises. He can say it as often as he…

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