New Anticoagulant May Cut VTE In Medically Ill

–Generally positive results for Portola’s betrixaban, despite missed key endpoint Betrixaban may yet become the first new oral anticoagulant to gain approval for extended venous thromboembolism (VTE) prophylaxis in the important and underserved group of medically-ill patients, even though its pivotal trial was damaged by a self-inflicted statistical wound. There were consistent differences in favor of…

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The American Heart Association’s Strong Stance Against Science

Once again the American Heart Association has taken a strong stance against science. Of course, that’s not how the AHA phrases it. In its own words the AHA says it “strongly refutes the findings” of a “flawed study” which “you shouldn’t use… to inform yourself about how you’re going to eat.” But in fact the…

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Flu Vaccine May Benefit Heart Failure Patients

–Studies find fewer hospitalizations and less dementia after vaccination Two new observational studies offer new evidence that heart failure patients may benefit from the flu vaccine. The studies were presented in Florence, Italy, at the Heart Failure 2016 and the 3rd World Congress on Acute Heart Failure. In the first study Kazem Rahimi (University of…

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Study Suggests Salt Restriction Only Beneficial In People With Hypertension

–More questions raised about broad efforts to restrict salt; AHA condemns study A large new analysis offers more evidence that broad salt restriction doesn’t benefit most people and may even harm some people. The study did find that salt restriction may be beneficial to the minority of people with high blood pressure who also consume…

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ASGR1 Gene Tied to Heart Health

(Updated) –May have stronger impact than PCSK9 variants on disease risk A large new study from Iceland has identified variants in a gene that appear to have powerful cardioprotective effects, perhaps an first early step toward a novel therapy for heart disease prevention and treatment. The gene, ASGR1, was identified by the well known genetic…

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You Say Potato, I Say Worthless Epidemiology

(Updated) –Observational study links potatoes to high blood pressure Depending on your position in the dietary wars, potatoes are now either a newly-confirmed nutritional villain or an innocent victim of overzealous and misapplied epidemiology. A new study, published in The BMJ, is the first to establish a direct link between potato consumption and blood pressure….

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Noted Skeptic Calls For More Randomized Nutrition Trials

Defying conventional wisdom Ioannidis says we need more negative trials to clear away all our misconceptions about nutrition Defying conventional wisdom Ioannidis says we need more negative trials to clear away all our misconceptions about nutritionDefying conventional wisdom Ioannidis says we need more negative trials to clear away all our misconceptions about nutritionDefying conventional wisdom…

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Pioneering Lipoprotein Researcher Richard Havel Dead

–Nobel laureates Brown and Goldstein say when they were starting out Havel taught them 90% of what they knew Richard Havel, a scientist who helped create the entire entire modern field of research in lipoprotein metabolism, died last month. In response to the news scientists in the field have poured extravagant praise on the man…

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Experts Foresee Major Role For Generic Crestor

— Finally there’s a challenger to the long reign of Lipitor The FDA approval on Friday of the first generic version of Crestor (rosuvastatin calcium) marks the end of an era and the beginning of a major shift in cardiovascular medicine. Over time, as the price of the drug drops with generic competition, it seems…

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No Evidence To Support Screening Young Athletes

–More questions raised about key study suggesting ECG screening can save lives There is no good evidence to support screening young athletes to prevent sudden cardiac arrest, concludes a new analysis published in the BMJ. The analysis also raises new and troubling questions about a key Italian study that has been the main study used…

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New Company Bets Hundreds Of Millions Of Dollars On A Genetic Strategy To Resurrect A CETP Inhibitor

–But skeptics think CETP inhibitors are a dead end A new company is betting hundreds of millions of dollars that it can snatch victory from the jaws of defeat. Over the last decade no class of drugs has undergone a reversal of fortune as dramatic as the cholesterol ester transfer protein (CETP) inhibitors, the once…

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FDA Ends Niacin and Fenofibric Acid Combinations With Statins

–“In the absence of benefits, there remain only harms.” The FDA is putting an end to the combined use of statins with two once-popular lipid drugs, niacin and fenofibric acid. On Monday the FDA will announce in the Federal Register that it is withdrawing its approval for indications for coadministration of these drugs with statins…

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Orexigen Terminates Another Cardiovascular Outcomes Trial

Updated–In a further sign of the chaos surrounding its weight loss drug Contrave, Orexigen has again terminated an FDA-mandated cardiovascular outcomes trial with the drug. Following a year of controversy (see below) Orexigen last month assumed sole control of Contrave (the combination of naltrexone and bupropion) from its former partner, Takeda. The company has now terminated enrollment…

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New Analysis Of Old Study Delivers Another Blow To Traditional Diet Advice

–Replacing saturated fat with vegetable oils lowered cholesterol but didn’t improve outcomes A new analysis from a long-forgotten study dating to the 1960s adds to mounting doubts over a cornerstone of dietary advice for more than 50 years: the demonization of saturated fat in the diet. Although in recent years the nutritional establishment has retreated…

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USPSTF Updates Aspirin for Primary Prevention Recommendation

–But many experts think the evidence base is slim at best. The U.S. Preventive Services Task Force (USPSTF) finalized the update to its guidelines regarding the use of aspirin for the primary prevention of cardiovascular disease and colorectal cancer. The USPSTF is now recommending that people between the ages of 50 and 59 who are at increased…

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FDA Expands Metformin Label

— The diabetes drug can now be used in more patients with reduced kidney function The FDA on Friday greatly expanded the indication for the type 2 diabetes drug metformin. Until now use of metformin in patients with reduced kidney function had not been recommended. The new label states that metformin “can be used safely…

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FDA Adds Heart Failure Warning To Saxagliptin and Alogliptin Labels

The FDA said on Tuesday that it was adding new warning to the labels of diabetes drugs containing the  saxagliptin and alogliptin. The FDA said the drugs “may increase the risk of heart failure, particularly in patients who already have heart or kidney disease.” The announcement comes two years after an FDA panel recommended that…

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Not So Rare, FH Is Truly Risky Lipid Disorder

–Not all elevated is LDL is equally dangerous CHICAGO — Familial hypercholesterolemia (FH), a condition that has long been overshadowed by more common cardiovascular diagnoses, has now found the spotlight in the big tent as a hot and even controversial topic. The new interest is driven by important advances in understanding the genetics of the…

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ACCELERATE Puts the Brake on CETP Inhibition

–No benefit with evacetrapib despite increase in HDL and decrease in LDL The fat lady hasn’t sung, the referee hasn’t counted up to 10, but it’s sure not looking good for the once highly promising class of drugs known as the CETP inhibitors. Bang the Drum Slowly, and Play the Fife Lowly Following the crash…

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How Does HOPE-3 Change Thinking About Primary Prevention?

–The study lends strong support for statins but delivers a mixed message for antihypertensives. The widely reported results of HOPE-3 may bolster the case for primary prevention with statins and blood pressure drugs. But the trial also makes clear that the benefits, though real, are also modest, and may not be evenly distributed between statins…

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How Should SPRINT Influence High Blood Pressure In Children And Adolescents?

–Editorialists say pediatric hypertension in children is ready for a ‘paradigm shift’ Last year’s influential— and highly controversial— SPRINT trial should be used to better inform and influence our understanding and management of hypertension in children, write two influential physicians who have played a key role in the cardiovascular guidelines for children and adolescents. They…

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Court Decision In Patent Battle Threatens PCSK9 Drug

—-One analyst thinks the decision might take Praluent off the market. A jury’s decision last week in a patent case might possibly lead to the removal of one of the new PCSK9 inhibitor cholesterol lowering drugs from the US market, according to a Wall Street analyst who has been closely following the case. Amgen, which…

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New Evidence Fitness Trackers Don’t Actually Track Fitness

–Little agreement found when 12 wearable devices were compared to gold standards Fitness trackers have not been found to help people improve the way they exercise, an article in the Sunday New York Times noted in a summary of the case against wearable fitness trackers, pointing up technical and even philosophical limitations of the devices….

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A Novel Way To Think About Primary Prevention, Death, And Statins

A new paper offers a novel way to think about disease prevention. The way we think– and talk– about disease prevention now is complicated and confusing. A key ingredient in the decision to take statins for the prevention of cardiovascular disease, for instance, is the estimation of 10-year cardiovascular risk. This single number, which represents…

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Confusion In The Age Of Genetic Information

(Updated)– We may live in the age of information but we really have no idea how to use all that information, especially when it comes to health. One new study, published in the BMJ, is a good illustration of this principle. “There are high expectations that advances in genetics will usher in a new era…

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