Comments for CardioBrief

Comment on Study Explores Role of Periprocedural Dabigatran in AF Ablation by Wilbur Larch MD FACC

Wilbur Larch MD FACC — Fri, 03 Feb 2012 00:45:57 +0000

The obvious question, why start with an unknown, not superior and perhaps inferior drug, dabigatran? One then wont have the dilema of switching between the proven and the promoted.

Wilbur Larch MD, FACC

Comment on FAME II: Additional Thoughts About FFR in the Real World by steve

steve — Wed, 01 Feb 2012 14:13:04 +0000

if more doctors took the time to ask the right questions and intergrate the patients responses about the pattern of the chest pain they have and utilize a duke treadmill score properly, many fewer caths would happen and far fewer mild to moderate lesions would ever be seen at angiography
one big reason that these intermediate lesions get to the ffr scenario is that the threshold for cath is so low ,

Comment on Heart Rhythm Society Advising DOJ in Investigation of ICD Implants by IrateVictim

IrateVictim — Mon, 30 Jan 2012 09:47:05 +0000

As nearly decade long ICD patient with a history of pure hell, it is about time the rotten underbelly of this money pit industry of bad design and lousy manufacturing received attention. What a joy to have a defective lead that may kill if left in or kill taking it out. Defective software that allows uncontrolled shocks, bad reed switches that don’t reliably disable the device, garbage algorithms that shock for all the wrong reasons even when the device is not doing that on its own. All stats point to this thing having reduced my all ready threatened life span by 100s of percent. In this witches brew, the Supreme court has stripped citizens the right to petition the courts of compensation (a fundamental function of an legal system) by claiming deference to an obviously less than capable FDA approval process. Guess what – that leaves medical malpractice as the main way to achieve justice for damages and wrongful death. Still want to remove regulations? Oh yes, and stop implanting these killer devices “prophetically” without good stats to justify it.

Comment on Huge Study Finds Risk Factors Do In Fact Predict Risk by OldMajor

OldMajor — Fri, 27 Jan 2012 15:58:13 +0000

the title of the article is hilarious. I hope you didn’t spend too much money on this huge study.

Comment on Rita Redberg and Roger Blumenthal Clash Over Statins for Primary Prevention in the Wall Street Journal by Larry Husten

Larry Husten — Thu, 26 Jan 2012 00:53:17 +0000

Roger, I agree with you that high risk and even some intermediate risk people should take statins for primary prevention. And I think that Rita should take a more nuanced position. But she also makes some powerful points, and the evidence base in favor of primary prevention is much less persuasive than it should be. I think the major weakness in your statement is the reliance on relative risk. The NNTs need to be reasonably low to justify statins for primary prevention.

In addition: I’m not sure that cardiologists are quite as unanimous about this as you think. Certainly the cholesterol mafia and the prevention mafia –but I mean mafia in the best possible sense! — are largely in agreement here, but I’ve spoken with many cardiologists and other experts who are fairly skeptical about statins for primary prevention.

Finally, I’ll note that 70% of Wall Street Journal readers voted against using statins in healthy people. I won’t pretend that this is necessarily a meaningful result– but it’s at least as meaningful as a participant in the debate also serving as the referee!

Comment on Rita Redberg and Roger Blumenthal Clash Over Statins for Primary Prevention in the Wall Street Journal by Roger Blumenthal

Roger Blumenthal — Thu, 26 Jan 2012 00:25:41 +0000

Larry, if you think that this debate was a draw, you must have call the Holmes-Ali fight a draw. “C’Mon Man!” as Keyshawn Johnson and Chris Berman would say on Monday Night Football. Dr. Redberg does not believe that statins yield a net a benefit in the secondary prevention setting either. Simply incredible and anathema to any reasonable Cardiologist. She doesn’t think that the high risk primary prevention subjects in West of Scotland are reasonable to look at and she apparently thinks that Paul Ridker, Rory Collins, and Bernard Gersh did funny things with the JUPITER trial results. Collins and Gersh were two of the senior persons on the DSMB that recommended early termination of the trial. Both West of Scotland and JUPITER showed decreases in total mortality – the only thing that she cares about. Every medical guideline in the world recommends that certain high risk patients (as determined by the presence of risk factors) be considered for statin therapy. Common sense, Larry. I don’t think that you realize how extreme and ridiculous the editor of the Archives of internal Medicine is being. C’Mon Man and Woman. Happy New Year to all.

Comment on Heart Disease and Stroke in 2011: Mortality Continues to Decline, but Overall Burden Remains High by Heart disease tattoos

Heart disease tattoos — Tue, 24 Jan 2012 22:08:28 +0000

Folks being affected by type 2 diabetes are usually continually staying instructed that will fats will be the reason behind heart problems. Despite well-liked perception, fatty foods usually are not the actual ...Heart Disease

Comment on Rita Redberg and Roger Blumenthal Clash Over Statins for Primary Prevention in the Wall Street Journal by Larry Husten

Larry Husten — Tue, 24 Jan 2012 14:40:49 +0000

Rita Redberg sent the following response to Sackner-Bernstein’s comment:

Dr Sackner-Bernstein is absolutely correct that one must look at benefits and risks, and that is why I don’t recommend statins for healthy people. Numerous scientific studies show no benefit for statins in primary prevention on mortality even in high-risk populations (Ray K et al Archives Internal Medicine June 28, 2010 and Cochrane report 2011) . In addition, the actual incidence of adverse events is closer to 20% in real world use. There is an increased risk of diabetes with statins, seen in randomized and observational trial data. There is overwhelming epidemiologic and observational data from numerous studies on the benefits of healthy lifestyle, including less depression and arthritis, decreased memory loss, improved quality of life and longer life.

Comment on St Jude Medical Statement on the Riata ICD Lead Summit by Guest Post: Report from the Riata ICD Lead Summit « CardioBrief

Guest Post: Report from the Riata ICD Lead Summit « CardioBrief — Tue, 24 Jan 2012 14:18:37 +0000

[...] Posts Guest Post: Report from the Riata ICD Lead SummitSt Jude Medical Statement on the Riata ICD Lead Summit Rita Redberg and Roger Blumenthal Clash Over Statins for Primary Prevention in the Wall Street [...]

Comment on Rita Redberg and Roger Blumenthal Clash Over Statins for Primary Prevention in the Wall Street Journal by Roger Blumenthal

Roger Blumenthal — Tue, 24 Jan 2012 01:26:04 +0000

I agree with Dr. Weiss, who is a brilliant Hopkins trainee. It is inconceivable that a responsible clinician would not treat certain high risk individuals with a statin if their Framingham risk estimate for an MI was > 20% over the next decade. If that is too low, then how about a 50% risk of an MI over 10 years. One can used hsCRP to identify a subgroup that will derive greater benefit. Of course, Mike Blaha’s Lancet paper from MESA showed that moderate coronary calcium identifies a group in whom most of the CV events over the next 7 years occur. By the way, statin therapy using most generic agents is ~$5 per month.