New Study Finds Hydrochlorothiazide Inferior To All Other BP Drugs

At the doses most often used, hydrochlorothiazide (HCTZ), the most widely used antihypertensive agent in the world, is “consistently inferior” to all other drugs, according to a new meta-analysis published in JACC. Franz Messerli and colleagues performed a systematic review of studies that compared HCTZ to other drugs using 24-hour ambulatory blood pressure monitoring and found that…

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AHA Estimates Cost of Heart Disease Will Triple by 2030

The American Heart Association (AHA) is projecting that the cost to treat heart disease in the US will triple by 2030, from $273 billion today to $818 billion. The AHA policy statement is published in Circulation. The AHA estimates that the incidence of stroke and heart failure will each  grow by about 25% by 2030….

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Heart Rhythm Society Advising DOJ in Investigation of ICD Implants

The Heart Rhythm Society has informed its members that it is “aware of an ongoing US Department of Justice (DOJ) civil investigation of Implantable Cardioverter Defibrillator (ICD) implants” and that it has “agreed to assist in an advisory role to lend expertise concerning proper guidelines for clinical decision making.” HRS explained that its role involved “reviewing…

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Guest Post: Prevention Magazine Pushes High-Tech Non-Evidence Based Heart Screening More Than Basic Prevention

Editor’s Note: The following post by Gary Schwitzer is reprinted with permission from his blog at HealthNewsReview.Org. HealthNewsReview has received many praises and awards, including Medgadget’s Best Medical Blog award for 2009, which wrote that “Gary has become renowned for his critique of media’s coverage of health care topics. And that’s what his blog is mostly…

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Braunwald: Vorapaxar Problem Based on Intracranial Bleeding in Patients with History of Stroke

Updated with additional information from TRACER chair Bob Harrington. A key detail has now emerged about the problems encountered with vorapaxar, Merck’s thrombin receptor antagonist that suffered a large setback last week. TIMI investigators in the TRA-2P TIMI 50 trial have been informed by Eugene Braunwald that the reason vorapaxar would be discontinued in patients…

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Guest Post: What PROSPECT Doesn’t Tell Us

Editor’s Note: The following guest post, about the recent publication of PROSPECT in the New England Journal of Medicine, is by Richard Lange and L. David Hillis. This post is reprinted with permission from CardioExchange, where Lange and Hillis write a blog about interventional cardiology. Among their many other titles, Lange is the Executive Vice Chairman of Medicine and…

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Review Raises Questions About Statins for Primary Prevention

A Cochrane Review raises troubling questions about the evidence base supporting the use of statins for primary prevention. The Cochrane reviewers analyzed 14 randomized trials including 34,272 participants and found that statins were associated with significant reductions in overall mortality, fatal and nonfatal CV endpoints, and revascularization procedures. The reviewers found no evidence of harm….

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Study Supports a New Enhanced Form of CPR

A study published in the Lancet lends support to a new form of CPR that uses a combination of two devices to provide three times more blood flow to the heart and brain than standard CPR. The first device is a small suction cup on the patient’s chest used to actively lift the chest and perform…

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FDA Warns About Severe Liver Injury Associated with Multaq (Dronedarone)

The FDA has released a safety communication (reprinted below) about severe liver injury associated with Multaq (dronedarone). The  communication confirms and provides additional details about the 2 liver transplant cases that were first reported here on CardioBrief. (Click here for the response from Sanofi-Aventis to the CardioBrief report.) The FDA said that information about the risk…

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Sanofi-Aventis Provides More Details About Multaq Letter

A Sanofi-Aventis spokesperson has confirmed CardioBrief’s story yesterday and has provided further details and clarifications about the Dear Doctor letter. Here is the Sanofi statement:…

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Sanofi-Aventis To Inform Doctors About Liver Transplants in 2 Patients Taking Multaq (Dronedarone)

Sanofi-Aventis is about to send a “Dear Doctor” letter to physicians informing them of two cases of fulminant hepatic failure/necrosis resulting in liver transplanation in two patients taking Multaq (dronedarone), CardioBrief has learned. The two patients were women in their 70’s with no other apparent causes of liver injury or known elevations of liver function…

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Merck’s Thrombin Receptor Antagonist Suffers Major Setback

Merck’s thrombin receptor antagonist, vorapaxar, has suffered a major setback in its clinical trial program. In one trial, TRACER, the study drug is being discontinued and the trial will be closed out. The second trial, TRA-2P TIMI 50, is being curtailed but not stopped. The actions were based on recommendations from the combined Data and…

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Why Do Military Doctors Have Stricter Rules Than Other Doctors?

Jason Layne Davis, a US Army cardiologist, has pleaded guilty to accepting nearly $5,000 from Guidant. Last year Guidant paid $600,000 to settle claims that it had illegally paid Davis so that he would use the company’s devices at Madigan Army Hospital. Accepting a payment from an illegal source is a misdemeanor punishable by up…

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Researchers Shed New Light on HDL Cholesterol

Two papers published in the New England Journal of Medicine shed new light on the important but often mysterious role of HDL cholesterol in cardiovascular disease. In the first paper, researchers at the University of Pennsylvania studied 1,000 healthy volunteers and patients with coronary artery disease and observed a strong inverse relationship between cholesterol efflux from macrophages (a…

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Large Meta-Analysis Explores Cardiovascular Safety of NSAIDs

A large network meta-analysis has found “little evidence” to suggest that any of the commonly used NSAIDs or COX 2 inhibitors are safe in terms of cardiovascular risk. In a paper published in BMJ, Sven Trelle and colleagues analyzed data from 31 trials in which patients receiving an NSAID were compared to another NSAID or…

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Candesartan Beats Losartan in Swedish HF Registry

The Swedish Heart Failure Registry followed more than 5,000 patients treated with the angiotensin II receptor blockers (ARBs) candsartan or losartan between 2000 and 2009. According to a paper published in JAMA, survival at one year was 90% in the candesartan group compared to 83% in the losartan group. Five-year survival was 61% and 44%. After…

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World’s First Drug Eluting Bioresorbable Stent Gains CE Mark Approval

Abbott announced today that it had received CE Mark approval for Absorb, its bioresorbable vascular scaffold (BVS) device.  The device props a narrowed coronary artery open but then dissolves within 2 years, leaving the patient without a permanent implant. One hope for the device is that it will allow stent patients to safely discontinue dual antiplatelet…

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ACC and HRS Downplay Data From Their Own Registry

[Updated]– A study in JAMA earlier this week received a lot of attention when it reported that 22.5% of ICD implantations in the US did not have a firm basis in evidence. The study was derived from a very large dataset taken from the NCDR ICD registry, which was established by the American College of…

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Bevacizumab in Breast Cancer Linked to Increase in Heart Failure Risk

A meta-analysis in the Journal of Clinical Oncology suggests that bevacizumab (Avastin) significantly raises the risk for heart failure when given to patients with breast cancer. Toni Choueiri and colleagues analyzed data from 3,784 patients and found a significant increase in the incidence of heart failure among those taking bevacizumab compared with those taking placebo…

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Study Finds Mixed Long-Term Results for AF Catheter Ablation

Long-term results after catheter ablation for AF are decidedly mixed, according to the longest study yet to follow patients after the procedure. In a report in the Journal of the American College of Cardiology, Rukshen Weerasooriya and colleagues followed 100 patients treated at a French hospital for 5 years. After a single procedure, the rates of arrhythmia-free survival…

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J&J Submits Application for Rivaroxaban for Stroke Prevention in AF

Johnson & Johnson announced today that it had submitted a new drug application to the FDA for rivaroxaban for the prevention of stroke and systemic embolism in AF patients. The submission is largely based on the recently reported ROCKET AF trial. J&J also said the company had submitted its response to the FDA’s request for…

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JAMA Study Finds 22.5% of ICDs Implanted Without Evidence Base

A paper in JAMA from a very large registry reports that a substantial proportion of ICD implantations are not supported by a firm evidence base. Sana Al-Khatib and colleagues examined data from the National Cardiovascular Data Registry (NCDR) including 117,707 patients who received ICDs between January 1, 2006 and June 30, 2009 and found that…

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PLATO CABG Substudy Raises Hope and Questions

The much-anticipated CABG substudy from the PLATO (Platelet Inhibition and Patient Outcomes) trialcomparing ticagrelor to clopidogrel in ACS patients has been published online in JACC. About 10% of the 18,624 patients enrolled in  PLATO underwent CABG. The substudy reports on the 1,261 who received the study drug within 7 days prior to their surgery. The study protocol…

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Guest Post: Medicare: The MasterCard That Keeps On Giving

Editor’s Note: This following guest post by Dr. Shanti Bansai is reprinted with permission from CardioExchange. Medicare: The MasterCard That Keeps On Giving by Shanti Bansal, MD In the cardiac catheterization lab one Tuesday morning, I encountered a situation that made me reflect on a bit of 18th-century British history. At that time, the British government was overburdened…

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Abbott and AstraZeneca End Efforts to Develop Certriad (Rosuvastatin/Fenofibric Acid)

Abbott and AstraZeneca announced today that they were discontinuing their collaboration for the development of Certriad, the combination of rosuvastatin and fenofibric acid. The companies received a Complete Response Letter from the FDA earlier this year, and said “the resulting regulatory delay and the commercial attractiveness of the product in the U.S. market.”…

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