Study Closes the Book on PFO Closure

Percutaneous PFO closure was no more effective than standard therapy in the prevention of recurrent stroke, according to results of the CLOSURE I trial presented in Chicago at the American Heart Association….

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Omega-3 Fails to Show Benefits in Atrial Fibrillation

In sharp contrast to earlier studies suggesting a positive effect, a large study of high dose prescription omega-3 fatty acids found no evidence of benefit in treating atrial fibrillation. The trial, called the Efficacy and Safety of Prescription Omega-3 Acid Ethyl Esters (P-OM3) for the Prevention of Recurrent Symptomatic Atrial Fibrillation, included 663 patients with AF…

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Drinking in ASCEND: Is the Cup Half Empty or Half Full?

Generally I’m a half-empty kind of guy. Even if the cup is maybe 60% full I still see it as half empty. But I must say that today I’m actually quite encouraged by ASCEND. Others disagree. NPR health blogger Scott Hensley tweeted this about ASCEND today: As usual, info is yrs too late. And of…

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New LVAD Shows Promise as Bridge-to-Transplant

ADVANCE (Evaluation of the HeartWare HVAD Left Ventricular Assist Device System for the Treatment of Advanced Heart Failure) evaluated the clinical efficacy of a novel small centrifugal flow pump as a bridge-to-transplant. In the trial, 140 patients who received the device were compared to a contemporaneous conrol group of 499 similar patients who had received a commercially…

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Lipstick on a Pig?

No, it’s the Exhibit Hall. Changing the name doesn’t change what it is….

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AHA: ASCEND Trial Finally Resolves the Nesiritide Controversy

In the end everyone was wrong. After many years of controversy, we finally know the truth about nesiritide, and all the experts were wrong. Steve Nissen and Jonathan Sackner-Bernstein, who first raised concerns about the safety of nesiritide in decompensated heart failure, turned out to be wrong. But the defenders of nesiritide, including its manufacturer,…

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Emphatic Support for Eplerenone in NYHA class II HF

Aldosterone antagonists have proven beneficial in heart failure patients with moderate to severe symptoms and in MI patients with LV dysfunction and heart failure. Now the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure) has extended these benefits to patients with systolic heart failure patients and mild symptoms. EMPHASIS HF randomized…

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ICD-CRT Found Beneficial in RAFT

RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure Trial) randomized 1798 patients with NYHA class II or III heart failure, LVEF < 30%, and a wide QRS complex to either an ICD alone or an ICD-CRT. After a mean followup of 40 months, the rate of death or heart failure hospitalization was reduced from 40.3% in the ICD…

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AHA: Study Explores Role of Familial AF in Risk of Developing New AF

Although it is well known that there is a heritable component to atrial fibrillation (AF), the precise clinical significance of familial AF has been unclear. Steven Lubitz and colleagues analyzed data from the Framingham Heart Study to assess the incremental predictive value of familial AF in a risk model for new-onset AF….

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Hypertension and Global Warming Are Not the Same Thing

Headrests on the AHA buses: Bad Pun. Bad Analogy. Bad Taste.   Update: I’ve now taken a second bus trip. The good news is that global warning hasn’t spread to every bus in Chicago.  …

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In Dialysis, Life-Saving Care at Great Risk and Cost

(The following article is reprinted with permission from ProPublica.) by Robin Fields, ProPublica In 1972, after a month of deliberation, Congress launched the nation’s most ambitious experiment in universal health care: a change to the Social Security Act that granted comprehensive coverage under Medicare to virtually anyone diagnosed with kidney failure, regardless of age or income….

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Statement from AHA, ACC, and ACG Reaffirms Use of PPIs with Antiplatelet Therapy

Despite recent warnings by the FDA, an Expert Consensus Document released jointly by the AHA, the ACC, and the American College of Gastroenterology states that it is acceptable to use proton pump inhibitors (PPIs) with thienopyridines like clopidogrel in patients at high risk for upper GI bleeds. The statement does not recommend routine use of PPIs…

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New Safety Questions Raised About Multaq

The Institute for Safe Medication Practices has identified a potential drug safety signal for dronedarone (Multaq, Sanofi-Aventis). The potential problem is outlined in QuarterWatch: 2010 Quarter 1, a publication of the ISMP that monitors FDA MedWatch reports, and was written about on the Pharmalot blog. The report concludes: Evidence is accumulating that the risks of the…

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RE-LY Substudy Finds Dabigatran Effective in Secondary Stroke Prevention

A substudy of the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial demonstrates that dabigatran is as effective in AF patients for secondary stroke prevention as it is for overall stroke prevention. In their paper in the Lancet Neurology, Hans-Christoph Diener and the RE-LY study group report the results of the trial in the predefined subset of…

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Guest Post: New Lipitor Ads Dis Exercise & Healthy Diet. Are You Kidding Me?

Editor’s Note: The following guest post by John Mack is reprinted with permission from Pharma Marketing Blog. by John Mack In its most recent TV and print ads for Lipitor, Pfizer highlights a middle-aged man working out in a gym. In bold text and voice overs, the ad asks “Are You Kidding Yourself?” The print…

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Meta-Analysis Turns Up Mixed Results for Vitamin E on Stroke Subtypes

In a meta-analysis appearing in BMJ, vitamin E supplements had no effect on the overall rate of stroke but were associated with a small reduction in the risk of ischemic stroke and a slightly larger increase in the risk of hemorrhagic stroke. Markus Schürks and colleagues analyzed data from 9 trials including 118,765 subjects. Although the…

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Cardiology and the Qur’an: Controversy Erupts Over Paper Published in the International Journal of Cardiology

A paper published in the International Journal of Cardiology has provoked criticism for mixing religion and science. The paper, “The heart and cardiovascular system in the Qur-an and Hadeeth,” asserts that modern scientific understanding of the heart  can be found in key Islamic texts. In his popular blog Pharyngula PZ Myers, biologist and debunker, writes:…

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Is Dabigatran (Pradaxa) More Cost-Effective Than Warfarin in AF?

Dabigatran (Pradaxa), newly approved by the FDA to prevent stroke in patients with atrial fibrillation (AF), might turn out to be a cost-effective alternative to warfarin, according to an Annals of Internal Medicine study. Using data from the RE-LY trial, James Freeman and colleagues modeled the quality-adjusted survival and cost-effectiveness of dabigatran compared with high- or low-dose warfarin…

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Pradaxa (dabigatran) Goes On Sale Wednesday, November 3

Dabigatran (Pradaxa, Boehringer Ingelheim) will go on sale in drugstores on Wednesday, November 3, according to a press release issued by Boehringer Ingelheim. The press release confirms the previously reported wholesale acquisition price of $6.75 a day for two capsules. Knowledgeable experts estimate that therefore the retail price of Pradaxa will likely be $7.90 per day, or…

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Bayer says rivaroxaban meets primary endpoint in ROCKET AF

Rivaroxaban (Xarelto) was as effective as warfarin in patients with AF in the ROCKET AF study, according to an announcement released by Bayer on Sunday ahead of the scheduled presentation of the trial at the AHA on November 15….

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Paper on Cardiopulmonary Bypass Priming Retracted; 200 Additional Papers Under Question

The journal Anesthesia & Analgesia, which calls itself “The Gold Standard in Anesthesiology,” has retracted a paper on cardiopulmonary bypass priming and has raised questions about 200 additional published papers by the author, Joachim Boldt, the head of the Department of Anesthesiology and Intensive Care Medicine, Klinikum Ludwigshafen, Bremserstr, Germany. A detailed report about the retraction was…

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Meta-Analysis Examines Risk Associated with CYP2C19 Genotypes

There has been widespread debate and disagreement over the clinical significance of people with reduced function CYP2C19 genotypes who take clopidogrel. In an effort to shed light on the topic, Jessica Mega and colleagues analyzed data from 9685 patients enrolled in nine clinical trials. Some 26% of patients had 1 reduced-function allele, and 2% had 2…

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Pradaxa (dabigatran) Pricing Starts to Emerge

It looks like Pradaxa (dabigatran) will cost about $237 a month at the drugstore counter. A Boehringer Ingelheim representative told CardioBrief that the wholesale acquisition cost (WAC) of the drug will be $6.75 per day for 2 pills. The price will apply to both the 150 mg and the 75 mg capsules.  According to knowledgeable experts,…

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Can Barbers Help Fight High Blood Pressure in Black Men?

A very long time ago, barbers performed surgical procedures. Now, once again, barbers may have a role to play in the health care of their community….

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Top New York City Interventional Cardiologists Now Making $3 Million a Year

There’s no recession for top interventional cardiologists in New York City. Mt. Sinai’s Samin Sharma and New York-Presbyterian’s Jeffrey Moses now make at least $3 million a year, Sharma told CardioBrief. Sharma will make his money staying in one place at Mt. Sinai. Moses, however, will have to travel between New York-Presbyterian’s uptown (Columbia University Medical…

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