Troponin T Test Helps Assess Risk Following Noncardiac Surgery

A new study in JAMA finds that postoperative Troponin T (TnT) tests can independently improve 30 day mortality risk assessment among patients who have had noncardiac surgery. The VISION (Vascular Events in Noncardiac Surgery Patients Cohort Evaluation) study investigators evaluated the prognostic power of postoperative fourth-generation TnT testing in 15,133 patients. Overall mortality at 30 days was…

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This Week In Medicine: Stop Exercising and Eat Chocolate!

It’s been a terrific few days of medical news for lazy people and chocoholics. First, a study in PLoS One provided ammunition to the exercise-averse crowd by claiming that exercise can actually be bad for some healthy people. As an added bonus, a story about the study was carried on the front page of the…

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Fascinating Debate Over Statins For Primary Prevention

The recent guest post by David Newman has prompted several thought-provoking comments. Since most readers will likely miss the comments, I’ve moved these comments to a separate post. Statin Island May 27, 2012, 3:35 PM: Thank you. Clearly, this important commentary raises questions about the integrity of Lancet as well as the authors of the study. But…

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Guest Post: Data, Drugs, And Deception– A True Story

Editor’s Note: The following guest post by Dr. David Newman is reprinted with permission from his website and blog, Smartem.Org. Dr. Newman is an Emergency Physician and Director of Clinical Research at Mt. Sinai School of Medicine in the Department of Emergency Medicine.  He is the author of the critically-acclaimed Hippocrates’ Shadow: Secrets From the House of…

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Aspirin Found To Prevent Recurrent Venous Thromboembolism

Aspirin can help prevent the recurrence of venous thromboembolism (VTE) after discontinuation of anticoagulation therapy, according to results of the WARFASA (the Warfarin and Aspirin) study published in the New England Journal of Medicine. Following 6 to 18 months of oral anticoagulation, 403 patients with first-time unprovoked VTE were randomized to aspirin (100 mg daily) or placebo…

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Studies Probe Effect Of CPAP And Sleep Apnea On Hypertension

Two studies published in JAMA provide additional but not surprising information about the relationship between obstructive sleep apnea (OSA), hypertension, and the role of continuous positive airway pressure (CPAP). In the first study, Ferran Barbé and colleagues randomized 725 people with OSA but no daytime sleepiness to either CPAP or no active treatment. Although there were…

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You Know Nothing, Dr. Snow: Why Medicine Can’t Be More Like Facebook

Medicine can never be like Facebook, despite what Matt Herper argues over at Forbes. Perhaps he was just trolling for hits on a day when everyone is thinking about the Facebook IPO, but Herper proposed, with apparently seriousness, that medicine needs to model itself on the tech world in order to match the kind of…

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Large Metaanalysis Finds Statins Effective in Low Risk Patients

A very large metaanalysis provides strong evidence that the relative reduction in risk of statins is at least as great in low-risk patients as in high-risk patients. The finding, write the authors, provides evidence that expansion of guidelines to lower risk populations should be considered. In their paper in the Lancet, the  the Cholesterol Treatment Trialists’ (CTT)…

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No Benefit Found For Exercise Echocardiography In Asymptomatic Patients Following CABG Or PCI

Routine exercise echocardiography in asymptomatic patients after revascularization does not lead to better outcomes, according to a new study published in Archives of Internal Medicine. Although guidelines generally discourage the practice, post-revascularization stress tests are still commonly performed. Serge Harb and colleagues performed exercise echocardiography on 2,105 patients following CABG surgery or PCI and followed…

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FDA Advisory Panel Recommends Approval For Weight Loss Drug Lorcaserin

The FDA’s Endocrinologic and Metabolic Drugs Advisory Committee voted to recommend approval of lorcaserin (Lorqess, Arena). The result signals a remarkable turnaround for the drug, which the same panel had rejected in September 2010. The vote was 18 in favor of approval, 4 against, and 1 abstention. Committee members seemed less disturbed this time around…

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Atorvastatin Lifts Ranbaxy While Pfizer Abandons Its Lipitor Marketing Efforts

Pfizer will no longer aggressively market Lipitor (atorvastatin), its former crown jewel and the most lucrative pharmaceutical product ever. At the same time, generic drug manufacturer Ranbaxy posted record revenue for the last business quarter, growth fueled largely by sales of generic atorvastatin in the United States. Pfizer told the Wall Street Journal that it…

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Roche Terminates Development Of CETP Inhibitor Dalcetrapib

Roche announced today that it had ended development of dalcetrapib, its entry in the once-promising class of HDL-raising CETP inhibitors. A data and safety monitoring board recommended that the dal-OUTCOMES phase 3 trial be stopped due to a lack of clinically meaningful efficacy. The DSMB found no evidence of safety problems….

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Company Fails To Disclose Details About Heart Failure Risk of Drug

Boehringer Ingelheim failed to fully disclose data suggesting that one of its drugs, pramipexole,  a dopamine agonist sold under the brand name of Mirapex, is associated with a significantly increased risk of heart failure, according to a recent news report. The drug, which was originally developed for the treatment of Parkinson’s disease, is now also used to treat…

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Guest Post: The Dark Side of EKG Screening in Athletes

The following guest post is reprinted with permission from DrWes, the blog written by Westby G. Fisher, a board certified internist, cardiologist, and cardiac electrophysiologist practicing at NorthShore University HealthSystem in Evanston, IL. The Dark Side of EKG Screening in Athletes by Westby Fisher They sat nervously with their son in the doctor’s office, wondering why they…

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Half the News That’s Fit To Print: NY Times On ECG Screening For Student Athletes

There may be no more horrifying medical catastrophe than the sudden death of a young athlete on the playing field in front of a large crowd of friends, family, and community. But it’s also a dizzyingly complex subject with no easy solutions. Experts are divided. The American Heart Association recently reaffirmed that it does not recommend…

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Aliskiren (Tekturna) Gets New Warning and Contraindication From FDA

The FDA has issued new warnings about antihypertensive drugs containing the direct renin inhibitor aliskiren (including Tekturna, Amturnide, Takamio, and Valturna) when used in combination with ACE inhibitors or angiotensin receptor blockers (ARBs). The FDA now states that these drug combinations are contraindicated in patients with diabetes, and it is adding a new warning to…

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Periodontal Disease and CV Disease: Just Friends?

Demonstrating once again that association and causation should not be confused, the American Heart Association today published a scientific statement in Circulation asserting that there is no convincing evidence showing that periodontal disease causes cardiovascular (CV) disease or that treating periodontal disease will reduce CV disease. The statement does not rule out the possibility that periodontal disease can…

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Suicide and CV Death Increase After Diagnosis of Cancer

The risk of suicide and cardiovascular death rises sharply after cancer is diagnosed, according to a new study from Sweden published in the New England Journal of Medicine. Fang Fang and colleagues analyzed data from more than 6 million Swedes, including more than half a million who received a first diagnosis of cancer. Following a…

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Medical Societies Release Lists of Overused Tests and Procedures

The American College of Cardiology (ACC) and other medical societies have released lists of commonly overused or misused tests of procedures. The action is part of Choosing Wisely, a broad initiative from the ABIM foundation. Here are the five tests or procedures identified by the ACC: Cardiac imaging tests (particularly, stress tests or advanced non-invasive imaging)…

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Proof-of-Concept for Bedside Rapid Genotyping Test of CYP2C19

A new point-of-care test can rapidly identify people with a common genetic variant associated with impaired clopidogrel function. The authors claim that this is the first study to demonstrate the feasibility of delivering a genetic test at bedside. In an article published online in the Lancet, Jason Roberts and colleagues report on a new point-of-care test that can…

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ASCERT Observational Study Finds Long Term Advantage for CABG Over PCI in High Risk Cases

A very large observational study finds that long-term mortality in high risk patients is lower after bypass surgery than after PCI. The results, which were previously revealed in January at the annual meeting of the Society of Thoracic Surgeons (STS), were presented in final form at the American College of Cardiology by William Weintraub and published simultaneously…

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Bariatric Surgery Turns Back the Clock on Diabetes

Two new randomized trials offer new evidence that bariatric surgery is highly effective in obese patients with diabetes. The results, according to Paul Zimmet and K. George M.M. Alberti, writing in an editorial in the New England Journal of Medicine, “are likely to have a major effect on future diabetes treatment.” In the STAMPEDE trial, which…

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Promising Phase 1 Results For New Monoclonal Antibody to PCSK9

Promising results from very early studies with an experimental new cholesterol-lowering drug, a monoclonal antibody to PCSK9, have been published in the New England Journal of Medicine. Evan Stein and colleagues report the results of two single-dose studies in which the drug, REGN727, was administered intravenously and subcutaneously to healthy subjects. In a third, randomized, placebo-controlled, dose-ranging…

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Meta-Analysis Adds New Evidence For Cancer Benefits Of Daily Aspirin

Although daily aspirin was originally proposed to reduce cardiovascular events, the effects on cancer of daily aspirin have become increasingly apparent while the vascular benefits, especially in primary prevention, have become less clear. Now a new meta-analysis in the Lancet adds significantly new details to our understanding about the effects of aspirin and increases the…

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Studies Provide Strongest Evidence To Date For Causative Role of Inflammation in Heart Disease

Two large new meta-analyses published in the Lancet provide the first strong evidence demonstrating a cause-and-effect relationship between a specific inflammatory protein and the development of coronary heart disease (CHD). Both studies illuminate the role of interleukin-6 receptor (IL6R) by focusing on the common Asp 358Ala variant of the IL6R gene. The variant is known to dampen the…

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