Two studies published on Tuesday on dietary composition offer a striking contrast. One tackles the interesting question of whether different diets producing the same amount of weight loss might have different effects on energy expenditure. The investigators performed a rigorous, carefully designed experiment that advances our knowledge about diets and metabolism. The second tackled an…
Good Science/Bad Science: Contrasting Papers On Dietary Compositon In JAMA And BMJ
June 27, 2012 by 3 Comments
Olmesartan Use Associated With GI Disorder That Mimics Celiac Disease
June 21, 2012 by Leave a Comment
A gastroenterologist at the Mayo Clinic has uncovered a rare but potentially serious association between the angiotensin II receptor antagonist (ARB) olmesartan and severe gastrointestinal problems that resemble Celiac disease. The report has been published online in Mayo Clinic Proceedings. In the US, olmesartan is sold as Benicar and, in combination with other drugs, as…
ACC Releases Appropriate Use Criteria For Noninvasive Peripheral Tests
June 12, 2012 by Leave a Comment
The American College of Cardiology (ACC) has published appropriate use criteria (AUC) for peripheral vascular ultrasound and physiological testing. The criteria were developed in coordination with 10 other medical societies. “This is the first systematic and comprehensive evaluation looking at appropriate indications for vascular testing, such as ultrasound or functional testing,” said Emile Mohler III,…
Basal Insulin And Omega-3 Fatty Acids Fail To Improve Outcomes In Diabetics And Prediabetics
June 11, 2012 by Leave a Comment
A large new study has found no evidence of cardiovascular (CV) benefits for either basal insulin or omega-3 fatty acids in a population of people with diabetes or at risk for diabetes. Results of the ORIGIN (Outcome Reduction with Initial Glargine Intervention) study were presented on Monday at the annual meeting of the American Diabetes…
Observational Study Finds Possible Long-Term Mortality Advantage for Rhythm Control Drugs In Atrial Fibrillation
June 4, 2012 by Leave a Comment
Challenging a decade-old influential trial, a large observational study of patients with atrial fibrillation (AF) suggests that rhythm control drugs may outperform rate control drugs after 4 years. Raluca Ionescu-Ittu and colleagues analyzed data from 26,130 patients 66 years or older diagnosed with AF in Quebec, Canada. Patients were followed for a mean of 3.1 years and…
FDA Advisory Committee Recommends Against ACS Indication For Rivaroxaban
May 23, 2012 by 1 Comment
The FDA’s Cardiovascular and Renal Drugs Advisory Committee voted against adding an indication for acute coronary syndromes (ACS) to the label of the anticoagulant rivaroxaban (Xarelto). The vote was 6 to 4 against approval, with 1 abstention. The advisory panel spent most of the day trying to reconcile diametrically opposed views of the pivotal ATLAS ACS 2-TIMI…
Rivaroxaban For ACS Gets Positive FDA Review, But Questions About ATLAS Trial Conduct Persist
May 21, 2012 by 2 Comments
The FDA will offer generally positive but also highly mixed advice to the FDA’s Cardiovascular and Renal Drugs Advisory Committee when it meets on Wednesday to consider the supplemental new drug application for rivaroxaban (Xarelto, Johnson & Johnson) for use in patients with acute coronary syndrome (ACS) already taking dual antiplatelet therapy. The FDA posted the briefing documents…
Improved Survival After Non-Shockable Cardiac Arrest With New CPR Guidelines
April 2, 2012 by Leave a Comment
In recent years resuscitation guidelines have evolved to emphasize chest compressions. At the same time, a greater proportion of out-of-hospital cardiac arrest (OHCA) cases are now due to “nonshockable” rhythms, defined as asystole and pulseless electrical activity, but the effect of the new guidelines on these type of OHCA cases is unknown. In a study published…
Rolling Up the Carpets at the ACC
March 27, 2012 by Leave a Comment
Rivaroxaban Found Safe and Effective for Pulmonary Embolism
March 26, 2012 by Leave a Comment
In recent years rivaroxaban has been found to be effective in the prevention of venous thromboembolism (VTE) after orthopedic surgery, for the prevention of stroke in AF patients, and as additional therapy to conventional antiplatelet therapy in ACS patients. Now, a study presented at the American College of Cardiology meeting in Chicago and published simultaneously…
Study Supports CT Angiography to Rule Out CAD in Chest-Pain Patients
March 26, 2012 by Leave a Comment
Six million people each year in the US go to the emergency department (ED) with acute chest pain. Although only 10-15% of them turn out to have an acute coronary syndrome (ACS), most are admitted to the hospital. Coronary CT angiography (CCTA) has been proposed as a good method to quickly establish the presence or absence…
Study Supports PCI Without Onsite Surgical Backup
March 25, 2012 by Leave a Comment
Here’s a great example of genuine medical progress: 10% of the first 50 patients who received balloon angioplasty from the developer of the procedure, Andreas Grüntzig, required emergency bypass surgery. By 2002 only 0.15% of PCI patients required emergency surgery, leading many to believe that surgical backup was no longer necessary. Now a large new…
Novel Antiplatelet Agent Reduces CV Events But Increases Bleeding
March 24, 2012 by 1 Comment
Vorapaxar, the novel antiplatelet agent from Merck, appears to effectively reduce cardiovascular death and ischemic events in patients with MI, ischemic stroke, or peripheral vascular disease, but its potential utility is clouded by bleeding complications, including intracranial hemorrhage. Results from the TRA 2P-TIMI 50 (Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events) trial were presented…
Meta-Analysis Adds New Evidence For Cancer Benefits Of Daily Aspirin
March 20, 2012 by 1 Comment
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…
Eric Topol, Megamind
March 5, 2012 by 2 Comments
Ralph Waldo Emerson famously wrote that “a foolish consistency is the hobgoblin of little minds.” If this is true then Eric Topol, who earlier today wrote a New York Times editorial highly critical of statins, is Megamind. Here’s what he wrote in a 2004 editorial in the New England Journal of Medicine: Even today, only a…
Meta-Analysis Confirms Benefits Of Statins In Women
February 1, 2012 by Leave a Comment
Although clinical trials have consistently found a beneficial effects for statins, some critics have questioned the strength of the evidence in women, who are often under-represented in clinical trials. A large new meta-analysis published in the Journal of the American College of Cardiology provides the best evidence yet that the relative reductions in events observed in…
Consensus Document Provides Roadmap To Uptake Of TAVI In US
January 31, 2012 by 3 Comments
Following the recent approval by the FDA of transcatheter aortic valve replacement (TAVR), the ACC, AATS, SCAI, and STS, in conjunction with several other medical organizations, have released a critical consensus document to guide use of the new landmark procedure. “We have tried to collate the evidence into a coherent road map for judicious use, rational…
ACC 2012 Roster of Late-Breaking Clinical Trials
January 27, 2012 by Leave a Comment
The American College of Cardiology has released the roster of late-breaking clinical trials that will be presented in March at the ACC Scientific Sessions: ACC.12 Opening Session and Late-Breaking Clinical Trials Saturday, March 24, 2012, 8:00 a.m. – 10:00 a.m. Effect of Transendocardial Autologous Bone Marrow Mononuclear Cell Delivery on Functional Capacity, Left Ventricular Function…
NHLBI Launches Two Large Cardiac Arrest Treatment Trials
January 26, 2012 by Leave a Comment
The NHLBI today announced the launch of two large clinical trials evaluating treatments for out-of-hospital cardiac arrest. The Continuous Chest Compressions (CCC) trial will randomize 23,600 people with out-of-hospital cardiac arrest to either standard CPR or continuous chest compressions, both delivered by paramedics or fire fighters. In recent years, studies published in the New England Journal of Medicine, …
Big Drop in Incidence and Fatality of MIs in England
January 26, 2012 by Leave a Comment
Since 2002 in England the incidence of acute MI has dropped by one-half and the case fatality rate by one-third, according to a new study published in BMJ. The overall decline in deaths from MI are about equally due to improvements in the prevention of MI and the treatment of MI. Kate Smolina and colleagues…
Huge Study Finds Risk Factors Do In Fact Predict Risk
January 25, 2012 by 1 Comment
An enormous new meta-analysis confirms the important role that risk factors play over a lifetime in the development of cardiovascular disease. In a paper published in the New England Journal of Medicine, Jarett Berry and colleagues report on the new meta-analysis from the Cardiovascular Lifetime Risk Pooling Project, which contains data from 18 epidemiological studies including more than…
FDA Rejects Proposed Chronic Kidney Disease Indication for Vytorin
January 25, 2012 by Leave a Comment
The FDA rejected a new indication for Merck’s Vytorin and Zetia (ezetimibe plus simvastatin and ezetimibe alone) in chronic kidney disease patients. As a consolation prize, however, the agency approved a new label for Vytorin that will incorporate the results of SHARP (Study of Heart and Renal Protection), which found that Vytorin reduced the incidence of…
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