–New high-sensitivity troponin tests may ease perpetual ED dilemma Only a small percentage of emergency department chest pain patients turn out to have acute myocardial infarction (AMI). Now a new blood test can help identify a significant number of patients who are extremely unlikely to have AMI and who can therefore be safely discharged immediately….
Ularitide Still a Bust After TRUE-AHF Peer Review
April 12, 2017 by Leave a Comment
–As reported at AHA, novel vasodilator failed to improve outcomes in heart failure Short-term treatment with the novel vasodilator ularitide did not lead to improved clinical outcomes in the long term. Results of the TRUE-AHF trial, first presented in preliminary form last November at the American Heart Association annual meeting, have now been published in…
Can SPRINT Be Used To Inform Hypertension Treatment?
April 9, 2017 by 3 Comments
–The landmark trial results are not easy to apply to clinical practice. Since the first breathless announcement of its preliminary results, SPRINT trial has been viewed as a landmark trial serving to establish a more aggressive approach to blood pressure management. It is now becoming increasingly clear, however, that the application of SPRINT in the…
Abbott Pulls Troubled Absorb Stent From European Market
April 6, 2017 by Leave a Comment
(Updated) Abbott Laboratories has sent a letter to European physicians informing them that the Absorb Bioresorbable Vascular Scaffold (BVS) and Absorb GT1 BVS “will only be available for use in clinical registry setting at select sites/institutions.” The company’s action comes in response to an avalanche of bad news for the controversial device. Last fall 3-year results from…
Pendulum Swings Further Away From Vitamin D Supplements
April 5, 2017 by 5 Comments
A new randomized controlled trial offers no support for the use of increasingly popular vitamin D supplements to prevent cardiovascular disease or reduce mortality. But the trial, published in JAMA Cardiology, is also not the last word on the subject and leaves open the possibility that vitamin D may be found beneficial in the future…
More Bad News For The Once Promising Bioresorbable Stent
March 31, 2017 by Leave a Comment
(Updated) –Problems for the Absorb BVS stent just won’t disappear Bad news for the Absorb BVS stent continues to accumulate, though defenders of the device keep looking for a silver lining. When it was approved in the US last summer the novel device appeared to have a bright future, with many prominent interventional cardiologists predicting…
Interventional Cardiologists Face Major Obstruction In Treatment Of Total Blockages
March 29, 2017 by 1 Comment
–Deep divisions over how CTO patients should be treated. In recent years ambitious interventional cardiologists have started to perform PCI on chronic total occlusions (CTOs), though these lesions have long been recognized as among the most difficult to successfully treat. Many other physicians, including some prominent interventional cardiologists, have expressed grave concerns about this expansion…
Controversial Pharma CEO To Chair AHA Charity Ball
March 24, 2017 by 5 Comments
–The Wizard of Oz-themed ball seeks to raise $2 million on the yellow brick road. The American Heart Association’s annual Heart & Stroke Ball will be chaired by John Thero, the CEO of Amarin Corporation, the controversial pharmaceutical company. Amarin manufactures the prescription fish oil product Vascepa for which it is aggressively seeking an expanded indication…
TV Ads Pushed Inappropriate Use of Testosterone
March 21, 2017 by Leave a Comment
–Study: prescriptions spiked in direct response to blizzard of ‘Low T’ ads Television ads for testosterone products were highly successful, leading to dramatic increases in the number of men taking testosterone drugs, according to a new study published in the Journal of the American Medical Association. J. Bradley Layton (University of North Carolina, Chapel Hill)…
Another HDL Therapy Crashes and Burns
March 19, 2017 by 3 Comments
–Failure of pre-beta HDL mimetic puts another nail in the HDL coffin Once again, an HDL-inspired therapy has failed when put to the test in a clinical trial. Although there are still ongoing trials with other HDL-related therapies, most experts now feel that it is time for the field to turn its attention elsewhere and…
Ebbinghaus Study May Help Refute Doctor Google
March 18, 2017 by 3 Comments
–No neurocognitive adverse effects linked to very low LDL levels Reaching very low LDL levels with a PCSK9 inhibitor was not associated with any increase in neurocognitive adverse events, according to the largest and most rigorous study to assess the topic to date. Small and preliminary studies have raised concerns over the possibility of the…
Novel Drug Delivers Long Term Cholesterol Reduction
March 17, 2017 by 1 Comment
A novel drug that dramatically lowers LDL cholesterol and needs to be administered only a few times a year has reached a new milestone. Positive results from a phase II study with the drug, now known as inclisiran, were reported at the American College of Cardiology meeting in Washington, DC and published simultaneously in the…
FOURIER Shows New Cholesterol Drugs Work, But Are They Worth It?
March 17, 2017 by 6 Comments
–Doctors and patients now must wrestle with a modestly effective but expensive drug. As it turns out the PCSK9 inhibitor saga ends not with a bang but a whimper. The results of the highly anticipated FOURIER trial show that the drugs work, though not as powerfully as many had hoped and expected. The question now…
Scott Gottlieb’s Sham Ideology Rejects Clinical Trials
March 14, 2017 by 3 Comments
Donald Trump has nominated Scott Gottlieb to be the next FDA Commissioner. To his credit, Gottlieb is not certifiably crazy like several of the other candidates who were reported to be under consideration for the job. But he is is a deeply conservative ideologue who is determined to reduce the government’s role in healthcare. On two occasions in…
For Scott Gottlieb, Business Trumps Health
March 14, 2017 by Leave a Comment
Donald Trump has nominated Scott Gottlieb to be the next FDA Commissioner. To his credit, Gottlieb is not certifiably crazy like several of the other candidates who were reported to be under consideration for the job. But he is is a deeply conservative ideologue who is determined to reduce the government’s role in healthcare. On two occasions in…
Has Nutrition Science Been Poisoned?
March 9, 2017 by 9 Comments
–The inevitable weaknesses of observational and diet studies “Science is the great antidote to the poison of enthusiasm and superstition,” Adam Smith wrote more than 200 years ago. Unfortunately, it often seems as if the science of nutrition has itself been poisoned. Two recently published papers illustrate this problem. Nutrition and Mortality A good example of…
Call For More Calcium Screening Gets Pushback
March 6, 2017 by 2 Comments
–But a zero calcium score can be useful to avoid statins, some argue Coronary artery calcium (CAC) scans should be widely used in routine clinical practice to improve the detection of coronary disease in people without known disease, according to the authors of a new review in JACC: Cardiovascular Imaging. But many experts urged caution,…
Top Cardiologist Blasts Nutrition Guidelines
February 27, 2017 by 15 Comments
–Salim Yusuf says new evidence fails to support many major diet recommendations. One of the world’s top cardiologists says that many of the major nutrition guidelines have no good basis in science. “I’m not a nutrition scientist and that may be an advantage because every week in the newspaper we read something is good for…
After Yet Another Failure, Stem Cell Leaders Double Down
February 20, 2017 by 1 Comment
–Could repeated doses of stem cells turn the tide of negative trials? Despite an unrelieved history of negative trials, stem cell leaders continue to defend their field. In response to the failure of yet another cardiac stem clinical trial, Roberto Bolli, a prominent leader in the field, argued that it’s time for a “paradigm shift” in…
International Experts Call Salt Guidelines Far Too Restrictive
February 14, 2017 by 5 Comments
A broad group of international experts are recommending a far more modest and less draconian approach to sodium restriction than current U.S. and international guidelines. In a new paper, published online in the European Heart Journal, they also focused on the broad gaps of knowledge in the field and drew attention to the paucity of…
Enormous Rivaroxaban Study Stopped Early For ‘Overwhelming Efficacy’
February 8, 2017 by Leave a Comment
(Updated) –Oral anticoagulant reduced CV events in patients with coronary and peripheral disease. The very large COMPASS study has been stopped early for “overwhelming efficacy,” according to a press release issued by Bayer AG and Janssen, manufacturers of rivaroxaban (Xarelto). The phase 3 trial randomized 27,402 patients with coronary artery disease (CAD) and peripheral artery…
New Questions Raised About SPRINT
February 8, 2017 by Leave a Comment
More questions are being raised about SPRINT, the enormous NIH-funded blood pressure lowering trial. Two recent developments will likely add more obstacles to the already difficult task of applying the results of the trial in the real world. Even before the full results of the trial were first made public the NIH and the SPRINT…
27,000 Patient PCSK9 Inhibitor Trial Meets Main Endpoints
February 2, 2017 by 3 Comments
(Updated) –Cardiovascular outcomes finally available for PCSK9 inhibitors. Amgen announced on Thursday afternoon that the FOURIER trial had met both its primary composite endpoint (cardiovascular death, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or coronary revascularization) and the even more rigorous key secondary composite endpoint (cardiovascular death, non-fatal MI or non-fatal stroke). The company…
In Which I Go Under The Knife And Learn About Medicine In The Real World
January 27, 2017 by 7 Comments
I’m not a doctor but I thought I knew something about anticoagulation. Over the course of a career covering cardiology I’ve written countless stories about heparin, warfarin, the low molecular weight heparins, and the new oral anticoagulants. So when I had bilateral total knee replacement a few weeks ago I thought I knew what to…
Long Unsuccessful Heart Failure Drug Once Again At Center Of Controversy
January 23, 2017 by 9 Comments
–The long, strange 30-year journey of BiDil. It’s been buried in the avalanche of related news but there’s an interesting and somewhat bizarre cardiology angle to the debate over Trump’s nomination of Tom Price to be the next HHS Secretary. ProPublica reported on Friday that last summer Price went to bat for the makers of…
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