Sanofi and Regeneron achieved a modest victory with the much anticipated ODYSSEY Outcomes trial of its cholesterol lowering drug Praluent (alirocumab). The trial met its primary endpoint and even reported a significant improvement in all-cause mortality. But the mortality finding has an asterisk attached to it and it is far from clear whether the overall…
CANTOS Substudy Shows Major Role For Inflammation
November 13, 2017 by 1 Comment
–Large reductions in hsCRP appeared to foretell improved outcomes. ANAHEIM — An important CANTOS trial substudy bolsters evidence that inflammation plays an independent role in cardiovascular disease (CVD) and may point toward a new targeted approach to treatment of CVD and perhaps even more profoundly impact cancer treatment. The report, presented by Paul Ridker (Brigham…
Merck Drops Development Of Once Promising CETP Inhibitor
October 11, 2017 by 1 Comment
–Despite positive results in the REVEAL trial anacetrapib is dead. Merck announced on Wednesday that it would not seek regulatory approval for its cholesterol drug anacetrapib. The decision did not surprise most observers, despite the fact that investigators recently reported positive results for the drug in the enormous 30,000+ patient REVEAL trial. The trial was…
Stopping Aspirin Hikes CV risk
September 25, 2017 by Leave a Comment
–37% increase in events seen after discontinuation in Sweden People who quit taking aspirin have an increased risk for a cardiovascular event, a large national registry has shown. The use of aspirin for primary prevention against cardiovascular disease has fallen from favor in recent years but aspirin for secondary prevention is still broadly popular and…
REVEAL Revealed: A Slightly Positive CETP Inhibitor Trial
August 29, 2017 by 3 Comments
—After 3 strikes a CETP inhibitor finally scores. BARCELONA — Finally there is a CETP inhibitor that actually confers more benefit than risk: anacetrapib. The benefit emerged from the Randomized EValuation of the Effects of Anacetrapib through Lipid-modification (HPS3/TIMI55-REVEAL) trial which was presented here at the European Society of Cardiology meeting and published simultaneously in…
CANTOS Validates Role Of Inflammation In Heart Disease
August 27, 2017 by 8 Comments
–Modest treatment effect of canakinumab may limit clinical role in heart disease, but strong anti-cancer signal sparks interest. Despite questions about its clinical importance, the CANTOS trial is being hailed by experts for finally validating the role of inflammation in heart disease. The cardiovascular benefits in the trial were real but modest. Even more exciting,…
Ethical Questions Raised About NIH Blood Transfusion Trial
August 4, 2017 by Leave a Comment
–Public Citizen says the MINT trial comparing blood transfusion strategies after MI should be halted. Public Citizen is calling for the immediate suspension of a large NIH-sponsored trial comparing blood transfusion strategies after heart attacks. The Myocardial Ischemia and Transfusion (MINT) trial should be halted “because of potentially serious ethical violations,” said the consumer advocacy…
Serious Bleeding Risk With Aspirin Soars With Age
June 14, 2017 by 1 Comment
–Routine PPI use might cut the risk of major bleeds in people over 75. Older people who take aspirin to prevent a recurrent cardiovascular event should take a proton-pump inhibitor to lower their risk of serious bleeding complications, say the authors of a new study published in the Lancet. After a transient ischemic attack, ischemic…
Concerns Over New Cardiac Blood Test Spark Intense Twitter Discussion
April 18, 2017 by 3 Comments
–Cardiologists fear the new high sensitivity troponin test will lead to lots of unnecessary testing. Along with many other cardiologists, Sek Kathiresan (Massachusetts General Hospital and Broad Institute) is worried that a new and improved diagnostic test will have disastrous unintended effects. Kathiresan expressed his concern on Twitter yesterday in response to my summary of a…
Single Blood Test Rapidly Rules Out MI in Chest Pain
April 17, 2017 by Leave a Comment
–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….
Impella No Better Than IABP in Cardiogenic Shock
October 30, 2016 by Leave a Comment
–Underpowered IMPRESS trial shows no mortality benefit A rare randomized trial and a new meta-analysis both failed to find any evidence that Impella mechanical circulatory support devices are any better than intra-aortic balloon pumps (IABPs) for patients with cardiogenic shock. For many years, the intra-aortic balloon pump has been the standard device to increase circulation…
Ticagrelor No Better Than Clopidogrel In Peripheral Artery Disease
October 4, 2016 by Leave a Comment
AstraZeneca announces top-line results from EUCLID trial ahead of the AHA. Ticagrelor is no better than clopidogrel in patients who have peripheral artery disease, a large new study will show. On Tuesday morning AstraZeneca announced the top line results of the EUCLID (Examining Use of Ticagrelor in PAD) trial. The full results will be presented…
Primary PCI Guideline Update: Multivessel Interventions In, Thrombectomy Out
October 21, 2015 by Leave a Comment
The guidelines for primary PCI for ST-elevation MI (STEMI) have been updated to reflect major findings from recent trials: PCI of a noninfarct artery is now acceptable for some STEMI patients with multivessel disease. In previous guidelines PCI of noninfarct arteries had been considered unsafe. Routine thrombectomy prior to primary PCI for stent implantation is now…
New Test May Allow Early Discharge Of Chest Pain Patients
October 8, 2015 by Leave a Comment
Each year in the US about six million people go to the emergency department with chest pain or other symptoms suggesting that they might be having a heart attack or other acute coronary syndrome (ACS). The vast majority of them do not have ACS, but because it is difficult to quickly rule out ACS many of them end…
Second Trial Of Controversial Chelation Therapy Gains Crucial Early Support
September 28, 2015 by 3 Comments
The National Institutes of Health is giving money to support the planning of a second trial to test the potential role of chelation therapy in treating patients with myocardial infarction. The first Trial to Assess Chelation Therapy (TACT) was extremely controversial. It was funded by the NIH more than a dozen ago as part of an initiative to…
Heart Attack Risk Jumps After Divorce
April 14, 2015 by Leave a Comment
A new study shows that after a divorce people have an increased lifetime risk for heart attacks (myocardial infarction). Although previous studies have found that MIs occur more frequently in people who are divorced, this is the first study to prospectively examine the lifetime relationship between divorce and MI. In a paper published in Circulation: Cardiovascular Quality and Outcomes, Duke…
A Requiem for Routine Clot Removal During Heart Attacks
March 16, 2015 by Leave a Comment
Using a stent to open a blocked coronary artery is the treatment of choice in the early period of a heart attack (myocardial infarction). A limitation is the risk of dislodging part of the clot, leading to new downstream blockages of smaller vessels. One strategy that has been under development for a long time is thrombectomy, in…
AstraZeneca Drug ‘Approaching The Point Of Diminishing Returns’
March 14, 2015 by Leave a Comment
After a heart attack (myocardial infarction or MI) patients remain at high risk for recurrent events. The precise role of blood thinning with dual antiplatelet therapy to lower this risk has been the subject of considerable disagreement. Now a new study offers fresh evidence that one important strategy, prolonged dual antiplatelet therapy, can lower risk…
AstraZeneca Drug Improves Outcomes After Heart Attacks
January 14, 2015 by Leave a Comment
For the first time a very large trial has shown that dual antiplatelet therapy (DAPT) improves cardiovascular outcomes when given to patients one to three years after a heart attack. Because it has been shown previously to reduce the high risk of recurrent events for up to a year following a heart attack, DAPT is considered to be…
Cardiology Drugs Of The Year: New, Old, And Not-So-Funny
December 18, 2014 by 1 Comment
New Drug Of The Year: LCZ696 from Novartis Old Drug of the Year: Ezetimibe Not-So-Funny Drug of the Year: Ivabradine … Click here to read the full post on Forbes. …
New Drug From Isis Breaks Important Ground But Unlikely To Dent The Market
December 7, 2014 by Leave a Comment
The first important results with a new drug under development by Isis Pharmaceuticals may well have an enormous long term impact on our understanding of how blood flows through the body and how that same blood forms clots in response to damage and disease. But it appears unlikely that the new drug– an anticoagulant unlike anything…
Counterintuitive Advice About Staying Alive After A Heart Attack
September 21, 2014 by 1 Comment
… An interventional cardiologist– the cardiologists who put in stents and usually treat heart attack patients in the first few hours– asked an electrophysiologist– the cardiologists who treat arrhythmias– whether wearable defibrillators should be used post-MI. Here’s what that electrophysiologist, Edward J. Schloss, the medical director of cardiac electrophysiology at Christ Hospital in Cincinnati, OH, replied….
Fractional Flow Reserve Gains Support in Stable CAD and NSTEMI
September 2, 2014 by Leave a Comment
In recent years interventional cardiologists have started to use a new catheter technique, called fractional flow reserve (FFR), in an attempt to assess which blocked vessels might benefit from a stent. Two studies presented at the European Society of Cardiology meeting in Barcelona offered new support for FFR, which has been slowly but surely gaining traction in the…
US Department Of Justice Ends Investigation Of AstraZenca Trial
August 19, 2014 by Leave a Comment
AstraZeneca announced today that the US Department of Justice has ended its investigation into alleged misconduct associated with the pivotal PLATO trial. The company said it had fully cooperated with the investigation, which began in October of 2013. … Click here to read the full post on Forbes. …
Clot Busters For Stroke Gain More Support
August 6, 2014 by Leave a Comment
Although thrombolysis for ischemic stroke has been widely recognized as beneficial, its use has been limited because of concerns about its effects on patients treated after 3 hours, on older patients, and on patients with mild and with severe strokes. Now a new metaanalysis published in the Lancet offers evidence that the use of thrombolysis should be more…
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