CardioExchange Archive

March 14th, 2010

Sunday, March 14 ACC News Roundup: ACCORD, NAVIGATOR, EVEREST II

Larry Husten, PHD

The ACC started the day with the release of 3 highly-anticipated clinical trials. ACCORD (Action to Control Cardiovascular Risk in Diabetes Study) tested two separate therapeutic approaches in type 2 diabetics. In one arm, 5,518 patients already taking simvastatin were randomized to fenofibrate or placebo. After 4.7 years of followup, the annual rate of nonfatal MI, […]

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March 14th, 2010

Does Fenofibrate ACCORD with the Treatment of Diabetes?

henrynginsberg and Andrew M. Kates, MD

CardioExchange welcomes Dr. Henry N. Ginsberg to discuss the findings of the ACCORD Lipid Study Group. In this paper, researchers randomized 5,500 diabetic patients to fenofibrate therapy versus placebo. All patients received simvastatin. Although triglyceride levels improved markedly with fenofibrate, the incidence of cardiovascular events was not affected. CardioExchange Editors: Should we abandon fenofibrate for treating […]

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March 14th, 2010

Saturday March 13 News: Phase 3 Mipomersen Study

Larry Husten, PHD

Frederic J Raal et al. report results in the Lancet of a phase 3 study in patients with homozygous familial hypercholesterolemia. Fifty one subjects on high dose lipid-lowering drugs were randomized (on a 2:1 basis) to either placebo or mipomersen, a novel antisense inhibitor of apolipoprotein B synthesis. Patients on mipomersen had a 24.7% decrease in LDL, […]

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March 13th, 2010

Follow Along with Your Colleagues at the ACC, Day 1

Andrew M. Kates, MD

See Next Post (ACC Day 2) Several Fellows in Cardiology who are attending this week’s ACC meeting are blogging together right here. The Fellows include Shane LaRue, Justin Bachmann, Nihar Desai, Shanti Bansal, and Hansie Mathelier. Check back often to learn about the biggest buzz at the ACC — whether it’s a poster, a presentation, […]

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March 12th, 2010

Friday March 12: Plavix Gets a Black Box

Larry Husten, PHD

The FDA has added a black box warning to the Plavix (clopidogrel) label. The black box warns about people “who do not effectively metabolize the drug… and therefore may not receive the full benefits of the drug.” The warning also informs healthcare professionals about tests that can identify the underlying genetic differences in clopidogrel metabolism […]

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March 11th, 2010

Thursday, March 11 News: Blood Pressure Variability Subject of 4 Simultaneous Papers in Lancet and Lancet Neurology

Larry Husten, PHD

Interest in blood pressure variability is likely to rise considerably with the publication of four simultaneous papers on the subject by Oxford’s Peter Rothwell in the Lancet and Lancet Neurology. Rothwell points out that by relying on traditional assessment of mean systolic blood pressure, researchers have been unable to fully understand the contribution of blood pressure to stroke […]

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March 11th, 2010

Low Diagnostic Yield of Elective Coronary Angiography

Richard A. Lange, MD, MBA

According to a recent study, of almost 400,000 patients referred for elective coronary angiography, only 38% had obstructive CAD.  Those with a positive noninvasive test before angiography were only moderately more likely to have obstructive CAD than those who did not undergo any testing (41% vs 35%, respectively).  However, in a comment in Journal Watch, […]

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March 10th, 2010

Is the Patient-Selection Process for Cardiac Cath Broken?

Pamela S. Douglas, MD

We welcome Pamela S. Douglas, MD, to answer our questions about her research team’s NEJM study on the diagnostic yield of coronary angiography. We encourage you to ask yours.   Background: In this observational study of the CathPCI database of the National Cardiovascular Data Registry (NCDR), 38% of about 400,000 patients without known coronary artery […]

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March 10th, 2010

Wednesday, March 10 News Roundup: Low Diagnostic Yield for Angiography; Is Acute MI Disappearing?

Larry Husten, PHD

Low Diagnostic Yield for Angiography: Coronary angiography as practiced in the U.S. has a startlingly low diagnostic yield, according to an important new study by Patel et al. in the New England Journal of Medicine using data from the ACC National Cardiovascular Data Registry. In 398,978 patients undergoing elective catheterization who did not have known coronary artery […]

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March 9th, 2010

Which Focus for Statin Therapy: Treat More Patients or Ensure Better Adherence?

JoAnne M. Foody, MD

Millions of people who take statins to reduce their cholesterol levels do not adhere to their prescribed regimens. That’s troubling in light of estimates from a recent analysis of data from more than 40,000 participants in the Melbourne Collaborative Cohort Study. It showed that if the percentage of patients with at least 80% adherence to […]

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