January 21st, 2011
To Arms! Or, Maybe Not?
Richard A. Lange, MD, MBA and L. David Hillis, MD
According to a recently published opinion piece in a British cardiology journal, enthusiasm for the transradial approach over the femoral approach in primary PCI is not justified. The authors cite numerous problems with the radial approach compared with the femoral approach (i.e., up to a 10% crossover rate, prolonged procedure time, increased radiation exposure for the patient and […]
January 20th, 2011
Braunwald: Vorapaxar Problem Based on Intracranial Bleeding in Patients with History of Stroke
Larry Husten, PHD
A key detail has now emerged about the problems encountered with vorapaxar, Merck’s thrombin receptor antagonist that suffered a large setback last week. TIMI investigators in the TRA-2P TIMI 50 trial have been informed by Eugene Braunwald that the reason vorapaxar would be discontinued in patients who experienced a stroke prior to entry or during the trial […]
January 19th, 2011
What PROSPECT Doesn’t Tell Us
Richard A. Lange, MD, MBA and L. David Hillis, MD
The PROSPECT trial provides some interesting insights about the mechanisms of thrombotic coronary artery disease, but how, if at all, should it change practice? Here are what the findings do and do not demonstrate: What the PROSPECT study says: In ACS patients treated with PCI, major adverse cardiovascular events that occurred during a median follow-up of 3.4 years were […]
January 19th, 2011
Review Raises Questions About Statins for Primary Prevention
Larry Husten, PHD
A Cochrane Review raises troubling questions about the evidence base supporting the use of statins for primary prevention. The Cochrane reviewers analyzed 14 randomized trials including 34,272 participants and found that statins were associated with significant reductions in overall mortality, fatal and nonfatal CV endpoints, and revascularization procedures. The reviewers found no evidence of harm. […]
January 18th, 2011
Study Supports a New Enhanced Form of CPR
Larry Husten, PHD
A study published in the Lancet lends support to a new form of CPR that uses a combination of two devices to provide three times more blood flow to the heart and brain than standard CPR. The first device is a small suction cup on the patient’s chest used to actively lift the chest and […]
January 14th, 2011
FDA Warns About Severe Liver Injury Associated with Multaq (Dronedarone)
Larry Husten, PHD
The FDA has released a safety communication about severe liver injury associated with Multaq (dronedarone). The FDA said that information about the risk of liver injury would be added to the dronedarone label. The drug’s manufacturer, Sanofi-Aventis, has also sent a letter to healthcare professionals informing them of the warning. The FDA is recommending that doctors […]
January 14th, 2011
Combination Therapy Beats Single Therapy As Initial Antihypertensive Therapy
Larry Husten, PHD
In the ACCELERATE (Aliskiren and the calcium channel blocker amlopdipine combination as an initial treatment strategy for hypertension control) trial, more than 1200 patients with early essential hypertension were randomized to either aliskiren, amlodipine, or the combination of the two drugs for 4 months. The results, which have been published online in the Lancet, showed […]
January 13th, 2011
Merck’s Thrombin Receptor Antagonist Suffers Major Setback
Larry Husten, PHD
Merck’s thrombin receptor antagonist, vorapaxar, has suffered a major setback in its clinical trial program. In one trial, TRACER, the study drug is being discontinued and the trial will be closed out. The second trial, TRA-2P TIMI 50, is being curtailed but not stopped. The actions were based on recommendations from the combined Data and […]
January 12th, 2011
Maybe TAVI Is Not All It’s Cracked Up To Be
Richard A. Lange, MD, MBA and L. David Hillis, MD
The PARTNER trial of transcatheter aortic valve implantation (TAVI) for severe aortic stenosis was among the hottest cardiology stories of 2010. Now that the hype is receding, some are questioning whether TAVI is ready for prime time. In three letters to the Editor of the New England Journal of Medicine, our colleagues point out that […]
January 12th, 2011
Researchers Shed New Light on HDL Cholesterol
Larry Husten, PHD
Two papers published in the New England Journal of Medicine shed new light on the important but often mysterious role of HDL cholesterol in cardiovascular disease. In the first paper, researchers at the University of Pennsylvania studied 1,000 healthy volunteers and patients with coronary artery disease and observed a strong inverse relationship between cholesterol efflux […]