October 31st, 2011
FDA Gives Favorable Review to SHARP Ahead of Vytorin Advisory Panel
Larry Husten, PHD
In preparation for Wednesday’s meeting of the FDA’s Endocrinologic and Metabolic Drugs Advisory Committee, an FDA reviewer has generally endorsed the positive interpretation of the SHARP trial of Vytorin (ezetimibe and simvastatin) in chronic kidney disease (CKD). Based on the results of SHARP (Study of Heart and Renal Protection), Merck is seeking an expansion of […]
October 28th, 2011
Belgian Study Supports Use of FFR to Guide Therapy in Intermediate LAD Lesions
Larry Husten, PHD
A study published in JACC: Cardiovascular Interventions suggests that fractional flow reserve (FFR) may be safely used to guide treatment in patients with an intermediate left anterior descending coronary artery (LAD) stenosis. Olivier Muller and colleagues report on 730 patients at a single center in Belgium who had a 30% to 70% stenosis in the proximal […]
October 28th, 2011
FDA Advisory Panel Votes 8-2 Against Approval of Medtronic AF Ablation System
Larry Husten, PHD
An FDA advisory panel has recommended against approval of Medtronic’s Ablation Frontiers Cardiac Ablation System for the treatment of symptomatic, drug refractory, persistent atrial fibrillation (AF) or longstanding persistent AF of up to four years in duration. In an 8-2 vote, members of the Circulatory System Devices Panel said that the risks of the device outweighed […]
October 28th, 2011
Joining the Fishbowl
Shengshou Hu, M.D.
With practice consolidation, your competitors become your colleagues. Do you trust each other? And where should dissatisfied patients turn?
October 27th, 2011
The Art of Arriving at a Diagnosis
John E Brush, MD
A 55-year-old man came to the emergency room complaining of aching chest pain radiating to the back. The pain had started the day before and recurred several times. It seemed to worsen with exertion and resolve with rest. One resting episode was associated with diaphoresis. Exam, EKG, and cardiac enzymes were normal. A portable chest […]
October 26th, 2011
Danish Study Clarifies VTE Risk Associated with Newer Progestogens in Oral Contraceptives
Larry Husten, PHD
A large new study from Denmark provides the best evidence yet that third-generation oral contraceptives (OCs) containing drospirenone, desogestrel, or gestodene (sometimes used to treat dysmenorrhea) are associated with twice the risk for venous thromboembolism (VTE) as second-generation OCs containing levonorgestrel. In a paper published in BMJ, Øjvind Lidegaard and colleagues analyzed data from national registries containing […]
October 25th, 2011
Genetic and Clinical Factors Linked to Stent Thrombosis
Larry Husten, PHD
French researchers have identified several genetic and clinical factors independently tied to early stent thrombosis. Writing in the Journal of the American Medical Association, Guillaume Cayla and colleagues report on their case-control study comparing 123 patients with definite early stent thrombosis with 246 matched controls without stent thrombosis. The researchers found three genes with variants […]
October 24th, 2011
New Study Proposes Possible Causative Role for HPV in Atherosclerosis
Larry Husten, PHD
Human papillomavirus (HPV) may play a role in the development of cardiovascular disease (CVD) in women, according to a new study published in the Journal of the American College of Cardiology. Hus-Ko Kuo and Ken Fujise speculated that HPV may be a risk factor for CVD because it inactivates the tumor-suppressor protein p53, which plays a […]
October 24th, 2011
Midlife Obesity Increases Risk for CHD Mortality
Larry Husten, PHD
Obesity in early adulthood doubles the risk of coronary heart disease (CHD) mortality, but this association is eliminated after midlife BMI is factored into the equation, according to a report in Archives of Internal Medicine. Linsay Gray and colleagues utilized data from the Harvard Alumni Health Study, which included nearly 19,000 men who were undergraduates between […]
October 24th, 2011
Does This Child Have More Than an Arrhythmia?
Thierry Legendre, MD and James Fang, MD
An 11-year-old boy presents with palpitations. He has no family history of heart disease and is asymptomatic while playing competitive sports. His cardiac physical examination is normal, but his ECG (shown below) shows a Wolff-Parkinson-White pattern with a short PR interval and delta waves. A systematic echocardiogram reveals normal LV function, normal atrioventricular valves, and […]