March 22nd, 2013
Macrolide Antibiotic Linked to Increased CV Risk in Patients with Lung Conditions
Nicholas Downing, MD
Use of the macrolide clarithromycin in patients admitted with exacerbations of chronic obstructive pulmonary disease or community-acquired pneumonia is associated with increased risk for cardiovascular events, a BMJ study finds. Researchers examined outcomes among nearly 3000 patients admitted to U.K. hospitals with either condition. During 1 year of follow-up, there were roughly 450 new admissions […]
March 21st, 2013
FDA Panel Gives Tepid Endorsement to Abbott’s MitraClip
Larry Husten, PHD
The FDA’s Circulatory System Devices advisory panel gave a tepid endorsement to Abbott Laboratories’ MitraClip device on Wednesday. The panel met to evaluate use of the novel device in patients with significant symptomatic mitral regurgitation (MR) who have been determined by a cardiac surgeon to be too high risk for open mitral valve surgery and in whom existing […]
March 21st, 2013
DIGging In: Three Reasons Why the Recent Digoxin Study Is Not Relevant to Readmission
Harlan M. Krumholz, MD, SM
The evidence is just not compelling that this this drug would reduce hospital readmissions
March 20th, 2013
Controversial PFO Closure Trials Published in NEJM
Larry Husten, PHD
Two controversial trials testing PFO closure in patients with cryptogenic stroke missed their primary endpoints but contained suggestions of possible benefit.
March 20th, 2013
Chlorthalidone Associated with More Electrolyte Problems Than Hydrochlorothiazide
The diuretics chlorthalidone and hydrochlorothiazide are similarly effective at preventing cardiovascular events among older adults with hypertension, but electrolyte abnormalities are more common with chlorthalidone, according to a study in the Annals of Internal Medicine. Canadian researchers used healthcare databases to identify nearly 30,000 adults over age 65 recently prescribed varying doses of chlorthalidone or […]
March 20th, 2013
High Potency Statins Linked to Increased Risk for Acute Kidney Injury
Larry Husten, PHD
Although the beneficial effects of high-potency statins have been well-characterized in clinical trials, these same trials have lacked the power to illuminate rare but potentially important adverse events. A suggestion of one such area of concern, acute kidney injury, was first raised in the SATURN trial. Now, a new study published in BMJ provides further information about this […]
March 18th, 2013
Vena Cava Filters: Little Evidence and Wide Variation in Use
Larry Husten, PHD
Despite the absence of any evidence demonstrating benefit or showing how best to use them, vena cava filters (VCF) are used in most hospitals. Now a new study published in JAMA Internal Medicine suggests that this same lack of evidence results in an extremely broad rate of use in different hospitals. An accompanying viewpoint raises the […]
March 18th, 2013
Selections from Richard Lehman’s Literature Review: March 18th
Richard Lehman, BM, BCh, MRCGP
This week’s topics include the association between smoking cessation and weight change with CV disease among those with and without diabetes, the risk of ischemic heart disease in women after radiotherapy for breast cancer, and more.
March 15th, 2013
Azithro a No Go?
Richard Joseph Kovacs, MD
When I am faced with a patient who needs an antibiotic, and there is an alternative antibiotic with similar efficacy and lower QT risk, I will choose the antibiotic with lower QT risk, and I’m especially careful with patients with certain characteristics that put them at increased risk.
March 15th, 2013
FDA Studying Whether Certain Diabetes Drugs Pose Pre-Cancer Risk
The FDA is investigating whether diabetes drugs in the class known as incretin mimetics pose an increased risk for pancreatic duct metaplasia. The agency is looking at unpublished data on pancreatic toxicity in a small number of tissue samples taken from patients with diabetes who died. It will examine the researchers’ methodology and the samples […]