{"id":5414,"date":"2010-12-20T00:44:30","date_gmt":"2010-12-20T05:44:30","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=5414"},"modified":"2011-07-19T17:45:22","modified_gmt":"2011-07-19T21:45:22","slug":"steve-nissen-looking-back-at-2010-and-ahead-to-2011","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2010\/12\/20\/steve-nissen-looking-back-at-2010-and-ahead-to-2011\/","title":{"rendered":"Steve Nissen: Looking Back at 2010 and Ahead to 2011"},"content":{"rendered":"

To celebrate the holiday season, CardioExchange<\/strong> asked several of our contributors to choose the 3 most important cardiology-related events of the past year and\u00a0 to make 3 predictions for 2011.\u00a0 Here is the first installment in the series.<\/em><\/p>\n

Looking back at 2010:<\/em><\/strong><\/p>\n

1. On September 23, the European Medicines Agency withdrew rosiglitazone from the market and the US FDA limited access to patients who have failed other diabetes therapies including pioglitazone. This decision ended a 3-year battle over the cardiovascular safety of a drug that was once the largest selling diabetes medication in the world.<\/p>\n

2. The first alternative to warfarin was approved by the FDA in 2010. Dabigatran is a direct thrombin inhibitor that protected atrial fibrillation patients from stroke with similar efficacy to warfarin. It\u2019s main advantage is the lack of need for monitoring anti-coagulant effect, potentially freeing patients from repeated INR testing. The major downside is the very high cost, approaching $8 day, which will limit use.
\n<\/a><\/p>\n

3. The ACCORD Lipid study was published<\/a>, demonstrating no benefit for routine administration of fenofibrate in diabetic patients. This study re-emphasizes the hazards of approving medications based upon surrogate endpoints. Despite favorable affects on lipids, fenofibrate failed to reduce morbidity and mortality. Unfortunately a widely used drug marketed since the 1970\u2019s, when finally studied, failed to show significant health outcome benefits.<\/p>\n

    <\/ol>\n

    Predictions for 2011:<\/em><\/strong><\/p>\n

    1. The Office of Inspector General will launch a major national investigation of the overuse of stents in cardiovascular practice.<\/p>\n

    2.The American College of Cardiology will acknowledge that it has been too cozy with industry and announce that the organization will no longer accept funding from drug and device makers.<\/p>\n

    3. The new Congress will consider revisions to the HealthCare Reform legislation, but each effort will fail due to a filibuster in the Senate.<\/p>\n

      <\/ol>\n","protected":false},"excerpt":{"rendered":"

      To celebrate the holiday season, CardioExchange asked several of our contributors to choose the 3 most important cardiology-related events of the past year and\u00a0 to make 3 predictions for 2011.\u00a0 Here is the first installment in the series. Looking back at 2010: 1. On September 23, the European Medicines Agency withdrew rosiglitazone from the market […]<\/p>\n","protected":false},"author":415,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[625],"class_list":["post-5414","post","type-post","status-publish","format-standard","hentry","category-general","tag-reviews-and-predictions"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/5414","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/415"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=5414"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/5414\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=5414"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=5414"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=5414"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}