CardioExchange Archive

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 for […]

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March 12th, 2013

Sildenafil Does Not Improve Exercise Capacity in HF with Preserved Ejection Fraction

Nicholas Downing, MD

Sildenafil does not improve exercise capacity or clinical status in patients with symptomatic heart failure (HF) and preserved ejection fraction, according to a JAMA study. This finding contrasts with previous research suggesting a potential benefit in such patients. Some 220 HF patients with ejection fractions of 50% or greater were randomized to receive oral sildenafil or […]

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November 15th, 2012

In Acute VTE, Novel Oral Anticoagulants and Conventional Therapy Show Similar Efficacy

Nicholas Downing, MD

Novel oral anticoagulants and vitamin K antagonists offer similar protection against venous thromboembolism recurrence, according to a BMJ meta-analysis. However, one of the newer agents, rivaroxaban, seems to offer better protection against bleeding. The analysis included nine randomized controlled trials comparing apixaban, dabigatran, rivaroxaban, or ximelagatran (no longer on the market) with traditional vitamin K antagonists […]

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October 24th, 2012

Four CV Risk Factors Predict Most of Peripheral Artery Disease Risk in Men

Nicholas Downing, MD

Four common cardiovascular risk factors — smoking, hypertension, hypercholesterolemia, and type 2 diabetes — appear to account for most of the risk for peripheral artery disease in middle-aged and older men.

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October 18th, 2012

Multivitamins May Confer a Small, but Significant, Cancer Risk Reduction in Men

Nicholas Downing, MD

Middle-aged and older men who take multivitamins have a modestly reduced risk for cancer, according to an industry-supported study in JAMA. Nearly 15,000 male U.S. physicians aged 50 and older were randomized to a daily multivitamin or placebo and then followed for roughly 11 years. Multivitamin recipients had a small but significant reduction in total cancer […]

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September 17th, 2012

Resuming Warfarin After a GI Bleed: Benefits Appear to Outweigh the Risks

Nicholas Downing, MD

Many patients who’ve had a warfarin-associated gastrointestinal bleed can safely resume warfarin therapy soon after the bleeding event, according to an industry-funded, retrospective study in the Archives of Internal Medicine. Researchers identified some 440 adults who experienced a GI bleed while taking warfarin; nearly 60% either stayed on warfarin continuously or resumed treatment within about a […]

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July 12th, 2012

Clopidogrel–PPI Interaction Deemed ‘Clinically Unimportant’

Nicholas Downing, MD

The interaction between clopidogrel and proton-pump inhibitors is “clinically unimportant,” researchers conclude in BMJ. The researchers used U.K. registries to study some 24,000 acute coronary syndrome patients who were prescribed both aspirin and clopidogrel; half the patients also received a PPI at some point during the study. After nearly a year’s follow-up, incident MI or all-cause mortality […]

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July 10th, 2012

Intensive Insulin Therapies Similarly Efficacious in Diabetes

Nicholas Downing, MD

Multiple daily insulin injections and continuous subcutaneous insulin analogue infusion are similarly effective in lowering hemoglobin A1c levels while limiting episodes of severe hypoglycemia in type 2 diabetes, according to a systematic review published in the Annals of Internal Medicine. The analysis included 33 randomized controlled trials among children and adults with type 1 or type […]

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May 16th, 2012

Changes in Air Pollution During Beijing Olympics Tied to Inflammatory Biomarkers

Nicholas Downing, MD

Reductions in air pollution during the Beijing Olympics were associated with decreases in certain biomarkers of inflammation and thrombosis in healthy young adults, according to a JAMA study. Researchers measured levels of air pollutants in 2-week periods before, during, and after the Olympics, and also measured blood levels of cardiovascular disease biomarkers in 125 healthy medical […]

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April 17th, 2012

What’s in a Name? Go for the Generic

Nicholas Downing, MD

A recent report published in the Archives of Internal Medicine highlights some “low-hanging fruit” for anyone trying to deliver more cost-effective healthcare. The authors (I am the first author and Harlan Krumholz, CardioExchange editor-in-chief, is the senior author) describe how branded formulations of fenofibrate — marketed by Abbott as Tricor and Trilipix — account for the vast majority […]

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