CardioExchange Archive

November 2nd, 2010

Meta-Analysis Provides Little Support for Prophylactic ICD Use in Older Adults

Amy Herman

Prophylactic implantable cardioverter-defibrillator (ICD) therapy does not appear to significantly improve survival among older adults with severe left ventricular dysfunction, according to a meta-analysis in the Annals of Internal Medicine. Researchers analyzed data from five randomized trials comparing ICD therapy with medical treatment among some 5800 adults with cardiomyopathy. Older adults (defined as 60 and older […]

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November 2nd, 2010

Is Dabigatran More Cost-Effective Than Warfarin in AF?

Amy Herman

Dabigatran, newly approved by the FDA to prevent stroke in patients with atrial fibrillation (AF), might turn out to be a cost-effective alternative to warfarin, according to an Annals of Internal Medicine study. Using data from the RE-LY trial, James Freeman and colleagues modeled the quality-adjusted survival and cost-effectiveness of dabigatran compared with high- or low-dose warfarin […]

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November 1st, 2010

ROCKET AF: Is Rivaroxaban Ready for Blast Off?

Harlan M. Krumholz, MD, SM

With the approval of dabigatran and now the preliminary and partial results of ROCKET AF, we’ll  need to be familiar with much more than just warfarin to address the anticoagulation needs of our patients. The early word on ROCKET AF, which will be presented at AHA, is that rivaroxaban is at least as effective as warfarin […]

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November 1st, 2010

Rivaroxaban Equals Warfarin in ROCKET AF

Larry Husten, PHD

Rivaroxaban (Xarelto) was as effective as warfarin in patients with AF in the ROCKET AF study, according to an announcement released by Bayer on Sunday ahead of the  trial’s scheduled presentation at the AHA on November 15. ROCKET AF randomized more than 14,000 patients with nonvalvular AF to either rivaroxaban or warfarin. The goal of the […]

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October 26th, 2010

Dabigatran to Cost $237 per Month at the Drugstore

Larry Husten, PHD

It looks like Pradaxa (dabigatran) will cost about $237 a month at the drugstore counter. A Boehringer Ingelheim representative says the wholesale acquisition cost (WAC) of the drug is set at $6.75 per day for 2 pills. The price will apply to both the 150-mg and the 75-mg capsules.  According to knowledgeable experts, the retail […]

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October 22nd, 2010

What Do I Plan to Do with Dabigatran?

Richard A. Lange, MD, MBA

1. Discuss its pros (no need for INR monitoring, less bleeding than coumadin) and cons (cost, dyspepsia) with my atrial fibrillation patients 2. Avoid its use in patients with renal dysfunction (CrCl  <60), liver disease, pregnancy or stroke within the past 6 months 3. Lament the absence of the INR monitoring requirement, which I currently […]

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October 21st, 2010

News Briefs: Recurrent Stroke Prevention Guidelines, Vernakalant Trial Suspended, GSK Investigated, Generic Enoxaparin Takes Off, Kaul Speaks, Midei Sues

Larry Husten, PHD

The American Heart Association published revised recurrent stroke prevention guidelines. The new guidelines state that recurrent stroke may be prevented by carotid angioplasty or by treating metabolic syndrome. The FDA warned about arrhythmias tied to HIV therapy. The FDA today updated the label for Invirase (saquinavir), noting that when used in combination with Norvir (ritonavir) it […]

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October 21st, 2010

INR Home Testing Found Comparable to Point-of-Care Testing

Larry Husten, PHD

Weekly INR self-testing at home is comparable to monthly point-of-care testing, according to results of THINRS (the Home International Normalized Ratio Study), published in the New England Journal of Medicine. David Matchar and colleagues found no difference in the incidence of stroke, major bleeding episode, or death in the 2922 patients taking warfarin who were randomized to […]

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October 21st, 2010

Let’s Call the Whole Thing Off!

Larry Husten, PHD

Some say “dabby-gat-ran.” I say “duh-big-a-tran.” Boehringer Ingelheim wants you to say “pra-dax-a.” One of the most important advances in cardiovascular therapeutics in years is dampened by the inability of cardiologists and other highly educated professionals to agree on how to pronounce “dabigatran.” What do you say? Update: Here’s an official response from a Boehringer spokesperson: “Da-big-a-tran” […]

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October 20th, 2010

Finally: Dabigatran – A New Oral Anticoagulant Is Approved by the FDA

Westby G Fisher, MD

CardioExchange welcomes this guest post reprinted with permission from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem, Evanston, IL, and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. A new era of nonvalvular atrial fibrillation management has arrived. Tuesday, the FDA approved the first new […]

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