CardioExchange Archive

March 9th, 2010

Which Focus for Statin Therapy: Treat More Patients or Ensure Better Adherence?

JoAnne M. Foody, MD

Millions of people who take statins to reduce their cholesterol levels do not adhere to their prescribed regimens. That’s troubling in light of estimates from a recent analysis of data from more than 40,000 participants in the Melbourne Collaborative Cohort Study. It showed that if the percentage of patients with at least 80% adherence to […]

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February 19th, 2010

Who Does and Who Doesn’t Get Aspirin? Can We Do Better?

Christopher Paul Cannon, MD

Aspirin is the best known and most widely used preventive therapy. A century of clinical experience and randomized trials in over 250,000 patients have proved its benefit in preventing cardiovascular events, and it costs pennies a day. So how can it be that not everyone who needs it gets it? In a new report, we used […]

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February 12th, 2010

Statins for Preventing CAD: Is It Better to Tailor Treatment or Treat to Target?

James De Lemos, MD

We welcome Rodney A. Hayward, MD, to this forum to talk about his recent article Optimizing Statin Treatment for Primary Prevention of Coronary Artery Disease (Ann Intern Med 2010; 152:69), which was coauthored by Harlan Krumholz, MD, Editor of CardioExchange. James de Lemos, MD, asked Hayward some key questions. We encourage you to ask yours and […]

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February 7th, 2010

Tackling Tobacco Cessation

Joseph S. Ross, MD, MHS

Last week, I posted a Voices blog detailing my concerns about a recent randomized controlled trial of varenicline that, in my opinion, was just another weak safety study. Absent from that post was a discussion of varenicline’s effectiveness, which was significant. At 12 weeks, 47% of varenicline users had been continuously abstinent, versus 14% of […]

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January 22nd, 2010

Chantix and Cardiovascular Risk: Another Weak Safety Study

Joseph S. Ross, MD, MHS

In 2008, Dr. John Spangler of the Wake Forest University School of Medicine wrote a letter to the editor of Current Medical Research and Opinion expressing concern about a Pfizer-funded, randomized, placebo-controlled trial of the smoking-cessation drug varenicline (Chantix). By 1 year, the varenicline group had experienced a higher rate of serious adverse events than the […]

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January 13th, 2010

Americans IGNORE prevention

JoAnne M. Foody, MD

The American Heart Association has issued its Heart Disease and Stroke Statistics 2010 Update, which underlines the fact that most Americans are ignoring prevention. While more than half a trillion dollars is spent annually on heart disease, little is spent on prevention. What can we do to change this? If more money were available for prevention, how do you think […]

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December 16th, 2009

FDA Advisers Recommend Expanded Use of Rosuvastatin

JoAnne M. Foody, MD

The Associated Press reports that, based on the JUPITER study, an FDA panel of advisers has recommended expansion of rosuvastatin. The FDA is expected to decide whether to act on this recommendation in 2010. According to the report, Astra Zeneca will develop an approach to use rosuvastatin in all patients at risk for heart disease based on hypertension and family history. […]

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December 7th, 2009

Dabigatran vs Warfarin: War or Peace?

Samuel Goldhaber, MD

CardioExchange Editors: Given the results of both your RE-COVER study and the recently published RE-LY study, should anybody still be using warfarin? Goldhaber: Warfarin is not going to fade away into oblivion.  Anyone currently stable on warfarin has little reason to abandon this time-tested drug.  If once monthly INRs are usually in the therapeutic range, and if […]

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November 20th, 2009

Remembering to Hold the Salt

Joseph S. Ross, MD, MHS

I think we can all agree that counseling patients on diet is one of the least rewarding parts of being a doctor. Nobody likes telling adults what they can and cannot eat. And sometimes the recommendations seem so obvious that, to us, it borders on nagging. Of course patients with hypertension and heart failure should avoid salt.  Of […]

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November 16th, 2009

ARBITER 6-HALTS: Will you change your practice? Will you halt your use of ezetimibe?

JoAnne M. Foody, MD

ARBITER 6-HALTS provides provocative information and suggests that niacin is the preferred secondary agent once statin therapy is maxed out in high-risk CAD patients with low HDL levels (for the study, go here; for editorials, go here and here; for a summary and analysis of the study, go here; and for a question-and-answer session with the author, go here). […]

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