CardioExchange Archive

February 24th, 2015

Increased Risk with NSAIDs Following Myocardial Infarction

Larry Husten, PHD

The cardiovascular safety of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and diclofenac  has been the subject of considerable uncertainty and controversy. Now a new study published in JAMA raises specific concerns about the safety of these drugs in the highly vulnerable population of people who have had a recent myocardial infarction. Using data from several linked national […]

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February 16th, 2015

Cardiovascular Risk Calculators Overestimate

Larry Husten, PHD

Calculating cardiovascular risk has become a central and highly controversial component of cardiovascular guidelines. Now a study in the Annals of Internal Medicine finds that most of the commonly employed tools seriously overestimate the risk of people today. Researchers used data from 4,227 people enrolled in the Multi-Ethnic Study of Atherosclerosis (MESA) between 2000 and 2002 to assess the predictive […]

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January 14th, 2015

Ticagrelor Improves Outcomes After Myocardial Infarction

Larry Husten, PHD

For the first time, a very large trial has shown that dual antiplatelet therapy (DAPT) improves cardiovascular outcomes when given to patients 1 to 3 years after a myocardial infarction. Because DAPT has been shown previously to reduce the high risk of recurrent events for up to a year following an MI, it is considered to be standard […]

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January 12th, 2015

High Rate of Inappropriate Use of Aspirin for Primary Prevention

Larry Husten, PHD

More than a third of U.S. adults — more than 50 million people — now take aspirin for the primary and secondary prevention of cardiovascular disease. Although it was once broadly recommended, aspirin for the primary prevention of cardiovascular disease is now only indicated in people who have a moderate-to-high 10-year risk. Now a new report published in […]

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December 4th, 2014

No Evidence to Support Routine Use of Aspirin in Women for Primary Prevention

Larry Husten, PHD

Although once widely recommended, aspirin for primary prevention has lost favor in recent years, as the large number of bleeding complications appeared to offset the reduction in cardiovascular events. But at the same time evidence has emerged demonstrating the long-term effect of aspirin in preventing colorectal cancer, leading some to think that the risk-to-benefit equation […]

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November 17th, 2014

Large Japanese Trial Casts Further Doubt on Aspirin for Primary Prevention

Larry Husten, PHD

A large trial from Japan failed to provide any evidence to support the use of routine aspirin in high-risk elderly people to prevent a first cardiovascular event. The Japanese Primary Prevention Project (JPPP),  presented at the American Heart Association meeting in Chicago and published simultaneously in JAMA, enrolled patients between 60 and 85 years of age with hypertension, dyslipidemia, or […]

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September 10th, 2014

FDA Advisory Panel Offers Cautious Support for Polypill

Larry Husten, PHD

The controversial polypill took one step closer to reaching the U.S. market after receiving a mostly positive reception from the FDA’s Cardiovascular and Renal Drugs Advisory Committee on Wednesday. The idea for the polypill– which in this case would be composed of aspirin, a statin, and one or more blood pressure drugs– has been kicking around for […]

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May 5th, 2014

FDA Comes Out Against Aspirin for Primary Prevention

Larry Husten, PHD

In the latest development in a long-simmering debate, the FDA has announced that aspirin should not be marketed for primary prevention for heart attack or stroke. The announcement follows the FDA’s rejection on Friday of Bayer Healthcare’s decade-old petition requesting approval of a primary prevention indication. [PDF of FDA rejection letter] Aspirin is still widely used for primary prevention. Many physicians, […]

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April 24th, 2014

Selections from Richard Lehman’s Literature Review: April 24th

Richard Lehman, BM, BCh, MRCGP

This week’s topics include trials of aspirin and clonidine in patients undergoing noncardiac surgery, changes in diabetes-related complications in the U.S., and more.

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March 31st, 2014

Aspirin and Clonidine Fail to Help Surgery Patients

Larry Husten, PHD

Myocardial infarction (MI) is among the most common and serious side effects of noncardiac surgery. An effective regimen to minimize this risk has been the subject of considerable debate in recent years. The controversy was recently exacerbated because the recommendation to use beta-blockers in this setting was based on research which has now been discredited. Substantial […]

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