For the second time in the past 6 months, a cardiology mainstay drug has lost patent protection and gone generic. Today, the FDA announced that it had approved several generic versions of clopidogrel (Plavix), the antiplatelet drug that for many years was the second best-selling drug in the world. Last November, the best-selling drug of all time,…

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A very large meta-analysis provides strong evidence that the relative reduction in vascular risk with statins is at least as great in low-risk patients as in high-risk patients. The finding, write the authors, provides evidence that expansion of guidelines to lower-risk populations should be considered. In their paper in the Lancet, the Cholesterol Treatment Trialists’ (CTT)…

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Coffee drinking is inversely associated with mortality in a dose-dependent manner, according to a New England Journal of Medicine study. Mortality risks were actually higher until the researchers adjusted for smoking — common among coffee drinkers. Over 400,000 people aged 50 to 71 were followed for roughly 14 years after completing an extensive questionnaire on…

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A genetics-based analysis finds that raising HDL will not necessarily lower risk for myocardial infarction. Reporting in the Lancet, researchers describe a two-pronged approach. First, they searched for the presence of a specific allele (LIPG Asn396Ser, associated with higher HDL levels in carriers) in a large cohort of subjects with and without MI. The allele’s…

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The antibiotic azithromycin — which may have proarrhythmic properties — is associated with increased risk for cardiovascular death, according to a retrospective cohort study in the New England Journal of Medicine. The study, in a Medicaid population, included nearly 350,000 azithromycin prescriptions, 1.4 million control periods without antibiotic prescriptions, and 1.8 million prescriptions for other…

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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…

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Routine exercise echocardiography in asymptomatic patients after revascularization does not lead to better outcomes, according to a new study published in Archives of Internal Medicine. Although guidelines generally discourage the practice, post-revascularization stress tests are still commonly performed. Serge Harb and colleagues performed exercise echocardiography on 2105 patients after CABG surgery or PCI and followed…

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The biggest drawback to drug-eluting stents has been the requirement for prolonged dual antiplatelet (DAPT) therapy following stent implantation to prevent stent thrombosis and other potential complications. The precise length of DAPT has been the subject of considerable discussion and research. Now the Xience Prime and Xience V everolimus-eluting stents have received the CE Mark…

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Interventional cardiology leader William O’Neill is leaving the University of Miami Miller School of Medicine to become the medical director of the new Center for Structural Heart Disease at Henry Ford Hospital in Detroit. The new center will focus on new minimally invasive treatments for heart failure and heart valve disease. Prior to going to Miami in…

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A large study looking at real-world use of elective coronary artery bypass surgery (CABG) and stenting (PCI) in New  York State finds that nearly two thirds of PCI procedures have inappropriate or uncertain indications. By contrast, 90% of CABG procedures were deemed appropriate and 1.1% inappropriate. In a paper published in the Journal of the American…

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