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FDA Grants Apixaban Expanded Indication for Venous Thromboembolism (21 Aug 2014)

The FDA today approved an expanded indication for the oral anticoagulant apixaban (Eliquis, Bristol-Myers Squibb and Pfizer). Apixaban will now be indicated for the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE), and for the reduction in the risk of recurrent DVT and PE (collectively known as venous thromboembolism) after initial therapy. The supplemental new…

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Increased Cardiac Risk Linked to Clarithromycin (19 Aug 2014)

Acute use of the popular macrolide antibiotic clarithromycin has been linked to a small but significant increase in cardiac death. In a report in the BMJ, researchers in Denmark analyzed the effects over a 14-year period of the acute use of penicillin V, roxithromycin, and clarithromycin. Earlier research raised concerns that marcrolide antibiotics in general, and erythromycin and azithromycin…

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An Expert’s Perspective: Why Salt Is Not Like Tobacco and Why Guidelines Are Tricky (18 Aug 2014)

At the center of this week’s renewed debate on salt was Salim Yusuf, the longtime influential and occasionally controversial cardiology researcher and clinical trialist based at McMaster University in Hamilton, Ontario. I spoke with Yusuf before the publication of the New England Journal of Medicine papers, which include his own two papers from the PURE study. Yusuf was troubled…

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New Analysis of Old Study Fuels Debate Over Blood Pressure Guidelines (18 Aug 2014)

In the last year new guidelines relating to cardiovascular disease have been the subject of intense criticism and debate. The status of the blood pressure guidelines has been particularly contentious, since several different groups have published contradictory guidelines, while several authors of the most prominent group, the Eighth Joint National Committee, published an impassioned dissent…

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Two New Studies Fuel the Debate Over Sodium (13 Aug 2014)

Three papers and an editorial in the New England Journal of Medicine are sure to throw fresh fuel on the ongoing fiery debate over sodium recommendations. Current guidelines recommend that people should limit their intake of sodium to 1.5  to 2.4 grams per day, but these recommendations are based on projections and have never been tested in…

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Stroke Risks Associated with Atrial Fibrillation Measured (12 Aug 2014)

Two retrospective JAMA studies examine aspects of the thromboembolic risks that accompany atrial fibrillation. One study measured stroke risks after perioperative AF. Researchers looked at claims data for some 1.7 million surgical patients, roughly 1.4% of whom had perioperative new-onset AF. Stroke rates by the 1-year mark were higher with perioperative AF, both after cardiac surgery (0.99%…

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Study Offers Little Support for an Old Drug (11 Aug 2014)

Digoxin is one of the oldest drugs in the cardiovascular arsenal, derived from the foxglove plant and first described in the 18th century by William Withering. It is frequently used in patients with heart failure (HF) and with atrial fibrillation (AF). The few trials supporting its use were performed in HF patients before newer treatments…

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Neck Manipulation Linked to Cervical Dissection (7 Aug 2014)

After a neck adjustment — also known as cervical manipulative therapy and typically employed by chiropractors and other healthcare providers — people are at increased risk for cervical dissections, which can lead to stroke, according to a scientific statement released by the American Heart Association/American Stroke Association. Although a cause-and-effect relationship is far from being proved, the groups say that…

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Large Analysis Supports Thrombolysis for Stroke (5 Aug 2014)

Although thrombolysis for ischemic stroke has been widely recognized as beneficial, its use has been limited because of concerns about its effects in patients treated after 3 hours, in older patients, and in patients with mild and with severe strokes. Now a meta-analysis published in the Lancet offers evidence that the use of thrombolysis should be…

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Review Panel Exonerates The BMJ in Statin Kerfuffle (4 Aug 2014)

An independent review panel has rejected a demand by a prominent researcher that The BMJ retract two controversial articles. The report largely exonerates the journal’s editors from any wrongdoing. As previously reported, Rory Collins, a prominent researcher and head of the Cholesterol Treatment Trialists’ (CTT) Collaboration, had demanded that The BMJ retract two articles that were highly critical of statins. Although The…

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