Results of the Carotid Revascularization Endarterectomy Versus Stenting Trial (CREST) were presented in San Antonio at the American Stroke Association’s International Stroke Conference 2010. The trial compared carotid endarterectomy to carotid stenting in 2,502 patients at centers in the US and Canada. The primary outcome—the 30 day rate of stroke, death, and MI combined with the rate…

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Carotid Stenting vs. Endarterectomy: The International Carotid Stenting Study (ICSS) is an ongoing randomized trial comparing carotid stenting to carotid endarterectomy in 1,713 patients. The primary endpoint is the 3-year rate of fatal or disabling stroke. The ICSS investigators report in the Lancet the results of an interim safety analysis. The rate of stroke, death,…

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AHA/ACC Publish Science Advisory on Thiazolidinedione Drugs: Apparently in response to the renewed controversy over rosiglitazone (Avandia), the AHA and the ACC published a science advisory on thiazolidinedione drugs and cardiovascular risks. The advisory contains a highly detailed and balanced analysis of the issue. The authors, led by Sanjay Kaul, conclude that “an association between…

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Avandia Stays in the News: Responding to all the news last weekend about rosiglitazone (Avandia), the FDA announced an ongoing review of the cardiovascular safety of Avandia based on the RECORD trial and published a safety announcement along with additional information for patients and healthcare professionals. Adding even more drama to events, a New York Times story by Gardiner Harris…

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Distal Protection for Primary PCI: The DEDICATION (Drug Elution and Distal Protection in STElevation Myocardial Infarction Trial) trial has turned up a troubling suggestion of an increased risk for stent thrombosis in STEMI patients who received distal protection (DP) adjunctive to primary PCI. In a study appearing in the Journal of the American College of Cardiology, the…

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A front page story in the New York Times reports that U.S. Senators and FDA officials are raising new questions about Avandia (rosiglitazone). A soon-to-be-released Senate report asks whether it is ethical to continue the ongoing 16,000 patient TIDE trial, while several FDA officials recommend that the drug should be removed from the market. In…

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The combination of benazepril plus amlodipine was more effective than the combination of benazepril plus hydrochlorothiazide in preventing progression of chronic kidney disease, according to a new report from the Avoiding Cardiovascular Events in Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial published online in the Lancet. ACCOMPLISH investigators had previously reported the main results of…

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Statins & Diabetes: Following the recent observation from JUPITER of an increased risk of developing diabetes among patients taking rosuvastatin, a large meta-analysis in the Lancet by Sattar et al. has found a small but significant increase in the risk of diabetes for all statins. The authors conclude that “the risk is low both in absolute terms…

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HRT & Increased Risk: A new report from the Women’s Health Initiative in the Annals of Internal Medicine finds “no suggestion of a decreased risk for CHD … within the first 2 years” of HRT, even in women who started therapy within 10 years after menopause. For women who started HRT close to menopause, a “possible”…

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Bill Clinton’s stent procedure received enormous amounts of attention in the news. Some of the reports even contained various doses of truthful information, though many were riddled with inaccuracies and misperceptions. According to reliable accounts, Clinton had a closed vein graft and received two Xience stents in his left circumflex artery at Columbia-Presbyterian Medical Center…

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