There has been widespread debate and disagreement over the clinical significance of people with reduced function CYP2C19 genotypes who take clopidogrel. In an effort to shed light on the topic, Jessica Mega and colleagues analyzed data from 9685 patients enrolled in nine clinical trials. Some 26% of patients had 1 reduced-function allele, and 2% had…

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It looks like Pradaxa (dabigatran) will cost about $237 a month at the drugstore counter. A Boehringer Ingelheim representative says the wholesale acquisition cost (WAC) of the drug is set at $6.75 per day for 2 pills. The price will apply to both the 150-mg and the 75-mg capsules.  According to knowledgeable experts, the retail…

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An alphabet soup of medical organizations (ACCF, SCCT, ACR, AHA, ASE, etc.) have updated their appropriate use criteria for cardiac CT. The lengthy document includes an evaluation of 93 clinical scenarios and finds that cardiac CT is appropriate in 38% of them. Use of cardiac CT in the rest of the scenarios is deemed inappropriate…

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A very long time ago, barbers performed surgical procedures. Now, once again, barbers may have a role to play in the health care of their community. In the BARBER-1 trial, published in the Archives of Internal Medicine, Ronald Victor and colleagues compared two hypertension monitoring and referral programs based in 17 black-owned barbershops in Texas….

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Our coverage of the FDA’s approval of dabigatran for the prevention of stroke and blood clots in patients with AF has triggered a flurry of comments from CardioExchange members, including questions about when dabigatran will be available, how much it will cost, who should — and shouldn’t — receive it, and what dosages should be…

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The American Heart Association published revised recurrent stroke prevention guidelines. The new guidelines state that recurrent stroke may be prevented by carotid angioplasty or by treating metabolic syndrome. The FDA warned about arrhythmias tied to HIV therapy. The FDA today updated the label for Invirase (saquinavir), noting that when used in combination with Norvir (ritonavir)…

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Weekly INR self-testing at home is comparable to monthly point-of-care testing, according to results of THINRS (the Home International Normalized Ratio Study), published in the New England Journal of Medicine. David Matchar and colleagues found no difference in the incidence of stroke, major bleeding episode, or death in the 2922 patients taking warfarin who were randomized to…

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The FDA announced on Tuesday that it has approved Pradaxa (dabigatran, Boehringer Ingelheim) for the prevention of stroke and blood clots in patients with atrial fibrillation. The drug will be available in 75-mg and 150-mg capsules. “Unlike warfarin, which requires patients to undergo periodic monitoring with blood tests, such monitoring is not necessary for Pradaxa,”…

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A new study adds to the evidence linking periodontal disease to cardiovascular events, suggesting a common basis in acute inflammation. In a report in the Annals of Internal Medicine, Caroline Minassian and colleagues analyzed a Medicaid database of 1175 patients discharged with ischemic stroke or MI who had received invasive dental treatment. They observed a…

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The FDA Cardiovascular and Renal Advisory Committee has endorsed the status quo for Aranesp (darbepoetin alfa). The committee met on Monday to discuss the Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT) and voted 15-1-1 against withdrawal of the indication for chronic kidney disease (CKD) patients not on dialysis. The committee also voted against adoption…

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