Among patients with atrial fibrillation (AF), women have a higher risk than men of having a stroke, according to a new study published in BMJ. The increased risk was mostly found in women over 65 years of age and in women with multiple risk factors. Leif Friberg and colleagues analyzed data from more than 100,000 Swedish patients…

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Aspirin can help prevent the recurrence of venous thromboembolism (VTE) after discontinuation of anticoagulation therapy, according to results of the WARFASA (the Warfarin and Aspirin) study published in the New England Journal of Medicine. Following 6 to 18 months of oral anticoagulation, 403 patients with first-time unprovoked VTE were randomized to aspirin (100 mg daily) or placebo for…

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The FDA’s Cardiovascular and Renal Drugs Advisory Committee voted today against adding an indication for acute coronary syndromes (ACS) to the label of the anticoagulant rivaroxaban (Xarelto). The vote was 6 to 4 against approval, with 1 abstention. The advisory panel spent most of the day trying to reconcile diametrically opposed views of the pivotal ATLAS ACS…

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Two studies published in JAMA provide additional, but not surprising, information about the relationship between obstructive sleep apnea (OSA) and hypertension — and the role of continuous positive airway pressure (CPAP). In the first study, Ferran Barbé and colleagues randomized 725 people with OSA but no daytime sleepiness to either CPAP or no active treatment. After a…

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The FDA will offer generally positive – but also highly mixed – advice to the FDA’s Cardiovascular and Renal Drugs Advisory Committee when it meets on Wednesday to consider the supplemental new drug application for rivaroxaban (Xarelto, Johnson & Johnson) for use in patients with acute coronary syndrome (ACS) already taking dual antiplatelet therapy. The FDA posted the briefing…

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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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