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Archives for January 2010

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Engage with independent insights, opinions, and analysis from an array of leaders in cardiology.
Avatar of Joseph S. Ross, MD, MHS

Chantix and Cardiovascular Risk: Another Weak Safety Study (22 Jan 2010)

Joseph Ross, MD, MHS

In 2008, Dr. John Spangler of the Wake Forest University School of Medicine wrote a letter to the editor of Current Medical Research and Opinion expressing concern about a Pfizer-funded, randomized, placebo-controlled trial of the smoking-cessation drug varenicline (Chantix). By 1 year, the varenicline group had experienced a higher rate of serious adverse events than the placebo group; many were cardiovascular (CV) events. The difference was not statistically significant, but Spangler considered it clinically significant and deserving of further study.   When I initially read Spangler’s letter and reviewed the varenicline… Continue Reading

Avatar of Paul S. Chan, MD, MS

Do Rapid Response Teams and Remote ICU Monitoring Actually Prevent Deaths? (19 Jan 2010)

Paul S. Chan, MD, MS

Hospitals devote a lot of resources to preventing in-hospital cardiac arrests. That makes sense because when one actually occurs, the patient has only a 1 in 6 chance of surviving to discharge. Two popular strategies for helping clinicians recognize and treat clinical deterioration before an in-hospital cardiac arrest are remote ICU monitoring and rapid response teams. After all, it’s intuitively appealing to pay close attention to patients who are doing poorly and, when they deteriorate, to intervene quickly and change their course. Yet, evidence regarding the effectiveness of these two… Continue Reading

Avatar of L. David Hillis, MD

Lp(a): Risk and Relevance (6 Jan 2010)

L. David Hillis, MD

Clarke et al. provide convincing evidence that plasma Lp(a) lipoprotein is causally related to coronary artery disease. What’s needed next? First, we need to assess whether knowledge of Lp(a) lipoprotein concentrations improves predictive discrimination over more traditional risk factors. Second, we need an intervention that selectively lowers plasma Lp(a) lipoprotein concentrations and a randomized clinical trial to assess its efficacy. Of currently FDA-approved medications, niacin is the only agent that effectively lowers plasma Lp(a) lipoprotein concentrations. Is it time for a randomized trial of niacin in patients with elevated plasma Lp(a) lipoprotein concentrations?

Avatar of Harlan M. Krumholz, MD, SM

Top Cardiology Stories of 2009 (3 Jan 2010)

Harlan M. Krumholz, MD, SM

Dear Readers, This year the annual Journal Watch Cardiology Top Stories feature has a new dimension. We are presenting two lists — one from us and one from you. To create the Journal Watch Cardiology 2009: Editors’ Choice list, our editors voted for the stories that they believe to be most important to you and your practices. For the Top 10 Most Read Online list, we looked at which cardiology stories were viewed most often by Journal Watch registered users and subscribers. Surprisingly, the lists have only one story in… Continue Reading

Avatar of Harlan M. Krumholz, MD, SM

CardioExchange in 2010 (3 Jan 2010)

Harlan M. Krumholz, MD, SM

Happy New Year! On behalf of everyone at CardioExchange, I want to thank you for being part of our experiment. I hope that all of you have seen the potential for what a community of cardiologists led by a group of independent experts can do to improve patient care. CardioExchange is still very much a work in progress, and we realize that many of you are still trying to figure out what this site is and what needs it fulfills in your busy days. And we know that many of… Continue Reading