Cohort study: Chlorthalidone vs. hydrochlorothiazide for the treatment of hypertension
Source: Ann Intern Med Area: News The Annals of Internal Medicine has featured a study comparing the effectiveness and safety of chlorthalidone and hydrochlorothiazide for the treatment of hypertension in older adults.   The Canadian propensity score-matched observational cohort study with up to 5 years of follow-up, incorporated data from 29,873 identified individuals aged 66 years or older who were newly treated with chlorthalidone or hydrochlorothiazide and who were not hospitalised for heart failure, stroke, or myocardial infarction in the prior year. Each chlorthalidone recipient was matched to up to 2 hydro...
Source: NeLM - Cardiovascular Medicine - March 19, 2013 Category: Cardiology Source Type: news

Review: New therapeutic principles in dyslipidaemia
Source: Eur Heart J Area: News This review article on new therapeutic approaches to the treatment of dyslipidaemia focuses on low-density-lipoprotein (LDL) cholesterol-lowering drugs and also those that could potentially modulate other lipoprotein classes linked to LDL, such as lipoprotein a. (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 18, 2013 Category: Cardiology Source Type: news

Review: The long QT syndrome
Source: Eur Heart J Area: News This review focuses on the diagnosis and treatment of the long QT syndrome, including beta-adrenergic blockade, left cardiac sympathetic denervation, implantable cardioverter defibrillators, and gene-specific therapy and management. (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 18, 2013 Category: Cardiology Source Type: news

Vorapaxar in patients with peripheral artery disease: subgroup analysis of the TRA 2P-TIMI 50 study
Source: Circulation Area: News According to research reported early online in Circulation, the addition of vorapaxar to standard therapy for peripheral arterial disease (PAD) was not associated with a statistically significant reduction on the risk of cardiovascular death, MI or stroke. Although it reduced the incidence of acute limb ischaemia and peripheral revascularisation, it was associated with an increased risk of bleeding.   The authors note that patients with PAD are at an increased risk of acute thromboembolic events. Those without clinically manifest coronary or cerebrovascular disease will often have s...
Source: NeLM - Cardiovascular Medicine - March 18, 2013 Category: Cardiology Source Type: news

Review: Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives
Source: European Heart Journal Area: News A review published in the European Heart Journal discusses the use and evidence of intravenous iron therapy on the functional status, quality of life, and exercise capacity  in patients with heart failure. (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 15, 2013 Category: Cardiology Source Type: news

Strategy to reduce salt intake 'could lead to 20,000 fewer deaths each year from cardiovascular disease'
Source: NICE Area: News NICE has reported that a new government strategy to reduce salt intake could lead to 20,000 fewer deaths each year from cardiovascular disease (CVD). In order to limit the harm caused to health by excess of salt, the government has launched a new strategy that aims to help reduce the daily intake of salt from an average of 8.1g a day to 6g a day. The policy follows the NICE pathway on diet, based on guidance originally published in 2010, which recommends aiming for a maximum salt intake of 6g per day per adult by 2015, and 3g by 2025.   NICE says that a 3g reduction of daily salt intake b...
Source: NeLM - Cardiovascular Medicine - March 15, 2013 Category: Cardiology Source Type: news

Cohort study: Smoking, surgery, and venous thromboembolism risk in women
Source: Circulation Area: News Evidence about the effect of smoking on venous thromboembolism risk, generally and in the post-operative period, is limited and inconsistent. A large prospective study of UK women sought to examine the incidence of venous thromboembolism in relation to smoking habits, both in the absence of surgery and in the first 12 post-operative weeks.   The authors followed-up 1,162,718 women, mean age 56 years, for 6 years and reported the following results:   . 4630 women were admitted to hospital for, or died from, venous thromboembolism. . In the absence of surgery, cu...
Source: NeLM - Cardiovascular Medicine - March 15, 2013 Category: Cardiology Source Type: news

European Heart Rhythm Association launches a practical guide on new oral anticoagulants in atrial fibrillation
Source: Eur Heart J Area: News The European Heart Rhythm Association of the European Society of Cardiology has developed a practical guide on how to use the new oral anticoagulants for stroke prevention in atrial fibrillation. The guide has 15 chapters on clinical situations, including start up and follow-up for patients on newer oral anticoagulant drugs.   See the link below for more details (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 15, 2013 Category: Cardiology Source Type: news

RCT: Digoxin reduces 30-day All cause hospital admission in older patients with chronic systolic heart failure
Source: Am J Med Area: News Heart failure is a leading cause of hospital admission and readmission in older adults. The authors of this RCT investigated the effect of digoxin on 30 day all cause hospital admission in older patients with heart failure and reduced ejection fraction. Ambulatory patients with chronic heart failure (ejection fraction ?45%) (n=6,800) were randomly assigned to digoxin or placebo. Of these, 3405 were aged ?65 years (mean age, 72 years and 25% were women). The main outcome in the current analysis was 30-day all-cause hospital admission.   The authors reported the following results: ...
Source: NeLM - Cardiovascular Medicine - March 15, 2013 Category: Cardiology Source Type: news

Editorial: Trastuzumab induced cardiomyopathy-wider implications for cardio-oncology
Source: Heart Area: News This editorial in 'Heart' notes the twofold rise in incidence of breast cancer over the past 20 years and that treatments have become significantly more effective and mortality has fallen by 50% over the last 30 years, though this has required more aggressive treatment regimens. The authors discuss anthracyclines, HER-2, anthracyclines plus trastuzumab and recent clinical studies, and note a number of unresolved issues:   (1) How big a problem is chemotherapy cardiomyopathy in routine clinical practice (2) Do we have effective means of early diagnosis? (3) Are there effective pharm...
Source: NeLM - Cardiovascular Medicine - March 14, 2013 Category: Cardiology Source Type: news

BMJ Analysis: Is an EMA review on hormonal contraception and thrombosis needed?
Source: BMJ Area: News In February 2013, the European Medicines Agency (EMA) announced a review of the safety of combined oral contraceptives, particularly third and fourth generation drugs, including Diane-35(cyproterone acetate 2mg, ethinylestradiol 35mcg) and its generics. The authors of this BMJ Analysis note that third and fourth generation oral contraceptives are overprescribed and that the safest oral contraceptive is one that contains the lowest tolerable dose of ethinylestradiol (lowest dose that prevents breakthrough bleeding; 30mcg) together with the second generation progestogen, levonorgestrel, which is also ...
Source: NeLM - Cardiovascular Medicine - March 14, 2013 Category: Cardiology Source Type: news

Horizon scanning: Phase II study of betrixaban vs. warfarin in patients with atrial fibrillation (Explore-Xa)
Source: Eur Heart J Area: News Betrixaban is an investigational once daily oral factor Xa inhibitor mostly excreted unchanged in the bile and with low (17%) renal excretion. The phase II study assessed its safety and tolerability at three different doses compared with warfarin in 508 patients with AF and more than one risk factor for stroke.   The patients had mean CHADS2 score of 2.2 and 87% had previously received vitamin K antagonist therapy. They were randomised to betrixaban 40, 60, or 80 mg once daily (n= 127 each dose) or unblinded warfarin, adjusted to an INR of 2.0-3.0 (n= 127). The primary outcome was ...
Source: NeLM - Cardiovascular Medicine - March 14, 2013 Category: Cardiology Source Type: news

RCT: Ranolazine shows benefit for persistent angina in patients with type 2 diabetes
Source: Journal of the American College of Cardiology Area: News According to data presented at the American Society of Cardiology annual meeting, and published early online in the Journal of the American College of Cardiology, ranolazine reduced episodes of chest pain in patients with diabetes.   Researchers examined the efficacy of ranolazine versus placebo on weekly angina frequency in patients with type 2 diabetes, coronary artery disease (CAD), and chronic stable angina who remain symptomatic despite treatment with up to 2 anti-anginal agents.   The trial, Type 2 Diabetes Evaluation of Ranolazine i...
Source: NeLM - Cardiovascular Medicine - March 12, 2013 Category: Cardiology Source Type: news

Conference report: Niacin/laropripant combination (Tredaptive) associated with increased risk of bleeding and infections
Source: Reuters Health News Area: News Reuters Health News has reported that according to data presented at the annual American College of Cardiology scientific meeting, niacin in combination with laropripant (Tredaptive) was associated with statistically significantly higher rates of bleeding (2.5% vs 1.9%), and infections (8.0% vs 6.6%) compared to patients taking simvastatin or simvastatin/ezetimibe. They called the differences unexpected.   Additionally, patients taking Tredaptive also experienced higher rates of serious health problems that researchers said are known side effects of niacin, which included ne...
Source: NeLM - Cardiovascular Medicine - March 12, 2013 Category: Cardiology Source Type: news

RCT: Effect of phosphodiesterase-5 inhibition on exercise capacity and clinical status in heart failure - results from the RELAX trial
Source: JAMA Area: News According to research presented at the American College of Cardiology's Annual Scientific Session and published early online in the Journal of the American Medical Association, among patients with heart failure with preserved ejection fraction (HFPEF), phosphodiesterase-5 inhibition with administration of sildenafil for 24 weeks, did not result in significant improvement in exercise capacity or clinical status.   Studies in experimental and human heart failure suggest that phosphodiesterase-5 inhibitors may enhance cardiovascular function and thus exercise capacity in HFPEF. Researchers th...
Source: NeLM - Cardiovascular Medicine - March 12, 2013 Category: Cardiology Source Type: news