1. ARISTOTLE trial: new oral factor Xa inhibitor apixaban is better than warfarin in atrial fibrillation (AF) patients.
2. British scientists have reported that it may be possible for the heart to repair itself after injury, and they have discovered a protein molecule that seems to stimulate this process [Dr Peter Weissberg, medical director of the British Heart Foundation]. The cells that are capable of this healing are already there in the epicardium.
3. Cholesteryl ester transfer protein (CETP) inhibitor dalcetrapib) raised HDL-cholesterol levels without increasing blood pressure and without impairing endothelial function. [dal-VESSEL trial]
4. The FDA is recommending that physicians restrict prescribing high-dose simvastatin (Zocor, Merck) to patients, given an increased risk of muscle damage . The new FDA drug safety communication, states that physicians should limit using the 80-mg dose unless the patient has already been taking the drug for 12 months and there is no evidence of myopathy. Simvastatin 80 mg should not be started in new patients, including patients already taking lower doses of the drug. The new label has warnings not to use the drug with various medications, including itraconazole , ketoconazole, posaconazole , erythromycin, clarithromycin, telithromycin, HIV protease inhibitors, nefazodone, gemfibrozil, cyclosporine, and danazol. In addition, the 10-mg dose should not be exceeded in patients taking amiodarone, verapamil, and diltiazem, and the 20-mg dose should not be exceeded with amlodipine and ranolazine.
5. A trial of high-dose extended-release niacin given in addition to statin therapy in patients with a history of cardiovascular disease, high triglycerides (TG), and low levels of HDL cholesterol has been halted prematurely, 18 months ahead of schedule, because niacin offered no additional benefits in this patient population [AIM-HIGH].
6. New reports of two elderly women faring badly when taking the novel anticoagulant dabigatran for stroke prevention in atrial fibrillation (AF) have prompted more discussion about the caution needed with this drug when treating the very old or those with renal impairment.
7. Sanofi-Aventis has sent US healthcare professionals a letter warning them about cases of rare but severe hepatic injury associated with use of the anti arrhythmic drug dronedarone. The FDA has also issued a “safety communication”.
8. A new Cochrane review has provoked controversy by concluding that there is not enough evidence to recommend the widespread use of statins in the primary prevention of heart disease [Dr Fiona Taylor at London School of Hygiene and Tropical Medicine, UK]
9. New data help shed light on the malpractice risk physicians face in clinical practice. Cardiologists have a higher-than-average risk of being sued, but these lawsuits are less likely to result in a financial payment to plaintiffs. The surgical specialties face the largest threat of litigation, with approximately 20% of neurosurgeons and cardiothoracic surgeons facing a malpractice claim each year. Pediatricians and psychiatrists had the lowest risk of being sued [Dr Amitabh Chandra (Harvard University, Boston].
10. Arrhythmia-free survival rates after a single catheter-ablation procedure are relatively low at five years, just 29%, but the long-term success increases to 63% when outcomes are measured after the last ablation procedure [Dr Rukshen Weerasooriya HÃ´pital Cardiologique du Haut-LÃ©vÃªque, Bordeaux-Pessac, France].