RCT: Effect of aliskiren on postdischarge mortality and heart failure readmissions - results from the ASTRONAUT study
Source: JAMA
Area: News
The Journal of the American Medical Association has featured a study evaluating the addition of aliskiren (a direct renin inhibitor) to standard therapy in the management of patients with heart failure and its effects on the rate of cardiovascular death or rehospitalisation due to heart failure (HF).
The double-blind, placebo-controlled study involved patients with haemodynamically stable HF after a median of 5 days after admission into hospital. Eligible patients were 18 years or older with left ventricular ejection fraction (LVEF) 40% or less, elevated natriuretic peptides (brain natri...
Source: NeLM - Cardiovascular Medicine - March 12, 2013 Category: Cardiology Source Type: news
SMC accepts rivaroxaban (Xarelto®) for treatment of PE and prevention of recurrent DVT or PE
Source: Scottish Medicines Consortium (SMC)
Area: Evidence > Drug Specific Reviews
The Scottish Medicines Consortium has accepted rivaroxaban (Xarelto®) for the treatment of pulmonary embolism (PE), and prevention of recurrent deep vein thrombosis (DVT) and PE in adults in NHS Scotland.
According to the SMC advice, rivaroxaban was non-inferior to a regimen including a low molecular weight heparin and a vitamin K antagonist for the treatment of PE and the prevention of recurrence of DVT or PE. The duration of treatment was 3, 6 or 12 months at the discretion of the treating physician. Experience with ...
Source: NeLM - Cardiovascular Medicine - March 12, 2013 Category: Cardiology Source Type: news
Variations in the organization and delivery of the 'NHS health check' in primary care
Source: Journal of Public Health
Area: Evidence > Medicines Management > References
Background: To evaluate the organisation of the new cardiovascular risk assessment programme, NHS Health Checks, in general practices.
Methods: All 99 general practices in two inner London boroughs were invited to participate in a cross-sectional survey by completing an online questionnaire.
Results: Data were analysed for 66/99 (67%) eligible practices. Training attended for delivering the Health Check included measurement methods (43%), delivering risk information (65%) and advising on lifestyle change (62%). The ...
Source: NeLM - Cardiovascular Medicine - March 12, 2013 Category: Cardiology Source Type: news
EMA starts risk-benefit review of nicotinic acid and related substances
Source: European Medicines Agency
Area: News
The European Medicines Agency (EMA) has started a review of nicotinic acid and its related substances acipimox and xantinol nicotinate used to treat lipid disorders.
The review follows new data from a study which found the combination of nicotinic acid and laropiprant did not reduce the risk of major vascular events, and was in fact associated with a higher frequency of non-fatal but serious side effects. As a result, the EMA recommended the suspension of medicines containing the combination of nicotinic acid and laropiprant across the EU.
As data from th...
Source: NeLM - Cardiovascular Medicine - March 11, 2013 Category: Cardiology Source Type: news
Treatment of anaemia with darbepoetin alfa in systolic heart failure
Source: New England Journal of Medicine
Area: News
The findings of a study evaluating whether darbepoetin alfa improves clinical outcomes in patients with chronic systolic heart failure and non-iron-deficiency anaemia have been presented at the meeting of the American College of Cardiology and published early online in the New England Journal of Medicine.
The authors note that there is evidence to suggest that increasing haemoglobin (Hb) level with the use of erythropoiesis-stimulating agents (ESAs) may improve outcomes in patients with heart failure and anaemia, but it is not robust. Their study (Reduction of ...
Source: NeLM - Cardiovascular Medicine - March 11, 2013 Category: Cardiology Source Type: news
Fibrinolysis or primary PCI in ST-segment elevation myocardial infarction
Source: New England Journal of Medicine
Area: News
The findings of a study comparing primary percutaneous coronary intervention (PCI) with an early fibrinolytic strategy in patients presenting with acute ST-segment elevation myocardial infarction (STEMI) have been presented at the meeting of the American College of Cardiology and published early online in the New England Journal of Medicine.
The authors note that primary PCI is recommended as the preferred reperfusion strategy in patients with acute STEMI; however this is contingent upon its performance in a timely fashion, and most patients presenting to non-P...
Source: NeLM - Cardiovascular Medicine - March 11, 2013 Category: Cardiology Source Type: news
Effect of platelet inhibition with cangrelor during PCI on ischaemic events
Source: New England Journal of Medicine
Area: News
The findings of a study evaluating whether cangrelor reduces ischaemic complications of percutaneous coronary intervention (PCI) have been presented at the meeting of the American College of Cardiology and published early online in the New England Journal of Medicine.
The authors note that thrombotic complications during PCI remain a major concern, despite advances in adjunctive pharmacotherapy. Although platelet adenosine diphosphate (ADP) P2Y12 inhibitors reduce the risk of ischaemic events, particularly stent thrombosis, only oral agents are currently availa...
Source: NeLM - Cardiovascular Medicine - March 11, 2013 Category: Cardiology Source Type: news
Are low molecular weight heparins preferred to unfractionated heparin in people with renal impairment for treatment indications?
Source: South West Medicines Information and Training
Area: Evidence > Medicines Q & A
. The American College of Chest Physicians (ACCP), National Institute for Health and Clinical Excellence (NICE) and British Society of Haematology (BSH) suggest the use of unfractionated heparin (UFH) may be preferred over low molecular weight heparins (LMWHs) for treatment indications in patients with severe renal impairment (RI) i.e. a CrCl of <30ml/min.
. Important advantages of UFH compared to LMWHs are that its renal excretion is minimal, it has a relatively short half-life and its effects can be easily monitore...
Source: NeLM - Cardiovascular Medicine - March 11, 2013 Category: Cardiology Source Type: news
Conference report: Eplerenone in patients with acute STEMI without heart failure
Source: PharmaLive
Area: News
PharmaLive has reported on results from the REMINDER trial, which evaluated eplerenone in the early treatment of acute ST-segment elevation myocardial infarction (STEMI). These results were presented at the 62nd Annual Scientific Session of the American College of Cardiology.
The REMINDER study included 1,012 patients with acute STEMI without a history of heart failure (HF) or an ejection fraction of <40% and without signs of HF. They were randomised to treatment (preferably before myocardial reperfusion) with eplerenone (25-50 mg OD) or placebo in addition to standard th...
Source: NeLM - Cardiovascular Medicine - March 11, 2013 Category: Cardiology Source Type: news
Horizon Scanning: Pitavastatin versus pravastatin for LDL cholesterol reduction in HIV infected adults with dyslipidaemia
Source: BioSpace
Area: News
According to a report in BioSpace, results of a comparative superiority study investigating pitavastatin 4mg versus pravastatin 40mg in adult HIV infected patients with dyslipidaemia met its primary endpoint, percent reduction in LDL cholesterol, and reported that, after 12 weeks of therapy, pitavastatin had a significantly greater decrease in LDL cholesterol compared with pravastatin (pitavastatin 31% vs. pravastatin 21% reduction, p<0.001).
The overall incidence of treatment emergent adverse events was 61.1% for pitavastatin and 62.7% for pravastatin.
Pravastatin is...
Source: NeLM - Cardiovascular Medicine - March 8, 2013 Category: Cardiology Source Type: news
RCT: High-dose allopurinol reduces left ventricular mass in patients with ischaemic heart disease
Source: J Am Coll Cardiol
Area: News
Left ventricular hypertrophy (LVH) is common in patients with IHD including normotensive patients. Allopurinol, a xanthine oxidase inhibitor, has been shown to reduce LV afterload in IHD and may therefore also regress LVH. This randomised placebo-controlled study sought to ascertain if high-dose allopurinol regresses left ventricular mass (LVM) in patients with ischemic heart disease (IHD). Sixty six patients with IHD and LVH were randomised to either 600mg allopurinol daily or placebo for 9 months. The primary outcome measure was change in LVM, assessed by cardiac magnetic resonance i...
Source: NeLM - Cardiovascular Medicine - March 8, 2013 Category: Cardiology Source Type: news
Systematic review and meta-analysis of new oral anticoagulants in addition to single or dual antiplatelet therapy after an acute coronary syndrome
Source: European Heart Journal
Area: News
Oral vitamin K antagonists have been shown to prevent recurrent ischaemic events after acute coronary syndrome (ACS), both as mono-therapy and in combination with aspirin, but substantially increase bleeding. The potential of new oral anticoagulants as antithrombotic therapy after ACSs has been investigated over the past few years and consistent increases in bleeding and the less consistent reduction in ischaemic events have been reported. The overall benefit-risk profile of adding new oral anticoagulants to antiplatelet treatment after an ACS is unknown.
This meta-anal...
Source: NeLM - Cardiovascular Medicine - March 7, 2013 Category: Cardiology Source Type: news
American Society of Clinical Oncology Clinical Practice Guideline on central venous catheter care for the patient with cancer
Source: JCO
Area: News
This evidence-based guideline addresses catheter type, insertion site, and placement as well as effective prophylaxis and management of catheter related infections, prophylaxis of catheter related thrombosis and treatment of catheter related occlusions. (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 7, 2013 Category: Cardiology Source Type: news
Systematic review and meta-analysis of effect of statins on cardiovascular and renal outcomes in patients with chronic kidney disease
Source: European Heart Journal
Area: News
This systematic review and meta-analysis investigated the balance of risks and benefits of statin therapy in patients with chronic kidney disease (CKD) and the effect of kidney function on statin use.
A literature search was conducted for prospective RCTs assessing the effects of statins on cardiovascular outcomes in people with CKD published between 1970 and November 2011. Thirty-one trials that include at least one event were identified, providing data for 48,429 patients with CKD, including 6690 major cardiovascular events and 6653 deaths.
The following ...
Source: NeLM - Cardiovascular Medicine - March 7, 2013 Category: Cardiology Source Type: news
Systematic review and meta-analysis of new oral anticoagulants in addition to single or dual antiplatelet therapy after an acute coronary syndrome
Source: European Heart Journal
Area: News
Oral vitamin K antagonists have been shown to prevent recurrent ischaemic events after acute coronary syndrome (ACS), both as mono-therapy and in combination with aspirin, but substantially increase bleeding. The potential of new oral anticoagulants as antithrombotic therapy after ACSs has been investigated over the past few years and consistent increases in bleeding and the less consistent reduction in ischaemic events have been reported. The overall benefit-risk profile of adding new oral anticoagulants to antiplatelet treatment after an ACS is unknown.
This meta-anal...
Source: NeLM - Cardiovascular Medicine - March 7, 2013 Category: Cardiology Source Type: news
