CADTH review: Antithrombotic therapy for patients with atrial fibrillation
Source: Canadian Agency for Drugs and Technologies in Health (CADTH) Area: News The Canadian Agency for Drugs and Technologies in Health (CADTH) has published a review addressing the use of novel oral anticoagulants (NOAC) and antiplatelet agents for the management of patients with atrial fibrillation (AF). Evidence-informed recommendations were developed to address the following policy questions:   . In AF patients with a lower risk of stroke (CHADS2 score < 2), which antithrombotic therapy is optimal? . In AF patients with a higher risk of stroke (CHADS2 score ? 2) who are unable to achieve a...
Source: NeLM - Cardiovascular Medicine - March 26, 2013 Category: Cardiology Source Type: news

FDA rejects oral treprostinil diolamine for pulmonary arterial hypertension
Source: Reuters Health News Area: News Reuters Health News has reported that the US Food and Drug Administration (FDA) has denied approval of oral treprostinil diolamine for the treatment of pulmonary arterial hypertension. The drug was first rejected by the FDA in October 2012 after it had failed to show statistically significant results in patients taking the six-minute walk test during clinical studies.   The report does not provide information on the reasons for the rejection.   [Editor's note: Treprostinil is not licensed in the UK.] (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 26, 2013 Category: Cardiology Source Type: news

A pharmacist-led, American Heart Association Heart360 web-enabled home blood pressure monitoring program
Source: Circulation: Cardiovascular Quality and Outcomes Area: Evidence > Medicines Management > References Background: To determine whether a pharmacist-led, Heart360-enabled, home blood pressure monitoring (HBPM) intervention improves blood pressure (BP) control compared with usual care (UC). Methods: This randomised, controlled trial was conducted by clinical pharmacy specialists at 10 Kaiser Permanente Colorado clinics.  Patients assigned to the HBPM intervention group were provided a properly fitted home BP cuff (Omron HEM-790IT) and were trained on how to use it.  Patients were as...
Source: NeLM - Cardiovascular Medicine - March 26, 2013 Category: Cardiology Source Type: news

The UK National Health Service: delivering equitable treatment across the spectrum of coronary disease
Source: Circulation: Cardiovascular Quality and Outcomes Area: Evidence > Medicines Management > References Background: Social gradients in cardiovascular mortality across the United Kingdom may reflect differences in incidence, disease severity or treatment.  It is unknown whether a universal healthcare system delivers equitable lifesaving medical therapy for coronary heart disease.  We therefore examined secular trends in the use of key medical therapies stratified by socioeconomic circumstances across a broad spectrum of coronary disease presentations, including acute coronary syndromes, secondary pr...
Source: NeLM - Cardiovascular Medicine - March 26, 2013 Category: Cardiology Source Type: news

Adherence to clinical guidelines in management of diabetes and prevention of cardiovascular disease in Qatar
Source: International Journal of Clinical Pharmacy Area: Evidence > Medicines Management > References Introduction: The prevalence of diabetes mellitus (DM) in the UK increased in 2009 to 4%, of which type-2 diabetes accounts for 85-95% of all cases.  In Qatar the prevalence of DM among the adult Qatari population in 2008 was 16.7%; around four times higher than the prevalence in the UK.  The aim of the study was to design and to apply a medication assessment tool (MAT) to determine the level of adherence to internationally recognised guideline recommendations in type-2 diabetes management and in primary...
Source: NeLM - Cardiovascular Medicine - March 26, 2013 Category: Cardiology Source Type: news

CHMP confirms refusal of marketing authorisation for mipomersen (Kynamro®) for familial hypercholesterolaemia
Source: European Medicines Agency Area: News Following a re-examination, the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended the refusal of the marketing authorisation for mipomersen (Kynamro®), intended for the treatment of patients with certain forms of familial hypercholesterolaemia.   At the request of the applicant, the CHMP re-examined its initial negative opinion, and has confirmed the refusal of the marketing authorisation. Please see the link below for details. (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 25, 2013 Category: Cardiology Source Type: news

CHMP recommends approval of rituximab (MabThera®) for granulomatosis with polyangiitis (Wegener's) and microscopic polyangiitis
Source: European Medicines Agency Area: News The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended the approval of a new indication for rituximab (MabThera®) - for use in combination with glucocorticoids, for the induction of remission in adult patients with severe, active Granulomatosis with polyangiitis (Wegener's) (GPA) and Microscopic polyangiitis (MPA).   Detailed recommendations for the use of this product will be described in the updated summary of product characteristics (SmPC), which will be published in the revised European public assessment r...
Source: NeLM - Cardiovascular Medicine - March 25, 2013 Category: Cardiology Source Type: news

CHMP adopts new indication for new strength of rivaroxaban (Xarelto®)
Source: European Medicines Agency Area: News The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has recommended a variation to the terms of the marketing authorisation for rivaroxaban (Xarelto®).    The CHMP has adopted a new indication for a new strength 2.5mg as follows: "Xarelto, co-administered with acetylsalicylic acid (ASA) alone or with ASA plus clopidogrel or ticlopidine, is indicated for the prevention of atherothrombotic events in adult patients after an acute coronary syndrome (ACS) with elevated cardiac biomarkers."   Detailed conditions...
Source: NeLM - Cardiovascular Medicine - March 25, 2013 Category: Cardiology Source Type: news

Systematic review and meta-analysis looks at risk factors for stroke in patients taking warfarin for AF
Source: Stroke Area: News The results of a systematic review and meta-analysis seeking to identify the risk factors that contribute to stroke risk in patients with atrial fibrillation (AF) who are taking an oral anticoagulant (OAC) have been published early online in the journal 'Stroke'.   The authors note that although OACs reduce the risks of stroke and mortality in patients with AF, some patients taking them will still sustain stroke.  They performed a systematic review to identify contemporary randomised clinical trials investigating OACs in patients with AF, and then performed a meta-analysis of recent...
Source: NeLM - Cardiovascular Medicine - March 25, 2013 Category: Cardiology Source Type: news

Cardiovascular events after clarithromycin use in lower respiratory tract infections: analysis of two prospective cohort studies
Source: BMJ Area: News There have been concerns about the possibility of harmful effects of widespread macrolide use on cardiovascular morbidity and mortality. Whilst clarithromycin is the macrolide that is used most often in the UK, the authors report that no studies have investigated the long term effect of clarithromycin on cardiovascular events and mortality in patients after acute exacerbations of chronic obstructive pulmonary disease (COPD) or community acquired pneumonia (CAP).  They conducted a secondary analysis of two large prospective cohort studies to investigate the association in these patient groups. T...
Source: NeLM - Cardiovascular Medicine - March 22, 2013 Category: Cardiology Source Type: news

European Medicines Agency recommends restricting use of cilostazol-containing medicines
Source: EMA Area: News Following a review of the current evidence, the European Medicines Agency's (EMA) Committee on Medicinal Products for Human Use (CHMP) has recommended that the use of cilostazol in the treatment of intermittent claudication should be restricted with a range of new measures aimed at targeting a patient population in which there are clinical benefits, and at the same time minimising important risks.   The Spanish Agency for Medicines and Health Products (AEMPS) asked the CHMP to carry out a review of cilostazol following a number of reports of serious suspected adverse effects, in particular...
Source: NeLM - Cardiovascular Medicine - March 22, 2013 Category: Cardiology Source Type: news

Meta-analysis of effects of calcium channel blockers in prevention of stroke in adults with hypertension
Source: PLoS One Area: News The specific effects of calcium channel blockers (CCBs) against stroke in patients with hypertension as compared to no treatment and other antihypertensive drug classes are not known.   A systematic review and meta-analysis of data from 273,543 participants in 31 RCTs was conducted to evaluate the efficacy of CCBs on stroke in patients with hypertension in studies of CCBs versus placebo, ACE inhibitors (ACEIs), ?-adrenergic blockers, and diuretics.   A literature search to July 31, 2012 identified 31 RCTs with 273,543 participants (including 130,466 experimental subjects and...
Source: NeLM - Cardiovascular Medicine - March 21, 2013 Category: Cardiology Source Type: news

Review: Carotid atherosclerosis
Source: British Medical Journal (BMJ) Area: News This review discusses the risk factors, clinical presentation, investigations, and the medical and surgical treatment options for symptomatic and asymptomatic carotid atherosclerosis (defined as a pathological thickening of the common or internal carotid intima, typically into focal areas known as plaques). (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 20, 2013 Category: Cardiology Source Type: news

NICE issues hypertension quality standard
Source: NICE Area: News This quality standard from NICE covering the diagnosis and treatment of primary hypertension in adults, defines clinical best practice and provides specific, concise quality statements, measures and audience descriptors to provide the public, health and social care professionals, commissioners and service providers with definitions of high-quality care. (Source: NeLM - Cardiovascular Medicine)
Source: NeLM - Cardiovascular Medicine - March 20, 2013 Category: Cardiology Source Type: news

The impact of pharmacist-initiated interventions in improving acute coronary syndrome secondary prevention pharmacotherapy prescribing upon discharge
Source: Journal of Clinical Pharmacy and Therapeutics Area: Evidence > Medicines Management > References Objectives: Pharmacists have the knowledge regarding optimal use of medications and the ability to influence physician prescribing.  Successful interventions by a pharmacist to implement cardioprotective medications to a coronary artery disease patient's regimen would not only improve the patient's quality of care but may also increase the likelihood of his or her survival.  Therefore, the aim of this study in Malaysia was (i) to evaluate the effectiveness of pharmacist-initiated interventio...
Source: NeLM - Cardiovascular Medicine - March 20, 2013 Category: Cardiology Source Type: news