Fast Forward - 23 October 2012
MO looks back 10 years, casting a fresh eye over what made the news in 2002. Then we hit the fast-forward button to see what’s changed.
ADVERTISEMENT
ADVERTISEMENT
ADVERTISEMENT
cardiovascular risk
The following articles have the tag cardiovascular risk
Cardiovascular risk doubles with earlier menopause
WOMEN who experience early menopause – either surgically induced or natural – have double the risk of a cardiovascular event compared to other women, research has found.
Aspirin neuroprotective in elderly women at high CV risk
LOW-dose aspirin may slow cognitive decline, at least in elderly women at increased risk for cardiovascular events, research suggests.
Diabetes drugs linked to increased CV risk
THE TGA is considering whether additional precautions are warranted for a number of the sulfonylureas within the class of insulin secretagogues, following a study suggesting they are associated with increased mortality and cardiovascular risk. A TGA spokesperson said findings from the European Heart Journal study, comparing insulin secretagogue monotherapy with metformin, were being reviewed. The Danish authors followed more than 100,000 subjects who had received insulin secretagogues or metformin for nine years. They found increased all-cause mortality, cardiovascular death, and a composite of myocardial infarction, stroke and cardiovascular death, associated with all of the ...
Least harmful NSAID for cardiovascular patients identified
THE safety of NSAIDs is back in the news, following a meta-analysis showing little evidence they are safe for patients at high cardiovascular risk. However, the researchers said that of the seven NSAIDs examined, naproxen appeared the least harmful. “In general, naproxen seems to be the safest analgesic for patients with osteoarthritis in cardiovascular terms,” the authors wrote. However, naproxen’s relative benefits should be weighed against the drug’s gastrointestinal toxicity and the need for concomitant use of proton pump inhibitors, they warned. Celecoxib 400 mg prescribed once daily may be considered an alternative, they said. ...
Delay of rosiglitazone study puts heat on FDA
CONTROVERSY over the continued use of rosiglitazone has flared again, following allegations that the US Food and Drug Administration (FDA) is sitting on a new study into the drug’s side-effects. The draft manuscript, posted online by the US Pharmalot blog, purports to show that rosiglitazone increased the risk of stroke, heart failure and death compared with pioglitazone, concluding it should be taken off the market. Lead author Dr David Graham, an FDA epidemiologist, emailed the FDA commissioner late in May to inform her the study was ready for publication but was being delayed by his supervisor. ...
Crunch time for eating nuts after lipid-lowering findings
EATING nuts can substantially reduce cholesterol levels and could offer a cheap and effective strategy for reducing cardiovascular risk. Spanish researchers have found that eating just 67 g of nuts a day reduced total cholesterol levels by 5.1% and LDL cholesterol by 7.4 per cent.
Fibrates found to offer CVD protection
THE uncertainty surrounding the role of fibrates in the prevention of cardiovascular disease may be a step closer to being clarified as Australian experts find that fibrates significantly reduce the risk of cardiovascular events. Their review and meta-analysis of 18 trials found use of fibrates led to a 10% reduction in major cardiovascular events and a 13% reduction in coronary events. Fibrates also reduced the risk of albuminuria progression by 14% and were not associated with a significant increase in drug-related adverse events. There was no reduction in stroke however, and no statistically significant effect on ...
TGA to review rosiglitazone safety
THE TGA is set to re-examine the safety of rosiglitazone, following a US senate report that has raised new fears about the drug’s cardiovascular risk. The report, released on Saturday, marked the conclusion of a two-year inquiry by the US Committee on Finance, which included a review of internal documents from the drug’s manufacturer GlaxoSmithKline (GSK). Senators accused GSK of downplaying findings that rosiglitazone might increase cardiovascular risk and failing to sufficiently warn patients and regulators. A spokeswoman said the TGA was reviewing the report and awaiting a response ...
Ankle brachial index identifies CVD risk earlier
THE high prevalence of peripheral arterial disease (PAD) in primary care patients should prompt more frequent and earlier use of ankle brachial index (ABI) in the assessment of cardiovascular risk, experts say. The comments follow a European study that found as many as one in five of 6880 men and women aged 65 years or older had PAD, with more than half of these being asymptomatic. The authors said measurement of ABI provided prognostic information for asymptomatic PAD that could not be derived from conventional risk factors alone. “This early form of PAD has been underestimated, ...
No need to fast for cholesterol check
THERE is no need to make patients fast before measuring lipids, and the contribution of triglyceride levels to the assessment of cardiovascular risk is limited, according to leading international experts. A synthesis of results from 68 long-term prospective studies involving more than 300,000 patients, by a collection of experts called the Emerging Risk Factors Collaboration, has reached these surprising conclusions. They also found that measuring HDL-C levels was just as useful as measuring apolipoproteins B and AI in the lipid assessment of vascular disease. They also found that, “in contrast with previous findings based on much ...
Program targets stroke prevention in CVD
LOW-DOSE aspirin should be routinely used for primary stroke prevention, according to a new campaign targeting GPs. The program, developed by the National Prescribing Service (NPS), recommends low-dose aspirin be considered for all patients at high cardiovascular risk. Professor Graeme Hankey, head of the stroke unit at Royal Perth Hospital, said GPs should consider aspirin in patients with a five-year absolute cardiovascular risk of greater than 10% based on the New Zealand Guidelines Group Cardiovascular Risk Calculator. “If the calculator gives them a score greater than 10% over five years, [doctors] should think perhaps the benefit ...
US clopidogrel safety probe
A REVIEW of the safety and efficacy of clopidogrel in patients with certain genetic variations is underway in the US. The US Food and Drug Administration (FDA) launched the review after recent data showed patients with allelic variations of the gene CYP2C19 had almost a two-fold increased risk of cardiovascular events compared to other patients receiving clopidogrel following a myocardial infarction or stent placement ( MO , 30 January ). An FDA release said the manufacturers of clopidogrel, Sanofi-Aventis and Bristol-Myers Squibb, had agreed to work with it to obtain additional information on genetic factors and ...
Spotlight thrown on safety of atypical antipsychotics
THE safety of atypical antipsychotics has been further questioned with new research finding they may be no safer than older antipsychotics in terms of cardiovascular risk. A retrospective study of 90,307 antipsychotic users showed that those on typical and atypical drugs had twice the incidence of sudden cardiac death compared to a matched cohort of non-users. In fact, users of atypical antipsychotics had a 14% higher sudden cardiac mortality rate than did those using typical antipsychotics. An editorial released with the paper called for a reduction in atypical antipsychotic use in higher ...
Doubts over impact of glycaemic control on CV risk
INTENSIVE glycaemic control may not be an effective strategy for preventing macrovascular disease in patients with type 2 diabetes, experts have argued. Two US researchers commenting in JAMA said that, while there was evidence to show that improved glycaemic control helped to prevent microvascular complications in type 2 diabetes, its effect on reducing cardiovascular risk remained unknown. They cited the Veterans Affairs Diabetes Trial and the ACCORD and ADVANCE trials, which failed to show cardiovascular risk reduction in response to intensive glycaemic control. The ACCORD trial was stopped early because of an increase in total ...