Showing posts from October, 2010

Pfizer recalls more Lipitor

Pfizer is recalling two additional lots of   atorvastatin   (Lipitor) 40 mg, or approximately 38 000 bottles, because of "customer reports of an uncharacteristic odor related to the bottles in which these lots of Lipitor were packaged. Earlier this month, Pfizer reported that it had recalled seven lots of atorvastatin for the same reason. Like the earlier recall, the company said the odor is consistent with the presence of 2,4,6 tribromoanisole (TBA), which was found at low levels in one of the complaint sample bottles during the first recall. The plastic bottles are sourced from a third party, according to Pfizer.

First of their kind: Canadian guidelines specific to antiplatelet therapy

The   Canadian Cardiovascular Society   (CCS) has issued guidelines, the first of their kind anywhere, specific to the use to antiplatelet therapy, including their use in multiple settings, such as primary and secondary prevention, as well as following PCI, CABG surgery, and in patients with peripheral arterial disease and diabetes. The evidence-based document is intended for practical use and is designed to help healthcare professionals manage individuals who have or are at risk of developing vascular disease. "We felt that although guidelines exist for the management of other cardiovascular risk factors, including hypertension, lipids, and diabetes, among others, in Canada there is really nothing to provide guidance to Canadian physicians on the use of antiplatelet therapy,"   Dr Alan Bell   (University of Toronto, ON), the cochair of the antiplatelet-therapy guideline committee "And it's really quite a confusing topic, with a number of drugs currently availa

Dispelling Myths and Discussing Unresolved Issues in Transradial vs Transfemoral Access in PCI

Despite a comparable number of percutaneous coronary intervention (PCI) procedures performed in the United States and in Europe, European countries have much higher rates of transradial PCI -- an approach associated with decreased vascular complication risk, improved outcomes, shorter hospital stays, lower costs, and increased patient satisfaction compared with transfemoral PCI. But barriers to a radial-first strategy remain. Interventional cardiologists may be hesitant to embrace the radial approach for a number of reasons, including concerns about the difficulty of learning or performing the procedure, reluctance of cath lab staff, risk for arterial spasm, arterial puncture failure, challenges in manipulating the guide catheter, procedural success, time to revascularization, or fluoroscopy time. For other clinicians, the radial approach is viewed as a fall back for patients with conditions that hinder femoral access (eg, peripheral artery disease, obesity) or after a failed femoral

Gene variant's CAD link blasted by study, disputing statin pharmacogenomic test

A new meta-analysis involving tens of thousands of patients challenges the validity of a pharmacogenomic assay marketed as a way to identify patients who might respond especially well to statin therapy, according to its authors and an accompanying editorial. The study, published online October 6, 2010 in the   Journal of the American College of Cardiology , found no significant relationship between development of clinical coronary artery disease (CAD) and the gene variant Trp719Arg in kinesinlike protein 6 ( KIF6 ) across 19 separate case-control studies. "These findings do not support the clinical utility of testing for the   KIF6   Trp719Arg polymorphism to identify subjects at higher risk of CAD," according to the authors, led by   Dr Themistocles L Assimes (Stanford University School of Medicine, CA). And they "indirectly question whether genotype information at this locus can reliably identify a population of subjects most likely to benefit from the use of sta

Aspirin paradox investigated in TIMI database

The idea that prior aspirin use by those who develop an ACS may actually predispose to worse outcomes does not appear to be a true phenomenon, and use of aspirin is more likely just a marker of a high-risk group, according to new results from the   TIMI   database including more than 66 000 ACS patients. In a paper in the October 19, 2010 issue of the   Journal of the American College of Cardiology , a group led by   Dr Jonathan Rich   (University of Chicago, IL) explain that despite the proven benefits of aspirin in the primary prevention, secondary prevention, and treatment of ACS, some studies have suggested that those already on aspirin before suffering an ACS have worse outcomes than those not having taken aspirin before the event. They note that this apparent "aspirin paradox" has resulted in much controversy without clear explanation. Although "aspirin resistance" might be an explanation, this would apply only to a small group, and prior aspirin use may a

The Guru Gaytri

"The Guru Gayatri of Guru Gobind Singh has the power of the four Vedas, six Puranas and 36 Simritis. All these are equal to reciting the Guru Gayatri just once. Traditionally, only a person who has been initiated by a guru is entitled to chant a gayatri. First you have to find a guru, one with God consciousness, and then he needs to initiate you. Only then are you entitled to chant the gayatri. That is why Guru Gobind Singh recited this Gayatri for his Sikhs, and that is why this is known as the Guru Gayatri. Whosoever shall chant it, the Primal Power, the Adi Shakti, will guard that being.   This mantra is a "Shakti" mantra. Shakti gives one the positive power of God. If you chant this mantra, there shall be no enemy, including one's own ego, which can overpower you. It is a mantra of deathlessness, and the personal mantra of Baba Deep Singh." – Siri Singh Sahib Bhai Sahib Harbhajan Singh Yogiji (7/9/75)  

Carotid surgery for silent stenosis cuts long-term stroke risk

For patients younger than age 75 with asymptomatic carotid stenosis, successful carotid endarterectomy (CEA) reduces the risk of stroke over the next 10 years by about 46%, with about half of this reduction in disabling or fatal strokes, suggest the   Asymptomatic Carotid Surgery Trial-1 (ACST-1) results published September 25, 2010 in the   Lancet . However, the perioperative risk of stroke or death is about 3%, note   Dr   Allison Halliday   (John Radcliffe Hospital, Oxford, UK) and colleagues. They conclude that "for otherwise-healthy men and women younger than 75 years . . . the results from this trial suggest net benefit from CEA, as long as perioperative risks remain low." In a statement on the study, Halliday notes that this trial took more than a decade to complete, "because we wanted to know about the long-term effects of surgery. The finding that successful carotid artery surgery can substantially reduce the stroke risk for many years is remarkable, becau