Cardiovascular

There are several advanced therapies in addition to blood thinners that physicians should consider when managing patients with deep vein thrombosis, according to a new scientific statement from the American Heart Association.

Clopidogrel hypersensitivity, which affects 6% of patients, can be successfully treated using short-course corticosteroids and antihistamines without interrupting drug therapy, reported researchers at Jefferson Medical College in Philadelphia.

Combining angiotensin-converting-enzyme inhibitors with angiotensin-receptor blockers is associated with increased risk of adverse renal outcomes, according to a recent study published in the Canadian Medical Association Journal.

The use of high-dose clopidogrel compared with use of standard-dose clopidogrel does not reduce the incidence of death from cardiovascular causes, nonfatal myocardial infarction, or stent thrombosis among patients with high on-treatment reactivity after percutaneous coronary intervention with drug-eluting stents, according to a recent multicenter study published in the Journal of the American Medical Association.

Available evidence reviewed by FDA does not suggest abacavir is associated with an increased risk of myocardial infarction, according to an updated safety communication released March 2011.

Investigators question whether the thiazide diuretic, hydrochlorothiazide, should be used as commonly as it is for treating hypertension, according to a report published in a recent edition of the Journal of the American College of Cardiology.

In a new study published ahead of print on the Mayo Clinic Proceedings website, researchers demonstrated that the cost of medications was a factor influencing the proportion of patients with heart failure who had poor medication adherence to beta-blockers, angiotensin converting-enzyme inhibitors or receptor blockers, and statins.

An update on the management of atrial fibrillation issued by a task force consisting of the American College of Cardiology Foundation, the American Heart Association, and the Heart Rhythm Society has incorporated dabigatran into its recommendations.

The use of angiotensin-receptor blockers alone are not associated with increased odds of cancer or cancer-related death, according to a meta-analysis published in a recent edition of Lancet Oncology.

Dabigatran etexilate mesylate (Pradaxa, Boehringer Ingelheim) capsules have received tier 2 formulary status with 2 key pharmacy benefit managers.

The willingness of the elderly to take medication for primary cardiovascular disease prevention is relatively insensitive to its benefit but highly sensitive to its adverse effects, according to a recent study published in the Archives of Internal Medicine.

FDA has approved a change to the prescribing information for ambrisentan 5-mg and 10-mg tablets (Letairis, Gilead Sciences) once-daily treatment to improve exercise ability and delay clinical worsening in patients with pulmonary arterial hypertension (PAH, WHO Group 1) and predominantly WHO Functional Class II-III symptoms.

FDA has announced that the physician labeling and patient medication guide for rosiglitazone (Avandia, GlaxoSmithKline) have been changed to include information on cardiovascular risks (including death) of this agent.

The recently FDA-approved oral direct thrombin inhibitor, dabigatran, may be cost-effective compared to the standard-of-care therapy of adjusted-dose warfarin in patients requiring anticoagulation for stroke prevention in atrial fibrillation, according to a pharmacoeconomic evaluation published in the Annals of Internal Medicine.

In a guest editorial, 2 researchers highlighted the importance of the FDA approval in October of dabigatran etexilate (Pradaxa, Boehringer Ingelheim), an oral thrombin inhibitor that provides an alternative to warfarin (Coumadin, Bristol-Myers Squibb) for long-term stroke prevention in patients with non-valvular atrial fibrillation.

The addition of bortezomib to the standard induction therapy before double autologous stem cell transplantation for patients with multiple myeloma appears to improve nearly threefold the rates of complete or near complete response, according to research published online in The Lancet, HealthDay News reported.

Patients who are newly treated with statin-fibrate concurrent therapy are slightly more likely to be hospitalized with rhabdomyolysis than those who take just one of the medications, according to research published in the American Journal of Cardiology, HealthDay News reported.

Antihypertensive therapy with an angiotensin receptor blocker is not associated with reductions in cardiovascular or all-cause mortality compared to non-ARB-based regimens in patients with type 2 diabetes, according to researchers at the Massachusetts College of Pharmacy and Health Sciences.

FDA is requiring a new warning be added to the prescribing information for saquinavir (Invirase) detailing the drug's potential to prolong both QT and PR intervals on an electrocardiogram, and thus potentially cause the dangerous abnormal heart rhythms called torsades de pointes and complete heart block.

Based on "a review of emerging safety information from clinical trials and postmarketing reports," Pfizer announced it would be voluntarily withdrawing sitaxsentan (Thelin), the manufacturer's pulmonary artery hypertension (PAH) treatment from the market worldwide.

Patients who switch statins have lower persistence to therapy compared to those who don't switch, found Gary J. Tereso, PharmD, director of pharmacy services at Health New England, Springfield, Mass.

On June 11, 2010, FDA announced in a drug safety communication that the agency was currently evaluating whether the use of the angiotensin II receptor blocker olmesartan (Benicar, Daiichi Sankyo) (also sold in combination with hydrocholorothiazide as Benicar HCT) was associated with increased cardiovascular mortality.

A systematic review and meta-analysis evaluating the effects of rosiglitazone on cardiovascular morbidity and mortality confirmed the finding of increased odds of myocardial infarction with rosiglitazone.

Agents in late-stage development for the treatment of mixed dyslipidemia, coronary heart disease, atherosclerosis, and hypertension

In the Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography III (DECREASE III) trial published in the New England Journal of Medicine, patients undergoing noncardiac vascular surgery who were treated with perioperative fluvastatin demonstrated a lower incidence of myocardial ischemia than patients treated with placebo.

In the Study of Platelet Inhibition and Patient Outcomes (PLATO) published in the New England Journal of Medicine, patients with acute coronary syndrome (ACS) who were treated with ticagrelor had significant reductions in the rate of death from vascular causes, myocardial infarction (MI), or stroke and no significant increase in the rate of overall major bleeding versus patients treated with clopidogrel.

The P&T committee is positioned to provide knowledge, strategies to improve treatment of patients with cardiometabolic disorders.

This review discusses emerging risk factors for CVD, including hs-CRP, lipoprotein(a), homocysteine, fibrinogen, homocysteine, and coronary artery calcification.

New molecular entity: Dronedarone (Multaq), a benzofuran derivative, was approved on July 1, 2009, to reduce the risk of CV hospitalization in patients with AF

New molecular entity: Prasugrel (Effient), a platelet activation and aggregation inhibitor, was approved on July 10, 2009, to reduce the rate of thrombotic CV events in patients with ACS undergoing PCI