Health System

An investigational oral anticoagulant-the factor Xa inhibitor rivaroxaban-performed well enough in a Phase II study in patients with acute coronary syndromes (ACS) to support a pivotal Phase III trial in patients with ACS, reports C. Michael Gibson, MD.

A patient on chronic warfarin is scheduled for a pacemaker implantation, so naturally you discontinue the warfarin several days prior to the procedure to reduce the chance of bleeding. That may not be necessary, says Peter H. Belott, MD, who contends that “we can keep the patient [at a] therapeutic INR [international normalized ratio] and will not incur any deleterious effects.”

Precisely defining intermediate cardiovascular-event risk using the Framingham Risk Score (FRS) is a challenge for clinicians. This is magnified when one considers that the number of patients who fall under the intermediate risk category outnumbers those considered low or high risk.

By itself, use of electronic health records (EHRs) does not improve the quality of care for heart failure, says Mary Norine Walsh, MD.

Drug-eluting stents (DES) were associated with decreased rates of death, myocardial infarction (MI), and revascularization at 3 years of follow up in diabetic patients compared to bare-metal stents (BMS), according to results of a large observational study. “Our primary concern was to look at safety,” says Laura Mauri, MD (pictured) Brigham and Women’s Hospital and Harvard Medical School, Boston. “Considering the safety concerns surrounding DES recently, it was to our surprise that we found a significant difference in the opposite direction.

Getting less than 7.5 hours of sleep daily is a predictor of incident cardiovascular disease in elderly patients with hypertension, reports Kazuo Eguchi, MD, Jichi Medical University, Tochigi, Japan. “Reflecting changing lifestyles, people are sleeping less in modern societies,” he says.

African Americans are half as likely to be hospitalized for atrial fibrillation (AF) as whites, according to Paul Tabereaux, MD, MPH, and colleagues.

The process of transitioning pediatric cardiology patients into adult cardiac care should begin in late childhood or early adolescence, says Arwa Saidi, MD (pictured) department of internal medicine and pediatric cardiology, University of Florida. The 2008 American College of Cardiology/American Heart Association guidelines recommend preparing young people for the transition beginning at age 12.

Researchers have successfully used umbilical cord stem cells to build a functional heart valve that may someday be perfected so that infants born with valve abnormalities could receive a new valve derived from their own stem cells, reports Philipp Schaefermeier, MD, University Hospital of Munich, Germany.

The executive vice president and CEO of a major pharmacy association plans to retire in June 2011. Read on to find out more.

A coalescence of factors usually conspires to cause resistant hypertension, which is defined as the failure to reach goal blood pressure in patients adhering to full doses of an appropriate three-drug antihypertensive treatment regimen, says Domenic Sica, MD.

Low-dose aspirin did not result in a significant reduction in first atherosclerotic events in patients with type 2 diabetes, reports Hisao Ogawa, MD, PhD (pictured), lead investigator of the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD) trial.

The final nail has been driven into the homocysteine-lowering coffin as a means to prevent recurrent coronary events. The results from the homocysteine-lowering arm of the SEARCH (Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine) trial found no benefit to folic acid combined with vitamin B12

Neither vitamin C nor vitamin E is effective for primary prevention of cardiovascular events in men, according to results of the Physician’s Health Study II, which evaluated the risk and benefits of both vitamins as well as a multivitamin in preventing cardiovascular disease and cancer. Results relating to cancer prevention will be presented November 17 at the Frontiers in Cancer Prevention Research conference.

Rosuvastatin treatment of patients with better than average lipid profiles but with elevated high-sensitivity C-reactive protein (hsCRP) resulted in a 44% relative risk reduction in cardiovascular events and a 20% reduction in all-cause mortality, reports Paul Ridker, MD (pictured), lead investigator for the JUPITER Trial Study Group. JUPITER was an investigator-initiated trial sponsored by AstraZeneca.

Johns Hopkins researchers have identified five proteins that may serve as an early warning of impending myocardial infarction (MI) in patients presenting to emergency rooms with ischemia symptoms. A blood test to detect all, or a subset of these proteins, could be used by physicians and paramedics in the 12- to 24-hour window before ischemia causes tissue damage or death.

Recovery following an acute coronary syndrome is a phase in a larger cardiovascular disease continuum, and prevention of downstream complications needs to begin immediately following the event, says Shirley M. Moore, PhD, RN.

A survey of new Rx, new OTC, new indications, and new generics

Physical and personal trainers recommend supplements and OTC products to their clients without considering possible interactions with other supplements or meds. By becoming an information resource to trainers, pharmacists can take the lead in promoting safe use of these products.

When adults and children mistakenly swallowed Benadryl Itch Stopping Gel, they ended up in the emergency room.

Information on OTC indigestion remedies that pharmacists can use to brief patients

As baby boomers age, the pool of patients needing prostate treatment is expanding dramatically. With more patients asking questions, pharmacists need to be ready with answers.

In the wake of hurricanes Gustav and Ike, volunteer pharmacists from around the country dispensed medications in the field, kept pharmacies open, and helped reopen others.

Jim Plagakis reports on what it was like to go through Hurricane Ike in Galveston.

Regulation of pharmacy techs in Florida goes into effect January 1, 2010.

Barr Pharmaceuticals has received final FDA approval for galantamine, its generic version of Ortho McNeil Janssen's Razadyne ER, for the treatment of mild to moderate dementia of the Alzheimer's type.

Pharmacists speak out about drug kiosks, tobacco sales, fee for service, and e-prescribing.

Medicare has stopped paying hospitals for blood conditions caused by poor inpatient glycemic control. Health-system pharmacists can help prevent these conditions and reduce uncompensated expenses by insisting on proper protocols.

The new Touro College in Harlem offers a 4-year PharmD program with an emphasis on community practice.

Pharmacists can help patients stay well by encouraging their compliance in use of prescribed medications. InnovationRx and other groups have launched a pilot program supporting their efforts.