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GLG News by Non-Electrophysiologist Cardiologists (US)

Ramin Ebrahimi, MD, Director of Cardiac Catheterization Lab
Wadsworth VA Medical Center
November 23, 2007
Risk Versus Benefit
Analysis of: Study Shows Weight-Loss Drug Rimonabant is Associated with Severe Adverse Psychiatric Events (pharmalive.com)
The pooled analysis of Rimonabant trials point to a significant increase in psychiatric disorders. These studies also point to significant improvements in markers of cardiovascular risk. Risks versus benefits must be considered before the final decision is made on this class of medications.
Analysis of: Study Shows Weight-Loss Drug Rimonabant is Associated with Severe Adverse Psychiatric Events (pharmalive.com)
The meta-analysis of the rimonabant trials points to an increase in psychiatric diagnoses. What is missing in this report is the numberical and statistical significance of the findings.  This debate needs more rigor; the type of rigor that is applied to cardiac endpoints, needs to be applied here. ...
Howard Weintraub, MD, Clinical Director
New York University Medical Center
Analysis of: Ranexa(R) Significantly Reduces Incidence Of CV Death, MI Or Recurrent Ischemia In MERLIN TIMI-36 Patients With Elevated BNP (www.medicalnewstoday.com)
By restoring function in the late Na channel and hence improving diastolic function (amongst other things), Ranexa has worked terrifically in my patients with any evidence for diastolic dysfunction. This typically manifests with shortness of breath and can be associated with an elevated level...
Howard Weintraub, MD, Clinical Director
New York University Medical Center
November 8, 2007
Even more benefit.
Analysis of: Ranexa(R) Significantly Reduces Incidence Of CV Death, MI Or Recurrent Ischemia In MERLIN TIMI-36 Patients With Elevated BNP (www.medicalnewstoday.com)
The good news gets better as there is now data from MERLIN that corroborates the news from CARISA showing a reduction in HbGA1C that was significant.
October 31, 2007
Undue Pessimism
Analysis of: Phase 2 Prasugrel Studies Suspended Prior to Release of Major Phase 3 Trial (www.medscape.com)
The devil is in the details! Far from disappointing, the protocol ammendments (dosing) based on pharmacokinetic analysis that have been effected are both prudent and reassuring. Prasugrel dosing is likely being adjusted to reflect its metabolism in various patient populations including the elderly and...
Analysis of: U.S. veterans dept to limit Glaxo's Avandia: report (www.reuters.com)
Another large provider votes thumbs-down on Avandia.Actos remains innocent until proven guilty.
Analysis of: Pfizer Abandons Exubera, Posts 77% Earnings Decline (online.wsj.com)
Ask any patient with diabetes what they want for a therapeutic option and they'll tell you non-injectable insulin.  They understand that all the other medications are a poor substitution for the replacement of pancreatic insulin and they are tired of taking multiple pills each day. So why did...
Analysis of: Enrollment Reaches 110 Patients In Investigator Initiated, Randomized Trial Of OrbusNeich's Genous(TM) Bio-Engineered R Stent(TM) (www.medicalnewstoday.com)
The failure of drug eluting stents in the eyes of the public and in the medical community is probably not a failure of the device as much as a failure of patient managment.  It is clear that atherothrombotic vascular disease requires a life-long commitment to blood pressure, cholesterol, and blood...
Analysis of: Patients Warned as Maker Halts Sale of Heart Implant Part (www.nytimes.com)
With the industry still struggling to recover from the relatively recent Guidant ICD recalls it is possible that this latest ICD lead recall will affect overall ICD implant rates.  It is also possible that Medtronic, the leader in the ICD market, will suffer a loss of market share due to this latest...
October 10, 2007
Great potential
Analysis of: Isis Reports That ISIS 301012 is Well Tolerated in Patients Treated for Five Or More Months (www.pipelinereview.com)
I think this drug has great potential for refractory high LDL and possibly in Acute Coronary Syndrome and CAD patients.

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