Zetia does not reduce carotid plaque size when added to zocor
January 15, 2008 Cardiovascular News Update Dear Colleague, Westside Medical Associates of Los Angeles (WMALA) in conjunction with Westside Medical Imaging (WMI) would like to provide you with this weekly update on important new developments in cardiovascular care.
Zetia does not reduce carotid plaque size when added to Zocor. Zetia (ezetimibe) "may not actually prevent heart attacks and strokes," according to the long- awaited results of the Enhance trial. Typically, patients "take Zetia in the form of Vytorin (ezetimibe and simvastatin), which combines Zetia with Zocor (simvastatin)." Zetia and Vytorin are jointly marketed by Merck & Co. and Schering-Plough Corp. Zetia reduces cholesterol 15 to 20 percent in most patients, no trial has been completed yet that has ever shown that it can reduce heart attacks and strokes -- or even that it reduces the growth of the fatty plaques in arteries that can cause heart problems. The Enhance trial "was designed to show that Zetia could reduce the growth" of fatty plaques in arteries. However, "the plaques actually grew by 0.005 mm more in those taking Zetia along with Zocor than in those taking Zocor alone."
The trial was conducted by a group headed by Dr. John J.P. Kastelein of the University of Amsterdam Medical Center. All 720 participants suffered from an unusual condition known as Early heterozygous familial hypercholesterolemia. Vytorin cut "LDL levels by 58 percent, compared detection to a 41 percent reduction with simvastatin alone. However, the researchers found that "the saves lives.
average thickness of the carotid artery plaque increased by 0.0111 of a millimeter in patients That’s what we do. Find
taking Vytorin, compared to an increase of 0.0058 of a millimeter in" those taking only
out more at
simvastatin. According to Dr. Norman Lepor, Westside Medical Associates of Los Angeles and
an expert on the treatment of hyperlipidemia, “The complete clinical trial results will be
researchers plan to present their data in March at a meeting of the American College of
Cardiology." He also said that “ one should not confuse the very, very small increase in carotid website at
plaque dimension with a risk of cardiovascular events, as this event data has not yet been
presented. Since there do not seem to be any safety issues, there is no urgency to having
patients taken off Zetia and replaced with either higher doses of statins, niacin or resins until the full clinical trial results are presented.”
PPI drugs may block anti-clotting medication in stent patients, study suggests. While acid-reducing proton pump inhibitor (PPI) drugs such as Prilosec (omeprazole) "prevent gastric bleeding in stent patients on Plavix (clopidogrel bisulfate)," the drugs may also "block Plavix's lifesaving anti-platelet action," according to research published in the Jan. 22 issue of the Journal of the American College of Cardiology. For the study, Martine Gilard, M.D., of Brest University Hospital, Brest, France, and colleagues looked at 124 heart patients who received stents to open stenotic coronary arteries. All patients were given Plavix, and 50 percent of them also received Prilosec. The researchers "tested the patients' blood using a measure of clotting activity that is not routinely used in the U.S. Following one week of treatment, the researchers "found that patients who took Plavix plus Prilosec were more than four times more likely to be 'poor responders' to Plavix than were those" given only Plavix. The key question as to whether this is associated with clinical events has not been answered. Often times PPI’s are taken by patients who may not need them or longer then their condition may require. It may be prudent to decide whether a patient who has undergone a coronary stent and is on dual antiplatelet therapy needs to be on that PPI. Statins may reduce heart risks in diabetes patients, research suggests. Statins reduce heart and stroke risks in people with diabetes and should be more widely used for these patients," according to research published in the Lancet medical journal. Researchers at the University of Oxford and the University of Sydney "looked at the health records of 18,686 people with diabetes, both inherited and acquired," who had participated in 14 different clinical trials. The researchers found that those who took statins reduced their risk of developing cardiovascular disease "over a five-year period by about 33 percent compared with" diabetes patients "who didn't take the drugs." According to the researchers, for every 39 mg/dL drop in LDL cholesterol, people with diabetes cut their risk of major heart events by approximately 20 percent. A typical dose of statins cuts LDL cholesterol by 57 mg/dL, which would lower this risk by one-third." The authors wrote that present guidelines might need to be revised to ensure that a statin regimen which is sufficient to produce a substantial reduction in LDL cholesterol is considered for all people with diabetes, irrespective of whether vascular disease has developed and irrespective of lipid profile. Incorporating healthy amounts of omega-3 fatty acids into diet may soon become easier. The federal National Institutes of Health concluded after a massive review three years ago that consuming omega-3 fatty acids cuts the risk of death from heart attacks and other cardiovascular causes, can reduce the joint pain of rheumatoid arthritis and may also be "mportant for proper brain development and function an individual may need to take fistfuls of capsules in order to receive the health benefits seen in clinical trials. However, it may soon become easier to get such hefty doses without taking so many pills, as a growing number of foods are fortified with omega-3. They also noted that a number of scientists believe omega-3's benefits flow primarily from its ability to damp low-level inflammation, which is thought to be a key culprit in just about every major scourge of aging, from clogged arteries to Alzheimer's. Some recent studies suggest that taking small doses of aspirin daily, which many people do to prevent heart attacks, magnifies the anti-inflammatory effect of taking fish oil. Research suggests link between oatmeal and cholesterol reduction may be stronger than once thought. The relationship between oatmeal and cholesterol reduction is stronger than initially" thought, according to a review published in the American Journal of Lifestyle Medicine. Dr. James W.
Anderson, of the University of Kentucky College of Medicine, and colleagues "analyzed studies conducted during the past 15 years on oatmeal and cholesterol and found without exception total cholesterol levels were lower after oat consumption." Furthermore, the researchers found that LDL cholesterol decreases "without adverse effects on" HDL cholesterol "or triglyceride concentrations."
Westside Medical Associates of Los Angeles (WMALA) and Westside Medical Imaging (WMI) are premier centers in cardiac diagnosis and treatment. Please feel free to contact or Ivor Geft MD at (310) 289-9955 or check our website at If you would like these newsletters to be sent to other friends or colleagues, please note their names and corresponding email addresses by clickin If you do not wish to receive future newsletters, you can unsubscribe by clickin Please include your full name and email address.
M É D E C I N E G É N É R A L E 2 0 0 6 LA BONNE OBSERVANCE RÉDUIT LA MORTALITÉ TOTALE DES PATIENTS INSUFFISANTS CARDIAQUES CHRONIQUES Adherence to candesartan and placebo and outcomes in chronic heart failure in the CHARM programme : double-blind randomized controlled clinical trial Observance dans le groupe candésartan et dans le groupe placebo , corrélée aux événements c
Carolina Digestive Health Associates Procedure Information You are scheduled for a colonoscopy. Please read all of the attached information as soon as possible so you are PHYSICIAN PERFORMING PROCEDURE : _______________________________________ DATE: _______________________ LOCATION:_______________________________ PROCEDURE TIME:________________ CHECK-IN TIME:________