a-heart-attack

Aspirin Doesn’t Prevent Heart Attacks in Those With No Symptoms

by on March 2, 2010

By Nicole Ostrow March 2 (Bloomberg) — Aspirin doesn’t prevent heart attacks or strokes in people who have a high risk of heart disease yet show no symptoms, a study in Scotland found. Half of the 3,350 people in the study were given low-dose aspirin after a screening test showed they had a higher-than- average risk for heart disease. They had a similar number of heart attacks and strokes to the other half of participants taking a placebo, researchers reported today in the Journal of the American Medical Association . The study is the first to look at an apparently healthy population, screen them for their heart disease risk using a test that detects artery blockages in their legs and then try to reduce that with aspirin, lead author F. Gerald Fowkes said. Aspirin has been shown to lower heart attacks in people who have symptoms of heart disease, and more studies are needed to find a way to prevent cardiovascular problems in people who have a high risk and no symptoms, he said. “One of the problems we have with coronary heart disease and stroke is we’re still not that good at preventing it in people who are supposedly healthy,” said Fowkes, a professor of epidemiology at the University of Edinburgh, in a telephone interview today. “We’ve not cracked that. This was an opportunity to pick people who are at increased risk and try to target a new population to try to prevent getting a heart attack or stroke.” Alternative Drugs Research is needed to see if Pfizer Inc. ’s Lipitor and AstraZeneca Plc ’s Crestor, two cholesterol-lowering drugs called statins, work in these patients to reduce their risk of heart attack or stroke, Fowkes said. Another approach is to test whether Bristol Myers Squibb Co. ’s Plavix, an anti-clotting drug, works in this group. More than 81 million people in the U.S. have one or more forms of cardiovascular disease, including coronary artery disease, high blood pressure and chest pain, according to the American Heart Association. It is the leading cause of death in the U.S. Aspirin helps prevent clots from forming in the arteries and has been shown to be effective in people who have symptoms of heart disease, said Jeffrey Berger , an assistant professor of medicine and surgery at New York University, who wrote an accompanying editorial in the journal. Right Population “I still think aspirin is a very effective drug,” Berger said in a telephone interview today. “We just have to find the right population to do it in for prevention of first heart attack or stroke.” Fowkes said he isn’t sure why aspirin didn’t appear to work in the study. It may be that the trial wasn’t large enough to detect a difference or people didn’t continue taking their aspirin, he said. The study included 3,350 people who had a low score on a test called the Ankle Brachial Index . The test measures blood pressure at the ankle compared with pressure in the arm. It is used to determine if someone has peripheral artery disease, or blocked arteries in their legs and other parts of the body, which increases the risk of heart attack and stroke. Eight Years Those in the study were randomly assigned to receive either a low-dose, 100 milligram aspirin tablet or a placebo. They were followed for about eight years. The researchers found that 181 people, or 10.8 percent, of the aspirin group and 176 people, or 10.5 percent, of the placebo group had a heart attack or stroke. Today’s study, was sponsored in part by the British Heart Foundation and Bayer AG, maker of a low-dose aspirin for cardiac health. Future trials should help identify patients who have increased levels of blood platelets, Berger said. Doctors know they have a higher risk for heart disease. Such research may determine if aspirin therapy decreases heart attacks and strokes by reducing those platelet levels, he said. For Related News and Information: To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Aspirin Doesn’t Prevent Heart Attacks in Those With No Symptoms

Genetic Tests No Help Predicting Heart Disease Risks in Women, Study Says

by on February 16, 2010

By Nicole Ostrow Feb. 16 (Bloomberg) — Genetic screening didn’t help doctors predict which women would develop heart disease in the first study assessing the effectiveness of the current gene markers for the disease, researchers said. Instead cholesterol levels, blood pressure and family history were better indicators for determining who is at risk for having a heart attack, stroke or dying from heart disease, research today in the Journal of the American Medical Association showed. More than 316,000 women died in the U.S. in 2006 from heart disease, the leading cause of death for American women, according to the Atlanta-based Centers for Disease Control and Prevention. About 8 million women are currently living with heart disease , according to the Women’s Heart Foundation, a nonprofit group based in Trenton, New Jersey. As more heart disease genes are discovered, they may eventually play a role in determining who might develop the disease, lead study author Nina Paynter said. “These findings were a checking in to see if we know enough yet about genetics for our risk prediction tool kit. We don’t have a good enough picture,” Paynter, an instructor in medicine at Brigham and Women’s Hospital in Boston, said today in a telephone interview. “It’s definitely possible that at some point when we get a better sense of everything, we’d be able to have some sort of genetic score or a panel that will help us actually identify people at higher risk.” First Study Today’s study is the first to look at genetic markers available for heart disease to see if they may help more effectively predict who is at risk for developing the condition, Paynter said. The results apply only to women. The researchers included 19,313 white women in the Women’s Genome Health Study who were followed for more than 12 years. Researchers developed two genetic risk scores. One was based on 12 markers known to be linked to heart disease. The second was based on the 12 markers plus 89 more linked to risk factors such as blood pressure and cholesterol levels . Just using the genetic risk factors alone was the equivalent of a “coin flip” in classifying who has a higher risk of heart disease, Paynter said. Blood pressure, cholesterol levels, age, smoking status and family history were more helpful, the authors said. Helpful Predictor “Family history of heart disease was a useful predictor. There is this implication that at some point we may be able to tease out the genetic part of that since some of that is shared genes and get a genetic predictor that is a good risk stratification tool,” she said. Unlike diseases that are more directly related to genes, heart disease is “complicated” and can develop many different ways, Paynter said. Genetic testing seems to help indicate who may be at risk for certain breast cancers and cystic fibrosis, she said. “Understanding genetics and its role in chronic disease remains absolutely vital for developing new therapies and new approaches to treatment,” said study author Paul Ridker , director of the Center for Cardiovascular Disease Prevention at Brigham and Women’s Hospital, in a statement. “Our data in no way undermine those efforts. However, it is sobering to find that the current body of genetic data adds little to our ability to predict cardiovascular disease.” The National Institutes of Health and the National Cancer Institute are among the organizations that fund the Women’s Genome Health Study. Genotyping for the Women’s Genome Health Study was supported by Thousand Oaks, California-based Amgen Inc. To contact the reporter on this story: Nicole Ostrow in New York at nostrow1@bloomberg.net .

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Genetic Tests No Help Predicting Heart Disease Risks in Women, Study Says

Merck’s Cholesterol Pill Woes May Intensify on Loss to Abbott’s Niaspan

November 16, 2009

By Shannon Pettypiece Nov. 16 (Bloomberg) — A finding that Merck & Co.’s cholesterol pills Vytorin and Zetia didn’t reopen clogged arteries as well as Abbott Laboratories ’ Niaspan has set off a medical debate on heart treatment strategies. In the trial, researchers reported finding a reduction in the thickness of artery walls in patients given Niaspan, while those on Zetia had no change. Artery thickness is believed to be a predictor of risk in heart attack and stroke because it restricts blood flow, the researchers said. The results reported yesterday at the American Heart Association meeting in Orlando, Florida, may raise doctor awareness of the role of good cholesterol, or HDL, in heart health. It could also pump up sales for Abbott’s drug, a form of niacin, or Vitamin B, that increases HDL, and mean less revenue for Merck’s Zetia and Vytorin, which combines Zetia with the statin simvastatin to lower bad cholesterol, or LDL. “There will be an up-tick in the use of niacin because of this,” said Steven Nissen , chief of cardiology at the Cleveland Clinic in Ohio, in an interview yesterday. “It was quite a compelling result. Yes, it is a small study; yes, it isn’t a substitute for a large definitive outcomes trial. But I do think it will get attention, and I do think it will inform us about the choices we have about what therapies we should administer.” Revenue Drop Revenue for Zetia and Vytorin could fall 20 percent, or $800 million, with a negative finding, said Seamus Fernandez , a Leerink Swann & Co. analyst in a note to investors last week. Sales for the two drugs have dropped 14 percent this year to about $3 billion. Merck, located in Whitehouse Station, New Jersey, rose 12 cents to $33.10 in New York Stock Exchange composite trading on Nov. 13, and has risen 21 percent in 2009. Abbott, of Abbott Park, Illinois, fell 28 cents to $52.95. It has declined 4 percent for the year. Roger Blumenthal , a professor of cardiology at Johns Hopkins University in Baltimore, said the study shouldn’t be used by doctors to decide treatment. In an editorial released by the New England Journal of Medicine, Blumenthal described artery thickness as a secondary measurement for heart risks that may not give the same result as a study gauging the total number of heart attacks and strokes from use of the drugs. Further, the benefits of Niaspan may also be exaggerated because the study was ended early, he said. The study wasn’t “large or long enough to draw broad conclusions’,’ said Ken Frazier , Merck’s president of global human health, in an interview yesterday “If people stop lowering LDL there are going to be deaths, that is a fact.” Four Months Sooner Allen Taylor, the study author and a cardiologist at Washington Hospital Center in the District of Columbia, said he ended the trial about four months sooner than expected when it became clear that Niaspan had significantly outperformed Zetia. It wouldn’t have been in the patients’ best interest to keep the trial going, Taylor said in a telephone interview. The study was able to reach a conclusion with fewer patients and over a shorter time period than first thought because the technology being used was more precise than expected, he said. The negative result is the third in two years for Zetia and Vytorin. The first trial, dubbed Enhance, found Vytorin didn’t help artery health more than Merck’s Zocor, sold generically as simvastatin for 77 percent less. Data presented in July 2008, in a trial called SEAS, found more patients taking Vytorin developed cancer than those on a placebo, a finding later contradicted in another study. Merck Study There are no studies that have shown that Zetia reduces the risk of heart attacks and stroke. Merck is currently working on one such study involving 18,000 patients. The results won’t be available until 2012, a decade after the drug came on the market. In the Abbott-funded study reported yesterday, called Arbiter-6 Halts, researchers measured the thickness of the neck artery leading to the brain in 208 patients, using an ultra- sound. They were given simvastatin along with either Niaspan, a modified form of vitamin B also known as niacin, or Zetia over 14 months. The study only looked at patients who had already lowered their LDL cholesterol to the recommended level of 100 milligrams per deciliter of blood or less using a statin. “We’re answering a simple question that clinicians need to know the answer to in order to take better care of their patients,” said Taylor, the study author. “The trial results are ultra-clear, Niaspan worked better than Zetia and, through that hopefully, patients are going to benefit.” Heart Attacks, Strokes Even with statins, which recorded $34 billion in worldwide sales last year, patients are having heart attacks and strokes, so doctors continue to seek additional treatments, said Richard Karas , a professor of medicine at Tufts University medical school in Boston, in a telephone interview. Previous studies suggest that HDL-raising drugs could double the benefit of lowering bad cholesterol, he said. Heart disease, the build up of fatty plaque in the arteries, killed 445,687 people in 2005 and is the leading cause of death in the U.S., according to the American Heart Association. With the introduction of statins and procedures to reopen arteries, the death rate from heart disease declined 34.3 percent between 2005 and 1995 in the U.S., though 1.26 million Americans will have a heart attack this year, according to the heart association. Digestive Track One approach to cutting the number of heart attacks has been trying to lower the LDL as much as possible by increasing the dosage of a statin, or using Zetia, which is designed to work in the digestive tract by stopping the absorption of cholesterol from food. Niaspan, by contrast, works by raising levels of high- density lipoprotein, or HDL cholesterol, believed to protect against heart attacks by collecting excess artery-clogging LDL cholesterol in the blood and taking it to the liver where it can be disposed. HDL may also provide a protective benefit to the heart and blood vessels through its antioxidants, anti-inflammatory and anti-clotting effects, according to the Mayo Clinic. Using Niaspan, with $786 million in sales last year, to raise HDL has been limited because the drug can cause facial flushing. Merck is testing a form of niacin in combination with an experimental drug laropiprant and will seek U.S. regulatory approval for the medicine as early as 2010. “If Niaspan is superior to Zetia in the study, we expect the data to provide the Niaspan franchise with a shot in the arm especially if there are significantly fewer events in the Niaspan group,” said Larry Biegelsen , an analyst with Wells Fargo Advisors LLC in New York, in a note to investors on Oct. 26, before the study’s finding were reported. Safety Differences The Arbiter study released today wasn’t large or long enough to detect a significant difference in the rates of heart attacks and strokes, said Taylor, the study author. Though the research found that 5 percent of patients taking Zetia had a heart attack or stroke compared with 1 percent on Niaspan, that finding is not definitive because of the limited size of the study, Taylor said. Patients taking Niaspan were more likely to drop out of the study because of side effects, the study showed. About a third of Niaspan patients said they experienced facial flushing. Zetia and Vytorin have been shown to lower levels of LDL cholesterol better than statins alone and doctors should focus on getting their patients’ LDL cholesterol to the levels recommended by the American Heart Association, said Merck’s head of research Peter Kim said in an interview. “Lowering LDL is an extremely well validated step toward improving cardiovascular health,” Kim said. “Numerous studies have shown, if you lower LDL you decrease cardiovascular risk and save lives.” To contact the reporter responsible for this story: Shannon Pettypiece at spettypiece@bloomberg.net .

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Jeffrey Picower, Madoff Associate, Leaves Fortune To Charity

November 10, 2009

NEW YORK — A man who made billions of dollars off Bernard Madoff’s Ponzi scheme signed a will leaving the bulk of his fortune to charity, but the gift’s ultimate size may depend on legal wrangling over how much of the money rightfully belongs to cheated victims. Jeffry Picower, 67, a prominent philanthropist, drowned after suffering a heart attack in the swimming pool of his Palm Beach, Fla., mansion on Oct. 25. Unlike some other Madoff investors, he died a rich man. The trustee unraveling Madoff’s financial web said Picower withdrew some $7 billion from his Madoff accounts over the decades – well more than he invested. That money is now known to have been stolen from other people, and Picower’s widow said in a statement this week that the family wished to return some of it through “a fair and generous settlement” that might help overcome some of the “devastation” wrought on Madoff’s victims. The exact amount of that settlement is still unknown. Madoff trustee Irving Picard has sued claiming victims are entitled to get back all $7 billion. The family has argued that under New York law, it should only have to return bogus profits they earned in the past six years, or around $2.4 billion. On Tuesday, the family’s lawyer, William D. Zabel, said the Picowers might be open to paying “more than the law would require them to, in order to help the victims of scheme.” Yet the family also made clear that it is trying to protect its own charitable projects. In a will signed on Oct. 15, Picower said he wished to donate most his multibillion-dollar estate to a new philanthropic foundation, minus $200 million for his widow, Barbara, $25 million for his daughter, Gabrielle, and additional millions for grandchildren and other friends and relatives. The foundation, the will said, would be “for broad charitable purposes,” although Picower suggested it spend half its money on medical research. He also gave $25 million to the Picower Institute of Learning and Memory at the Massachusetts Institute of Technology, $1 million each to the New York Public Library, the Harlem Children’s Zone and the Nurse-Family Partnership in Denver, Colo. and $4 million to a group of Parkinson’s disease research scientists. Picower had Parkinson’s disease. Lawyers for Picard have argued in court papers that Picower must have realized that the “implausibly high” returns he was getting from Madoff’s operation were the result of fraud. Barbara Picower said in her statement that it was “a great tragedy that my husband Jeffry’s sudden and untimely death prevented him from seeing the full restoration of his reputation for honesty, integrity and professional achievement.” Zabel said he couldn’t discuss how much the family might ultimately be willing to pay in a settlement because the two sides have been in negotiations. Zabel added that the Madoff case has been “an albatross” for the family, and weighed on Picower personally before his death.

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Steve Parker: Shocker! GM cancels Opel sale – but why?

November 4, 2009

On Monday of this week, German Prime Minister Angela Merkel met with President Obama in Washington and then addressed the US Congress, where she was warmly greeted, and made an impassioned address concerning the environment and global warming. She was on top of the world when, just minutes later, she heard the news that General Motors had decided call off the sale of their European division headquartered in Germany, Opel. And GM being GM, the company announced Wednesday that it will cut 10,000 jobs at Opel and their British division, Vauxhall, un-employing about 20% of the company’s 50,000 workers. Opel’s GT was one of the first Opel vehicles sold in America; some compared it to a “mini-Corvette” And boy, is Merkel pissed. She might not be making more warm and fuzzy speeches to Congress anytime soon. And European Union members share her feelings. Unions are all-powerful in Europe, and GM dropping the sale and the resultant job losses could wind up looking like a huge defeat for Germany and the entire EU at the hands of a recently bankrupt worldwide corporation. In Europe’s semi-socialist societies, people expect to train for good jobs, get good jobs and then keep those good jobs with benefits which would give a heart attack to the average Harvard-trained bean counter in this country. And they expect their governments to protect their rights … and their jobs. For years, union members have been on the boards of directors of most large companies. The sale would have needed approval from the Germans and the EU; apparently GM has had enough of dealing with national (and continental) governments and they cited the costs involved in the sale and the necessary waits for permissions from Euro entities as some of the reasons for their decision. Opel started making cars in 1899; here’s one of their first models John Smith (wonder what name he uses when he checks into a hotel?), GM’s group vice president for corporate planning and alliances, said other considerations in the cancellation were GM’s and Opel’s improved cash conditions. The new Opel GT served as the basis for the Pontiac Solstice and Saturn Sky The plan for GM was to sell Opel to a consortium led by gigantic Canadian auto parts-maker Magna International which would be bankrolled by a Russian bank, Sberbank; the bank and Magna would each get 27.5% of the company, GM would keep 35% and the employees would own 10%. Ironically, Magna may get more work orders from GM because they’re keeping Opel. The sales cancellation move came as a shock to almost everyone in the worldwide auto business. Insider consensus was that GM would sell Opel as they’ve planned to for the past seven months, a move which would have infused many, many needed millions into GM’s shaky coffers. Cancelling the sale is actually going to cost GM. They have to pay back a $2.3 billion bridge loan from the German government (meant to keep Opel open, up and running during the sales process) which they’ve already been paying back, but they still owe the Germans some $1.4 billion. GM plans to incur about $4.4 billion in restructuring expenses because of their decision to cancel Opel’s sale.

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Jeffry Picower Autopsy Results: Had Heart Attack, Drowned In Pool

October 26, 2009

WEST PALM BEACH, Fla. — A man accused of making more than $7 billion off the investment schemes of jailed financial manager Bernard Madoff drowned after having a heart attack, authorities said Monday. Jeffry Picower, 67, was found at about noon Sunday by his wife, Barbara, at the bottom of a pool at their oceanside mansion. She pulled him from the water with help from a housekeeper. He died a short time later at a nearby hospital. An autopsy conducted Monday found he suffered a heart attack and drowned, said Dr. Michael Bell, chief medical examiner for Palm Beach County. The death has been ruled accidental, and the heart attack was brought on by heart disease. Toxicology tests are pending. “Obviously, we won’t have results for a couple of weeks but we don’t anticipate them showing anything,” Bell said. “If they do and it shows something unusual, we will amend the death certificate to reflect that.” Police had been investigating the death, pending the autopsy results. They now say the case is closed. “Right now, that’s it for us,” said Janet Kinsella, a spokeswoman for the Palm Beach Police Department. Picower had been accused by Madoff investors of being the biggest beneficiary of Madoff’s schemes. In a lawsuit to recover Madoff’s assets, trustee Irving Picard demanded Picower return more than $7 billion in bogus profits. Picard has said the litigation could continue. Picower suffered from Parkinson’s disease and had “heart-related issues,” said family attorney William D. Zabel. He described Picower’s health as “poor.” Picower’s home and property is worth more than $33 million, according to the county records. He was No. 371 on the 2009 Forbes 400 list of the wealthiest Americans, with a net worth of $1 billion. Picower and his wife started the Picower Foundation in 1989, which has donated millions of dollars. But after the Madoff scandal broke in December, the Picower foundation, whose assets were managed by Madoff, said it would be forced to close. Picower had asked that the lawsuit against him be dismissed. Steven R. Schlesinger, a New York lawyer who represents about 25 Madoff investors, called his death “another tragedy in a string of tragedies surrounding Madoff.” “Only time will tell whether Jeffry Picower was a victim or a villain,” Schlesinger said Monday. While some speculated his death could make it more difficult for suing investors to recoup their money, at least one attorney called it “a minor hiccup in the litigation against him.” “I think it’s a tragic event,” said Peter Shapiro, a Florida attorney whose firm represents several Madoff investors. “Ultimately, the litigation against his estate will go forward and investors will watch closely on the bankruptcy trustee’s efforts with the expectation that there will be a recovery for their benefit.” Madoff is serving a 150-year prison sentence after he admitted losing billions of dollars for thousands of clients over a half-century career that saw him rise to be a Nasdaq chairman. Madoff’s attorney, Ira Sorkin, did not respond to a request for comment. ___ Associated Press Writer Larry Neumeister contributed to this report from New York.

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