Italian Research:Another Benefit of Aspirin

Another benefit of humble aspirin has been suggested by an Italian study at the University of Perugia.Based on its results,the researchers believe aspirin can be considered an alternative to extended treatment with anticoagulant drugs,or blood thinners,such as Warfarin,for secondary prevention of blood clots.Taking aspirin resulted in around 40% less of a chance of developing repeat blood clots in the veins.Warfarin is often prescribed for a period of several months after a blood clot event,but is eventually stopped because of the risk of major bleeding that it poses.In the new study,6.6% per year of the patients on aspirin had a repeat blood clot;while 11.2% per year of those taking a placebo had one.Aspirin reduced clot risk without increasing the risk of major bleeding,the study found.Blood clots in the deep veins of the legs can travel up to the lungs with fatal consequences,a condition known as VTE,or venous thromboembolism.Another,larger study of aspirin prevention of blood clots is already underway.Results of the two studies will be combined to help assess the merits of aspirin as a therapy for VTE.The University of Perugia study was led by Cecilia Becattini,MD,PhD,and published in the New England Journal of Medicine.Aspirin is a known preventer of heart attacks and strokes,and possibly colon cancer as well.Aspirin maker Bayer AG provides funding for such research.Bayer AG ADS(BAYRY)

After Open Heart Surgery:The Holter Monitor Experience

If heart palpitations develop,you may be referred to your local hospital cardiology department for attachment of an ambulatory electrocardiogram,or Holter monitor.This ingenious device was developed by Norman Holter,MD in the late 1940s.It is the size of a deck of cards and originally was a tape recorder;today,it is commonly a digital recorder with a flash card.Usually worn for 24 hours,the little machine is powered by two AA batteries and is connected to the chest by a number of electrodes,or leads.
The Holter monitor is indicated when a patient is suspected of possibly having a cardiac arrhythmia.It gives the medical team an extended look at the patient's heart rate and rhythm.Even silent abnormalities,of which the patient is unaware,may be detected.
A few emergency situations are detected by the monitor and the patient must be hospitalised.Mostly,patients are found to have a condition either not requiring treatment or one that may be addressed at the standard pace.
The monitor is clipped to your belt,put in your shirt pocket,or worn around your neck.As well,the patient fills out a short but carefully timed diary of activities and symptoms to aid in the interpretation of the data,which are uploaded to a computer with analytical software when the monitor is removed.The software flags any irregularities for the technician and cardiologist to focus on along with the diary material.
Wearing the device is mildly stressful as you wonder whether it will remain properly attached for the whole period and so on,as well as what the results could portend for you.
What you and your family would do if it recorded a serious problem is something that occurs to you.Perhaps you will not be so eager to get that telephone call when the report is in.On the other hand,you are intrigued by the science and engineering and curious about what is going on internally.
Probably it is nothing,you think,or else it will lead to more testing.Among the undesirable scenarios,you may need an implantable medical device such as a pacemaker or defibrillator.Maybe they will put you back on the anticoagulant Warfarin.
It is all a part of being a heart patient,a role you didn't seek but you might as well excel at along with all else in your life,for the benefit of everyone concerned.
The British firm Cardionetics makes a Holter monitor which analyses the data on its own.

Atrial Fibrillation:A Big Problem Getting Bigger

Atrial Fibrillation,or AFib,is a heart rhythm disorder which is sweeping through the growing ranks of the elderly.That's understandable,since age is one of the main predispositions for the disease.From a current patient population of about 5 million,the number of AFib patients is expected to triple by 2050.Many of them are already dealing with other chronic diseases-especially cardiovascular ones.
In AFib,the two upper chambers of the heart,or atria,beat erratically and out of sync with the two lower chambers,or ventricles.This can result in a number of symptoms such as heart palpitations;lightheadedness;fatigue;shortness of breath;disorientation;and even chest pain.During AFib,an electrical overload in the heart results in an irregular,rapid heartbeat.These erratic signals may be caused by factors such as damage to the heart's structure from hypertension;heart valve disease;heart attacks;congenital heart defects;metabolic disorders;lung disease;stimulants;heart surgery;viral infection;and sleep apnea.Age,alcoholism and heredity may predispose a patient for AFib.
AFib can lead to stroke and heart failure.Left untreated,it tends to become more severe and less amenable to treatment as time goes on.Recent studies point to a link between AFib and dementia.That stands to reason,since AFib can easily hinder blood flow to the brain.
AFib is typically diagnosed by means of various monitors attached to the body with electrodes.Treatment ranges from medication to electric shock therapy,as well as various catheter procedures.Blood thinners such as Warfarin and its branded form Coumadin,plus the newer Pradaxa are frequently prescribed to lesson the considerable risk of blood clot formation and stroke from AFib.
If your heart seems to be acting up,it's best to consult with your doctor about it.It could be AFib or another dangerous cardiac arrhythmia.
German pharmaceutical company Boehringer Ingelheim,which is privately held,makes Pradaxa,while Coumadin is a product of Bristol-Myers Squibb.
Bristol-Myers Squibb(BMY)

After Open Heart Surgery:Six Months On The Path

At the six month way point on my surgical path,many judicious thoughts occur to me.The giddy waves of promotion are sternly resisted in these quarters.
The medical secretary wants to know how the conventional heart valve surgery patient is doing.The patient says he is almost better.In fact,this may be as well as it will be possible to be,given all that has happened to me.I have been hit by a surgical truck,after all.
The after affects are still with me.Optical migraines are not as frequent,but these visual disturbances continue to flash from time to time.The large incision itself does still sting a bit on most days.It has fully healed at the top,but the bottom of the scar remains prominent,along with the chest drain scars.
You may think that minimally invasive surgery,including the robotic approach,will soon be available to all.Though widely available now,it may not be suitable for all.The most seriously ill patients could require the traditional big incision.Perhaps it still provides the most comprehensive access to the heart.
A tiny leak from the repaired valve might seem inconsequential.Given the laws of physics,though,even a small post-surgical leak must be monitored closely for the rest of a patient's life.Any leakage from anything tends to worsen over time.
The new anticoagulant drug Pradaxa is being heavily promoted on television,but hasn't been approved for patients with significant heart valve disease.At least four deaths in New Zealand are being attributed to the medication.As well,it is many times more expensive than the old standby Warfarin.In addition,no antidote for the new blood-thinner is currently available,while there are several for Warfarin.Plainly,Pradaxa has not had the benefit of an extensive history.
With such considerations,I have been dealing with some of the issues of these medical times.

Bristol-Myers/Pfizer Drug Apixiban Superior to Aspirin For AF Patients

A Phase 3 trial of the Bristol-Myers Squibb/Pfizer oral medication apixiban showed that,for atrial fibrillation patients unsuitable for a vitamin K antagonist such as warfarin,apixiban is superior to aspirin at reducing the risk of stroke or systemic embolism without a significant increase in major bleeding(annual event rate of 1.6% for apixiban versus 3.7% for aspirin).
The study also showed that apixiban was superior to aspirin at reducing the composite of stroke,systemic embolism,heart attack or vascular death for AF patients versus aspirin(annual event rate of 4.2% for apixiban versus 6.7% for aspirin).
Atrial fibrillation is the most common sustained cardiac arrhythmia.It afflicts about 5.1 million Americans and more than 6 million Europeans.About 40-50% of AF patients are considered unsuitable for vitamin K antagonists because of the risk of bleeding and incompatibility with other medications.
Lead investigator Dr.Stuart Conolly,MD,professor of medicine at McMaster University in Hamilton,Ontario,said the risk of stroke or systemic embolism is of great concern for patients with atrial fibrillation,especially because AF-related strokes are particularly devastating.Given the significant number of patients who are not eligible for vitamin K antagonists,it is especially important to have potential new treatment options that are both safe and effective.
Pfizer and Bristol-Myers have been in a worldwide collaboration to develop and commercialize apixiban since 2007.
Bristol-Myers Squibb(BMY),Pfizer(PFE)

Warfarin Substitute Shows Promise

Bristol-Myers Squibb and Pfizer have agreed to stop a Phase 3 trial of investigation agent apixaban in patients with atrial fibrillation,or irregular heartbeat,who are at risk of blood clots and stroke.An interim analysis showed clear evidence of a clinically significant reduction in stroke and blood clots in AF patients.These patients were considered intolerant of,or unsuitable for,vitamin K antagonist therapy,such as Warfarin,and received apixaban rather than aspirin.The analysis also showed apixaban is as safe as aspirin.
The study was conducted in 36 countries by the Population Health Research Institute,which is affiliated with McMaster University in Hamilton,Ontario and Hamilton Health Sciences.Further analysis of the study and an effort to publish and present the results are ongoing.
Pfizer and Bristol-Myers Squibb have been collaborating on the development and commercialization of apixaban since 2007.Apixaban is an oral anticoagulant discovered by Bristol-Myers Squibb.
Pfizer(PFE),Bristol-Myers Squibb(BMY)