(Press-News.org) Contact information: Stephen J. Nicholls, M.B.B.S., Ph.D.
stephen.nicholls@sahmri.com
The JAMA Network Journals
Among patients with recent ACS, use of enzyme inhibitor does not reduce risk of cardiovascular event
Chicago – Stephen J. Nicholls, M.B.B.S., Ph.D., of the South Australian Health and Medical Research Institute and University of Adelaide, Adelaide, Australia, and colleagues determined the effects of varespladib, a drug that inhibits the enzyme secretory phospholipase A2 on cardiovascular risk in patients with acute coronary syndrome (ACS; such as heart attack or unstable angina).
Despite contemporary therapies, patients with ACS face a substantial risk of early, recurrent adverse cardiovascular events. Increasing evidence supports a potential role of inflammation in the progression and clinical instability of coronary heart disease. Secretory phospholipase A2 (sPLA2) is an enzyme involved with inflammation and implicated in atherosclerosis. The results of some studies have stimulated interest in sPLA2 inhibition as a cardioprotective strategy. The sPLA2 inhibitor varespladib has favorable effects on lipid and inflammatory markers; however, its effect on cardiovascular outcomes is unknown, according to background information in the article.
The trial was conducted at 362 academic and community hospitals in Europe, Australia, New Zealand, India, and North America and included 5,145 patients randomized within 96 hours of presentation of an ACS to either 500-mg/d varespladib (n = 2,572) or placebo (n = 2,573) for 16 weeks (study termination on March 9, 2012). The participants also received atorvastatin and other established therapies. The primary efficacy measure was a composite of cardiovascular mortality, nonfatal heart attack, nonfatal stroke, and unstable angina with evidence of ischemia requiring hospitalization at 16 weeks. Six-month survival status was also evaluated.
At a prespecified interim analysis, including 212 patients with primary end point events, the independent data and safety monitoring board recommended termination of the trial for futility and possible harm. The primary end point occurred in 136 patients (6.1 percent) treated with varespladib compared with 109 patients (5.1 percent) treated with placebo. Varespladib was associated with a greater risk of heart attack (78 [3.4 percent] vs. 47 [2.2 percent]). The composite secondary end point of cardiovascular mortality, heart attack, and stroke was observed in 107 patients (4.6 percent) in the varespladib group and 79 patients (3.8 percent) in the placebo group.
"The sPLA2 inhibition with varespladib may be harmful and is not a useful strategy to reduce adverse cardiovascular outcomes after ACS," the authors write.###
(doi:10.l001/jama.2013.282836; Available pre-embargo to the media at http://media.jamanetwork.com)
Among patients with recent ACS, use of enzyme inhibitor does not reduce risk of cardiovascular event
2013-11-19
ELSE PRESS RELEASES FROM THIS DATE:
In enzyme's isoforms, hope for developing heart drugs that improve contractility, prevent SCD
2013-11-19
In enzyme's isoforms, hope for developing heart drugs that improve contractility, prevent SCD
(SALT LAKE CITY)—Drugs known as PDE3 inhibitors save many lives by helping failing hearts do a better job of pumping blood. But those same medications come with ...
National study finds renal stenting does not improve outcomes for renal artery stenosis patients
2013-11-19
National study finds renal stenting does not improve outcomes for renal artery stenosis patients
Rhode Island Hospital researchers play lead roles in study; will present findings at the annual meeting of the American Heart Association
PROVIDENCE, R.I. – According to the findings ...
2 studies on the use of breast MRI
2013-11-19
2 studies on the use of breast MRI
CHICAGO – The overall use of breast magnetic resonance imaging has increased, with the procedure most commonly used for diagnostic evaluations and screenings, according to a study published by JAMA Internal Medicine, a JAMA ...
Beta-blockers before surgery appear associated with lower risk of heart-related events
2013-11-19
Beta-blockers before surgery appear associated with lower risk of heart-related events
Giving beta-blocker medication to patients with heart disease undergoing noncardiac surgery appears to be associated with a lower risk of death and major adverse cardiovascular events (MACE) ...
Poorer, rural counties have lower CPR training rates
2013-11-19
Poorer, rural counties have lower CPR training rates
Cardiopulmonary resuscitation (CPR) training appears to be lower in more rural counties, those with higher proportions of black and Hispanic residents and lower household incomes, and in the South, Midwest ...
Drinking more milk as a teenager does not lower risk of hip fracture later
2013-11-19
Drinking more milk as a teenager does not lower risk of hip fracture later
Drinking more milk as a teenager apparently does not lower the risk of hip fracture as an older adult and instead appears to increase that risk for men, according to a study published by ...
Preterm birth risk increases for pregnant women exposed to phthalates
2013-11-19
Preterm birth risk increases for pregnant women exposed to phthalates
The odds of preterm delivery appear to increase for pregnant women exposed to phthalates, chemicals people are exposed to through contaminated food and water and in a variety of products ...
Gene plays major role in suppressing cancer
2013-11-19
Gene plays major role in suppressing cancer
Adelaide researchers have found that a specific gene plays an important role in suppressing lymphoma, a type of blood cell cancer.
The caspase-2 gene is related to a family of proteins that are essential for ...
Tackling early socioeconomic inequality as important as encouraging smoking cessation
2013-11-19
Tackling early socioeconomic inequality as important as encouraging smoking cessation
Although health behaviours such as smoking are directly linked to the majority of early deaths in the UK, tackling these individual factors fails to address the underlying ...
Bacteria recycle broken DNA
2013-11-19
Bacteria recycle broken DNA
Bacteria recycle broken DNA that bacteria can take up small as well as large pieces of old DNA from this scrapheap and include it in their own genome. This discovery may have major consequences – both in connection ...