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This week in the medical journals

By Peggy Peck Managing Editor

Editor's note: has a business partnership with, which provides custom health content. A medical journal roundup from MedPage Today appears each Thursday.


Health Organizations
Medical Research
Food and Drug Administration (FDA)


Lots of heart

It was all heart this week in the major medical journals, which teamed up with the American College of Cardiology meeting in Atlanta to report eight significant heart studies.

First, the good news.

Researchers reported that Crestor (rosouvastatin), considered the most potent of the cholesterol-lowering drugs called statins, can dramatically lower bad cholesterol while boosting good cholesterol.

The net effect, said researchers from the Cleveland Clinic, is that patients taking the drug can reverse the amount of artery-clogging plaque that causes heart attacks and strokes. The findings were published online by the Journal of the American Medical Association.

ACC: Aggressive statin therapy puts coronary artery disease into reverseexternal link

Taming heart attacks

Patients who develop acute coronary syndrome, a catch-all term for everything from minor heart attacks to crippling chest pain, will do better is they are treated with a combination of Plavix (clopidogrel) and ReoPro (abciximab) when they undergo procedures such as stenting, the use of a tiny, flexible tube to prop open clogged arteries.

That was the conclusion of researcher from Germany who studied more than 2,000 patients and also reported their findings in the Journal of the American Medical Association.

ACC: ReoPro lowers risk of adverse events in acute coronary syndrome patients having PCIexternal link

The most common type of heart attack is caused by a sudden, complete blockage of blood flow in an artery. This causes crushing chest pain and a heart attack called ST-segment elevation myocardial infarction, or STEMI.

This week researchers from Hamilton, Ontario, reported that giving a blood-thinner called Arixtra (fondarinux) to these patients when they have stenting can reduce the risk of second heart attacks or death.

The study was published online by the New England Journal of Medicine.

ACC: Arixtra reduces mortality in patients with STEMIexternal link

In praise of stent technology

Now, the ho hum news. Stents that are coated with drugs to prevent arteries from re-narrowing after they are opened actually work as advertised. And they work a whole lot better than zapping arteries with radiation to prevent re-narrowing called restenosis.

Cardiologists have known this for the last few years, and the zapping treatment, which is called brachytherapy, is now only rarely used. But that "common" knowledge was confirmed by two studies, both of which were published in the Journal of the American Medical Association.

ACC: Taxus stent beats radiation for treating in-stent restenosisexternal link

A losing combo

And, finally, the bad news -- a trio of studies about treatments that flopped.

Researchers at the Cleveland Clinic reported that combining two good drugs -- Plavix (clopidogrel) and aspirin -- to prevent first heart attacks in people who are at high risk is a poor idea. Aspirin by itself does a good job of preventing first heart attacks, but adding Plavix to the mix doesn't boost the benefit.

Worse yet, patients given the combo had a higher risk of hemorrhage and death, although the overall risk remained quite low. These results were reported in the New England Journal of Medicine.

ACC: Plavix-aspirin combo no better than aspirin alone for CVD event reductionexternal link

An "F" for B vitamins

Also reported in the New England Journal of Medicine were the disheartening results of a study called HOPE (Heart Outcomes Project Evaluation). This study found -- sadly for true believers -- that using vitamin B6 and B12 to lower blood levels of homocysteine doesn't prevent heart attacks.

A second vitamin B study from Norwegian researchers, again reported in the New England Journal of Medicine, confirmed no benefit for vitamin B treatments. And this study added a warning: too much vitamin B might be a bad thing -- patients who took folic acid, B12, and B6 had a trend toward an increased risk of heart attack.

ACC: Hope abandoned for benefit to lowering homocysteineexternal link

Blood pressure drugs prevent dementia

Moving from the heart to the head, a team of Johns Hopkins researchers reported that potassium-sparing diuretics -- medicine used to treat high blood pressure -- may cut the risk of Alzheimer's disease by almost 70 percent. The researchers, who reported their results in Archives of Neurology, based the finding on a study of more than 3,200 people ages 65 or older.

Antihypertensive agents appear protective against Alzheimer'sexternal link

Up in smoke

And on the subject of memory, this just in from Greece: Smoking marijuana four or more times a week is bad for one's memory and creates a slow learner.

The researchers compared two groups of heavy pot users -- those who have used it for at least 10 years and those who have used for at least five years --with a control group that tried pot at least once but hadn't used in at least two years, they reported in Neurology.

Heavy marijuana use linked to memory and learning deficitsexternal link

Antiobiotic risk

There was also disturbing use about possible adverse effects of antibiotics given to babies.

Doctors in Vancouver, British Columbia, reported in CHEST that babies given antibiotics during the first year of life may have an increased risk of developing asthma later.

Antibiotics in infancy linked to later asthmaexternal link

Smokers call for help

Here is a tip for smokers who are trying to kick the habit -- dial-up some help.

University of Minnesota researchers, conducting a randomized trial of 837 smokers, found that counseling services offered by telephone quit lines are an effective option. They reported their findings in the Archives of Internal Medicine.

Counseling and encouragement via phone helps smokers quitexternal link

Center seat, anyone?

And Dutch researchers shed more light on why air travel that features hours packed into crowded coach seats increases the chance of developing blood clots in the legs, called deep vein thrombosis.

It's not just the immobilization they found. Contributing to the problem appears to be the low-pressure, low-oxygen environment in the cabin, found the researchers, who tested the impact of air travel on 71 volunteers who volunteered for an eight-hour flight and also an eight-hour stint at the movies on the ground. They reported results in The Lancet.

Aircraft cabin environment contributes to venous thrombosisexternal link

Can you feel the rush?

Finally, a little boost to end the week -- but watch out because it packs a wallop.

High-octane energy drinks like Red Bull and SoBe No Fear are so high in caffeine that they exceed the FDA limit set for tamer drinks, like Coke or Pepsi. But the caffeine level isn't disclosed on the label, which means these drinks may pose a health hazard for people with high blood pressure, pregnant women, or people who are prone to anxiety attacks.

High-caffeine pop from energy drinks revealedexternal link

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