Cardiologists Report $325,000 Median Compensation in Survey Reply

Cardiologists were the third highest paid physician specialists in 2010, according to a survey of more than 15,000 physicians conducted by Medscape, including a detailed report on the approximately 475 cardiologists in the survey. The cardiologists reported a median compensation of $325,000. Only orthopedic surgeons and radiologists, at $350,000, topped the cardiologists. One-fifth of cardiologists said they made more than $500,000.
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Large Meta-Analysis Finds No Link Between ARBs and Risk Of MI Reply

Angiotensin-receptor blockers (ARBs) don’t increase the risk of MI, according to a very large new meta-analysis published in BMJ. The concern about ARBs and MI have lingered since the VALUE trial in 2004 found a 19% increase in the risk of MI, though subsequent trials have not reinforced the finding.
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Scientific Fraud Found In Wayne Alexander’s Research Group At Emory 3

Scientific fraud has been discovered in three papers from Wayne Alexander’s research group at Emory. As first reported on Retraction Watch, two papers in Arteriosclerosis, Thrombosis, and Vascular Biology  and one paper in Circulation Research have been retracted by the journals after being notified by the Emory University Office of Research Compliance following an investigation by the Emory University Investigation Committee.
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Drug-Eluting Stents Add $1.5 Billion Per Year To Medicare Costs 1

Drug-eluting stents (DESs) cost Medicare an additional $1.57 billion per year, according to a study published online in the Archives of Internal Medicine. Using a random sample of Medicare beneficiaries, Peter Groeneveld and colleagues compared annual costs for patients with coronary artery disease in 2002 (the year before DESs were introduced) to costs in the years from 2002 through 2006.

The researchers then calculated the difference in national expenditures attributable to DESs and found that for each CAD patient (whether or not they received a DES),  DES was associated with:
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Third Generation Paclitaxel-Eluting Platinum Chromium Coronary Stent Approved in US Reply

Boston Scientific said today that it had received FDA approval for a third generation drug-eluting stent, the ION Paclitaxel-Eluting Platinum Chromium Coronary Stent System. The “unique platinum chromium (PtCr) alloy” is specifically designed for use in the coronary arteries.

An article in the Wall Street Journal points out that commercial expectations for the new stent are modest because it uses paclitaxel. However, a version that uses everolimus on the same platform may have more appeal when it appears on the market, which is anticipated to take place in 2012.
Click here to read the Boston Scientific press release…

ACC & AHA Publish Expert Consensus Document On Hypertension In The Elderly Reply

Although 64% of elderly men and 78% of elderly women have hypertension, hypertension in the elderly was not considered a significant clinical problem until 2008, when the Hypertension in the Very Elderly Trial (HYVET) trial demonstrated the substantial benefits of reducing blood pressure in these patients. Largely in response to HYVET, the ACC and the AHA have published the first expert consensus document on hypertension in the elderly.
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Tracking Doctors’ Movements… And Prescriptions Reply

Editor’s Note: The following excerpt from the blog of Dr. Westby Fisher, an electrophysiologist at NorthShore University HealthSystem in Evanston, IL, is reprinted with permission. Fisher was the first to discover and comment upon the use of RFID tags at the ACC meeting earlier this month. Click here for my  perspective on RFID badges at medical conferences.

The Implications of Physician Tag and Release

 by Dr. Westby Fisher

Recently, a disturbing trend of monitoring physician quality and accountability has taken another ominous turn: tracking physician’s movements at scientific conferences (so called “tag and release”) using RFID tags imbedded in attendees name badges at national scientific sessions. Having had personal experience with the recent American College of Cardiology meeting, this technology will also be imbedded in the name badges for attendees at the upcoming Heart Rhythm Society meeting to be held in San Francisco in May.
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Mark Midei Gives A Preview Of His Defense Reply

Mark Midei, the embattled Maryland interventional cardiologist, has finally spoken. After more than a year of intense controversy and criticism, Midei has presented a preview of his defense in a commentary published by the Baltimore Sun.

Midei writes that he will soon appear before the Maryland Board of Physicians where “I will have the long-awaited opportunity to meet with my peers and make the case for retaining my license to practice medicine. In the meantime, I take the opportunity now to address some important points about the charges leveled against me in connection with my work with cardiac stents at St. Joseph Medical Center in Towson, Maryland.”
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The Impossible Dream: A Scientific Committee Free Of Conlicts Of Interest Reply

Editor’s Note: The following guest post, by Allan Brett, the director of the General Internal Medicine division at the University of South Carolina School of Medicine and editor-in-chief of Journal Watch General Medicine, is reprinted with permission from CardioExchange, the cardiology social media website published by the New England Journal of Medicine. The post is a response to the recent publication of an AHA scientific statement on triglycerides, which was summarized here earlier this week.

Today I saw in my office a healthy 70 year-old man with no cardiovascular risk factors and a healthy lifestyle. Recently he had lipid testing at a “screening fair,” showing a total cholesterol of 201, HDL of 70, triglycerides of 120, and LDL of 107, similar to past lipid profiles. Pointing to the “H” next to the total cholesterol of 201 on the lab report, he asked, “If this means “high,” don’t I need a cholesterol drug?” If the new AHA Scientific Statement has its way, his triglyceride level would also merit an “H” (high) and I would have even more explaining to do.
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CDC: Half The US Now Protected By Comprehensive Smoke-Free Laws Reply

According to the CDC, nearly half the US population is now protected from second-hand smoke by comprehensive laws that restrict smoking in 3 venues (private sector worksites, restaurants, and bars). If the current trend continues, all 50 states and the District of Columbia will be smoke-free by 2020.

The first law prohibiting indoor smoking was passed in Delaware in 2002. Today 26 states in the country have comprehensive smoke-free laws that restrict smoking. In addition, 10 states have laws that partially restrict smoking in 1 or 2 venues but not all 3 and 8 states have less restrictive laws allowing smoking in designated areas or areas with separate ventilation. 7 states have no smoking restrictions. The south has lagged behind the rest of the country in enacting smoke-free laws.
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New WHI Analysis Links Calcium Supplements To CV Risk Reply

A new study may renew concerns that the combination of calcium supplements and vitamin D might increase cardiovascular risk. The linkage has been proposed before, but the Women’s Health Initiative (WHI) found no additional risk. However, in an article appearing in BMJ, Mark Bolland and colleagues point out that more than half the 36,000 women in WHI were taking calcium supplements at the start of the trial.
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$50K: The Price For A VIP Dinner For 2 With The Cleveland Clinic CEO 1

Want to have dinner with Delos Cosgrove, the cardiac surgeon who’s the CEO of the Cleveland Clinic? Just sign up for a platinum sponsorship of the Cleveland Clinic’s 2011 Medical Innovation Summit and you’ll receive an invitation “to attend the private VIP dinner hosted by Cleveland Clinic CEO & President, Delos Cosgrove, MD.” The cost is $27,500 but you’ll have to go stag. If you want to bring along a friend you’ll have to spring for a premier sponsorship, which will cost you $50,000.

Of course, that’s not all you’ll get for your money. With the premier sponsoprship, you’ll also get, among other benefits:
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100 Is The New 150: AHA Lowers Optimal Triglyceride Level 2

In a newly released scientific statement on triglycerides, the AHA recommends that 100 mg/dL replace 150 mg/dL as the upper limit for the “optimal level” for triglycerides. But, the statement acknowledges, the cut point should not be used as a therapeutic target for drug therapy, “because there is insufficient evidence that lowering triglyceride levels” can improve risk. Instead, the statement puts a large emphasis on lifestyle changes, especially with diet and exercise, to cut triglycerides and reduce risk.
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FDA Offers Cautious Support For Olmesartan (Benicar) Reply

The FDA announced today that it had reviewed the results of the ROADMAP and ORIENT trials and had determined that the benefits of olmesartan (Benicar, Daiichi Sankyo) “continue to outweigh its potential risks” when used as indicated for the treatment of high blood pressure. In June 2010 the FDA had announced that it was conducting a safety review of the drug based on the unexpected finding of a greater number of deaths from cardiovascular causes associated with olmesartan in the two trials.
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FDA Officials Offer Explanation For Absence of Low Dose Dabigatran Reply

Following the approval last October of dabigatran some observers  criticized the FDA’s decision not to approve the lower 110 mg dose of the drug in addition to the higher 150 mg dose. Now, in a perspective in the New England Journal of Medicine, 3 FDA officials, B. Nhi Beasley, Ellis Unger, and Robert Temple, explain that their decision “was based on our inability to identify any subgroup in which use of the lower dose would not represent a substantial disadvantage.”
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NY Times Magazine: Sugar Is Not So Sweet Reply

You may want to skip your Sunday sweet this week. On Sunday the New York Times magazine section will publish a major assault on sugar by the veteran and often controversial journalist Gary Taubes. In a long and detailed feature article, Taubes outlines the case for the prosecution against sugar, along with its nearly identical and ubiquitous cousin, high-fructose corn syrup, which he argues may well be a chronic toxin that can cause not only obesity, cardiovascular disease, and diabetes, but cancer as well. Taubes writes:

It very well may be true that sugar and high-fructose corn syrup, because of the unique way in which we metabolize fructose and at the levels we now consume it, cause fat to accumulate in our livers followed by insulin resistance and metabolic syndrome, and so trigger the process that leads to heart disease, diabetes and obesity. They could indeed be toxic, but they take years to do their damage. It doesn’t happen overnight. Until long-term studies are done, we won’t know for sure.

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Particle Trap Reduces Harmful Diesel Emissions Reply

A commonly available particle trap can dramatically reduce harmful emissions from diesel engines and may prevent adverse cardiovascular effects from the emissions, according to a new study published in Circulation. In a randomized, double-blind, three-way crossover trial, Andrew Lucking and colleagues compared the effects of filtered air to diesel air with or without a particle trap for one hour in 19 healthy volunteers.
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Phentermine/Topiramate Combination Yields Significant Weight Loss 11

Updated– The experimental diet drug combination of phentermine and topiramate demonstrated “robust efficacy” in  CONQUER, a large new trial published online in the Lancet. The results of the trial follow a year in which the FDA turned down 3 new investigational diet drugs (including Qnexa, the phentermine and topiramate combination used here) and removed the diet drug sibutramine from the market, leaving only one diet drug, Orlistat, still on the market.
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ACC Satellites: Meet The New Boss, Same As The Old Boss? 3

The announcement by the ACC that it will eliminate the “current model of satellite symposia” has provoked a wide range of responses, although at this point no one knows exactly what the new model will look like. One  cardiologist who has often been critical of the college warned that the announcement is “NOT what it seems: the industry sponsored satellites will be handled by ‘business development’ with no scientific oversight. It’s an open door for the presentation of highly-biased promotional material.”

Dan Carlat, a psychiatrist who has been a pioneer in efforts to reform CME, said the impact of the change is “unclear:”
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Harlem Hospital’s Former Chief Of Cardiology Sues New York City Reply

The former chief cardiologist at the New York hospital where more than 4,000 echocardiograms went unread is suing the city, according to a report in the Daily News. Icilma Fergus was the chief of cardiology last May at Harlem Hospital when a report in the New York Times about the unread echocardiograms sparked a scandal. Fergus was fired from her job shortly afterward.

In her suit, according to the Daily News, Fergus claims “she was set up as a patsy for a massive backlog in unread heart tests at the hospital.” She states that “she began sounding the alarm” about the unread echocardiograms when she took the job in 2007, and asked her supervisors for extra assistance to read the echocardiograms. Fergus is seeking her old job back as well as lost wages and $10,000 in punitive damages.

In addition, Fergus said that there are “other city run medical facilities where the problem is equally as bad.”


Big Brother, Err, The ACC, Is Watching You 3

It didn’t feel creepy, but in fact the ACC, and anyone else it wanted to share the information with, was watching our every move in the convention center during the scientific sessions.

Credit the indefatigable electrophysiologist, Westby Fisher for peeking behind the curtain. Or, in this case, ripping apart his ACC congress badge. Here’s what he found: the ACC congress badges contained RFID tags that allowed the ACC to track the movement of everyone with a badge. Then he found a press release (reprinted below) from Alliance Tech, the company that provided the RFID technology, that explained what it’s all about.
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