PHYSICIANS OFFICE
NEWS BRIEFS
Selected by POR Editorial Board
M
P
otion-Tracking MRI May
Help ID Stroke Risk in A-Fib
CSK9 Inhibitors Cut LDL
Cholesterol, CVD Risk
A new class of cholesterol
medication could sharply cut
low-density lipoprotein (LDL) cholesterol in
patients who don't fare well on statins, a new
research review confirms. The findings were
published online April 28 in the Annals of
Internal Medicine.
The drugs, known as PCSK9 inhibitors, are
not yet on the market. But the U.S. Food and
Drug Administration is expected to decide
later this year on the first two medications in
the class: evolocumab (Repatha) and
alirocumab (Praluent). A team of researchers
led by Eliano Navarese, M.D., Ph.D., of Heinrich
Heine University in Dusseldorf, Germany,
pooled the results of 24 clinical trials involving
10,159 patients. Some compared a PCSK9
inhibitor to a placebo, while others used
ezetimibe (Zetia) for comparison.
The review of 24 clinical trials found that
PCSK9 inhibitors lowered patients' LDL
cholesterol by about 47 percent, on average.
More importantly, the drugs seemed to cut the
risk of myocardial infarction and cardiovascular
mortality, according to the researchers.
"The initial
clinical trial
experience with
PCSK9 inhibitors
fuels cautious
enthusiasm,"
write the authors
of an accompanying editorial. "The metaanalysis by Navarese and colleagues
provides important preliminary information
on clinical outcomes as the FDA considers
approval of PCSK9 inhibitors for clinical use.
Motion-tracking magnetic
resonance imaging (MRI)
scans of the heart can help identify people
with atrial fibrillation (AF) who are at high risk
for stroke, a new study indicates. The study
also calls into question the mechanism linking
AF with higher stroke risk, says a team
reporting the findings online April 27 in the
Journal of the American Heart Association.
A team led by
Hiroshi Ashikaga,
M.D., Ph.D., of the
Johns Hopkins
University School
of Medicine in
Baltimore,
performed MRI
scans on 169 patients with AF, aged 49 to 69.
Left atrial volume, emptying fraction, strain,
and strain rate were assessed by tissuetracking cardiac magnetic resonance.
The researchers determined that
depressed left atrial reservoir function may be
a sign of stroke risk. "Altered function in the
left atrium of the heart may lead to stroke
independently of the heart rhythm
disturbance itself," Joao Lima, M.D., a professor
of medicine and radiology at the medical
school and director of cardiovascular imaging
at Johns Hopkins Hospital, explained in a
Hopkins news release. He and Ashikaga
believe this altered heart chamber function
could occur even in people without AF.
"Our findings suggest that assessment of
left atrial reservoir function can improve the
risk stratification of cerebrovascular events in
AF patients," the authors write.
27
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