Big studies have shown that low HDL levels may be as important as high levels of low-density lipoprotein (LDL) in causing heart attacks.
Many hoped that the giant clinical trial--the biggest of its kind--could help settle whether these drugs run a risk of causing heart problems.
It was an analysis of published clinical trials that raised the first big questions about drug-coated stents causing heart attacks in rare cases.
These statin drugs do a great job cutting LDL, the bad cholesterol that cakes up in arteries and then breaks off, causing heart attacks.
Lorcaserin is a much safer way of hitting one of the receptors tripped by fenfluramine, a diet drug that was pulled from the market for causing heart valve problems.
He said that one of the problems with fen-phen, a diet drug combo that wound up causing heart-valve problems, was that doctors were too eager to hand them out.
Its pill, code-named AGI-1067, is the first drug designed to target cardiac inflammation--a problem that many cardiologists now think may be at least as important as high cholesterol in causing heart disease.
Even before the results of the study, dubbed ProACTIVE, it had been shown to reduce inflammation in the arteries, which some experts believe could be more important than cholesterol in causing heart attacks.
The FDA, he said, had ignored warnings that the pain pill Vioxx was killing people by causing heart attacks and strokes--and he said the agency was incapable of defending the public against another drug disaster.
Zetia (generically known as ezetimibe) lowers low-density lipoprotein (LDL), the bad cholesterol involved in causing heart attacks and strokes, but less so than existing drugs like Lipitor (generically known as atorvastatin), Crestor, from AstraZeneca, or simvastatin.
FORBES: Merck's Cholesterol Pill Win Is Already Drawing Fire
Just last month, researchers led by Armin Arbab-Zadeh of Johns Hopkins University School of Medicine in Baltimore published a comprehensive review of the biology of heart attacks in the journal Circulation, which said that vulnerable plaques often rupture without causing a heart attack and that a "perfect storm" of other conditions is required before one occurs.
Normally, orderly waves of electric activity pass through the cardiac tissue, causing the heart muscle to contract.
If it detects a severe arrhythmia, the device is designed to shock the heart, causing it to revert to normal rhythm.
Whereas LDL brings cholesterol to the artery wall, where it collects in heart attack-causing plaques, HDL carts it away.
An ablation sends radio frequency energy into the part of the heart that is causing the irregular heartbeat and kills the cells that cause the problem.
William Boden of the University of Buffalo says the idea that the arteries were thin does not explain away worries about Zetia's effectiveness against heart attack-causing atherosclerosis.
Based on the study Merck said it will move ahead with a massive 30, 000 patient study led by Oxford University to prove that anacetrapib can lower heart risk without causing other adverse effects.
FitzGerald says the results aren't surprising and that it was always likely that the heart-attack-causing properties of Vioxx might take time to decrease.
The study failed to prove that Vytorin, a combo pill of Zocor and the drug Zetia, did any better at preventing heart-attack-causing atherosclerosis than older medicines.
But in January results from an artery-imaging study showed that adding Zetia to Zocor didn't slow heart-attack-causing atherosclerosis in patients with a genetic disorder that causes high cholesterol.
The study, called ENHANCE and started in June 2002, intended to prove that adding Zetia to Zocor caused less heart-attack-causing plaque to build up in patients' arteries than Zocor alone.
It suggested that Falwell's heart had stopped suddenly, causing him to fall forward, striking his nose on the desk before sliding to the floor.
In a study of more than 1, 500 heart patients in two countries, the Icelandic gene-hunting firm found that defects in a crucial inflammation-causing gene nearly doubled the risk of heart attack and boosted the risk of stroke by 67%.
Meanwhile on the right end of the political spectrum, Tea Party heart throb Michelle Bachman famously accused vaccines of causing autism.
DeCode says that nearly 50% of heart attack patients in Iceland have one of the two inflammation-causing genes.
But sometimes scar tissue formed inside the stent, causing artery to close up again-leading to a repeat procedure or to heart bypass surgery.
One prediction from models of a chaotically beating heart is the break-up of regular electrical impulses into spirals, causing uneven contractions.
Heart failure is a degenerative, terminal disease affecting more than 20 million patients worldwide and causing more than 7.25 million deaths each year.
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