Mohler III, director of vascular medicine at the University of Pennsylvania, who participated in some early studies with the drug, known as MS-325.
Thirty-eight leading doctors in vascular medicine have written an open letter to Medicare and urged the program not to expand coverage for carotid stents.
Ms. Molnar is now being treated by Emile Mohler, director of vascular medicine at the University of Pennsylvania, who recommended an exercise program on a DVD and medication.
WSJ: Peripheral Artery Disease (PAD) - When Achy Legs Are a Warning
"Why this wasn't made available at the panel meeting a week ago, I have no idea, " says William Hiatt, the University of Colorado vascular medicine specialist who chaired the panel.
She and others in vascular medicine grew concerned that the purportedly "definitive" NIH study of stents versus surgery wouldn't be definitive at all, because there was no third patient group getting drugs only.
Clyde Yancy, medical director of the heart and vascular institute at the Baylor College of Medicine, and another FDA panelist, notes that with drugs, so-called off-label use is often a scandal.
He was also the lead author of the influential (but controversial) 1999 New England Journal of Medicine DECREASE study on the use of bisoprolol during vascular surgery.
"If people come in and say my chest hurts, that gets attention, but if they say my leg hurts when I walk a couple of blocks, most doctors don't think that is a big deal, " says William Hiatt, professor of cardiovascular research at the University of Colorado School of Medicine and chairman of the American Heart Association's Peripheral Vascular Disease Council.
WSJ: Peripheral Artery Disease (PAD) - When Achy Legs Are a Warning
The problem with the study, Diet Soft Drink Consumption is Associated with an Increased Risk of Vascular Events in the Northern Manhattan Study ( Gardner et al., Journal of General Internal Medicine) is that the numbers are low enough to leave us uncertain as to whether diet drinks were the cause or simply correlated with other factors that led to these events.
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