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Saturday, March 21, 2009

Nearly 90% of cardiologist-approved heart therapies are not supported by high-quality scientific testing

Recently the Wall Street Journal reported that a Study Questions Evidence Behind Heart Therapies -- specifically by this alarming statistic: “Just 11% of more than 2,700 recommendations approved by cardiologists for treating heart patients are supported by high-quality scientific testing.” It seems that the vast majority of prescribed treatments remain unratified by multiple randomized clinical trials – the highest level of evidence according to guidelines issued jointly by the American College of Cardiology and the American Heart Association.

I am caught up in this personally due to having had one heart attack some years ago. Ever since then I’ve been working hard to avoid a second one. My daily aspirin is strongly supported by scientific study, but it’s not very sure that I should be keeping on with the platelet inhibitor Clodiprogel (Plavix™, Bristol-Meyers Squibb/Sanofi Pharmaceuticals) prescribed after getting my clogged artery stented. I have to credit my cardiologist though – he is utterly impartial on the Clodiprogel – I cannot get any signal – pro or con. What can he say? As pointed out in this related article by US News & World Report no clinical trials exist beyond about one year (even that time is a bit vague!) of the heart surgery.

So as not to let all this cause me too much stress (possibly bad for the heart, but not strongly supported by solid scientific study) I picked up on this promising therapy – waltzing as a form of cardio-exercise. Evidently this works as well as trudging the treadmill and the dancing leads to a better quality of life as measured by the Minnesota Living With Heart Failure Questionnaire.* I note that the subjects were selected at random – that’s good, but “the study was not blinded, neither to the investigators nor to the patients.” Obviously it would not do to waltz blindly along, no matter how blissful that might be – until one hits the wall!

*I’d be skeptical if this weren’t based on Minnesota standards, that is, bitter cold, biting insects and so forth. ;)


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