Study: Old Drugs Could Give Tb A 1-2 Punch
TB is one of the worlds oldest killers, and the lung disease still claims the lives of more than 1.5 million people globally every year. The bacteria that cause TB are fast becoming impervious to many treatments, drug resistance that is seen worldwide but is a particular problem in parts of Asia and Africa. While typically the TB doesnt respond to two top treatments, an emerging threat is so-called extensively drug-resistant disease, or XDR-TB, that is virtually untreatable by remaining options.
So researchers are frantically hunting new approaches, including taking a fresh look at some old drugs.
TB bacteria contain a certain enzyme that renders the penicillin family of antibiotics drugs useless.
“It chews them up and spits them out and they never get to see their target,” explained biochemist John Blanchard of the Albert Einstein School of Medicine.
But there are different antibiotics that can block that enzyme, called beta-lactamase. One, named clavulanate, has long been sold as part of the two-drug Augmentin combination thats widely used for various childrens infections.
So Blanchards team tested whether administering clavulanate might make TB vulnerable to other antibiotics – and found a combination that in laboratory tests blocked the growth of 13 different drug-resistant TB strains.
The combo: Clavulanate to drop TBs shield, plus a long-sold injected antibiotic – meropenem, part of that penicillin-style family – that then attacks the bacteria.
The findings are reported Thursday in the journal Science.
What happens in a lab doesnt necessarily work in people. Still, the findings were so compelling that two teams of U.S. researchers – from the National Institutes of Health and New Yorks Montefiore Medical Center – already are planning small patient studies in South Korea and South Africa. They hope to begin those studies later this year.
“Its very clever,” said Dr. Anthony Fauci, director of NIHs National Institute of Allergy and Infectious Diseases. When one drug knocks out the TB microbes defense, “that leaves the original drug with the capability of doing what its supposed to be doing.”
Genentech Provokes Doctors Ire With Costly Avastin Trial
The 2,710-patient trial, whose results are expected in April, may show that 12 months of Avastin added to six months of chemotherapy can reduce the risk of colon cancer recurring. The test is part of a $1 billion campaign by the South San Francisco-based company to expand the uses of Avastin, already approved for advanced colon, lung and breast cancer
The drug, among the most expensive cancer medicines at a yearly wholesale cost of $52,800 a year, generated $4.8 billion in 2008 sales. Revenue may rise by $2 billion annually should the drug gain use against newly-diagnosed colon cancer, said Jason Zhang, an analyst for BMO Capital Markets in New York. A positive result may increase Genentechs value as the company fends off a hostile tender offer from Roche Holding AG.
“I was furious” about the study design, said Leonard Saltz, a research oncologist at Memorial Sloan-Kettering in New York who consults for Genentech, in a telephone interview. Saltz said in an interview that testing a drug for six months has been “standard practice for such a study for the last dozen years.
“It is a significant expense issue, and it is a convenience and psychology issue,” said Saltz, noting that the drug should first have been tested for half a year before testing it for a year. “I was very disappointed.”
Fair Question
Saltz and Alan Venook, a researcher at the University of California, San Francisco, both said they dont believe the study was designed just with profit in mind, and Venook praised the trials lead scientist, Carmen Allegra, the division chief of hematology and oncology at the University of Florida Shands Cancer Center in Gainesville.
Still, Venook said, “Its a fair question to ask. While I believe they want to help patients, they also have a fiduciary responsibility to their shareholders to get the best returns they can within the context of legal and ethical practices,” he said. “If I worked for Genentech, it would be my job to develop studies that would help them sell as much drug as possible.”
The study, called C-08, has emerged as a key point of contention between Genentech and Basel, Switzerland-based Roche Holding AG, now pressing a hostile tender offer.
Roche, which already owns 56 percent of Genentech shares, said its $86.50-a-share bid is based in part on a financial model giving the study 55 percent odds of success, compared to Genentechs 61 percent estimate. A Genentech board committee has said the company should be priced at $112-a-share. The Roche offer expires March 12, before the trial results are reported.
Swiss Army Knife
A positive finding is also critical to Genentechs long- term push to aim Avastin at a wide variety of early-stage tumors, making the drug a virtual Swiss army knife drug for cancer. Avastin is Genentechs “single most important value- driver over the next year,” said Mark Schoenebaum, a Deutsche Bank analyst in New York, in a telephone interview.
Monthly Price
The median monthly price of cancer treatment in the U.S. surged six-fold to $5,988 from $1,052 in the early 1990s, according to Peter Bach, a researcher at Memorial Sloan- Kettering Cancer Center in New York and former senior policy adviser at the federal Medicare program. Advances in treatment have not improved at the same pace as their costs, he wrote in a report in the Feb. 5 New England Journal of Medicine.
“With each advance in treatment, the magnitude of the increase in the cost of treatment exceeded the magnitude of improvement in efficacy,” wrote Bach, who consults for Genentech and other companies. He urged lawmakers to consider strategies for containing costs of cancer drugs such as having Medicare compare effectiveness of the medicines it pays for.
Cancer doctors buy Avastin and are allowed to charge the manufacturers price for the drug plus 6 percent. For advanced colon cancer patients who meet certain financial criteria, Genentech capped Avastins cost at $55,000.
The company hasnt announced what it would charge for Avastin as an adjuvant, or early-cancer, treatment.
Both Saltz and Venook say its also unknown whether longer use of Avastin, which fights cancer by crimping blood-vessel growth, may produce delayed side effects 15 years later if such patients are cured of their cancer.
Long-Term Effects
Alzheimers Attack On Brain May Be Enabled By Nerve Protein
The findings, in test tube experiments and in mice, appear to solve a mystery about how a substance called beta amyloid links to nerve cells in the brain and disrupts their ability to communicate.
The study, published today in the journal Nature, gives scientists at drug companies and universities a new target for Alzheimers. The results are likely to kick off a competition to find a medicine to treat the disease, which robs some 20 million people around the world of their memory and mental ability.
“The race will be to find the drug that blocks that receptor and protects the nerve cell,” said Sam Gandy, associate director of the Alzheimers Disease Research Center at Mount Sinai School of Medicine in New York and a scientific adviser to the Alzheimers Association. If the findings are confirmed, “this would immediately provide a new target, a new way to screen for new drugs that would otherwise have been totally undiscoverable.”
Researchers have been trying to understand the workings of Alzheimers disease ever since 1906, when Alois Alzheimer, a German pathologist, dissected the brain of a deceased patient and described the massive cellular damage he found.
Interference With Nerve Cells
In recent years, most researchers have come to believe that this damage is caused by clumps of the beta amyloid protein gathering around nerve cells and interfering with their ability to communicate.
One gap in that theory is that scientists hadnt offered an explanation as to how beta amyloid interacts with cells. The new study, led by Stephen Strittmatter, a Yale neurology professor, suggests that the small protein, known as a prion, acts as a receptor that allows beta amyloid to link to it and send signals into the cell.
Until now, prions have mostly been known for their role in mad cow disease. A toxic, misshapen form is linked to the human version of the illness, known as Creutzfeldt-Jakob disease. The form of the prion protein studied in the Alzheimers paper is normal and is found on the surface of nerve cells.
Lead Suspect
“Cellular prion protein has now emerged as the lead suspect,” said Lennart Mucke, an Alzheimers researcher and director of the Gladstone Institute for Neurological Disease in San Francisco, in a telephone interview yesterday. Strittmatters findings suggest that scientists could design a drug that would block the prion from binding to the nerve cell.
The goal of such a drug would be to prevent the beta amyloid clumps from attaching to the neurons and starting a “toxic cascade that prevents memory function,” said Strittmatter. “If you can do that, you can halt the disease.”
They sent electrical currents between groups of neurons that had been extracted from mice and exposed to beta amyloid. Some of the mice had been engineered to lack the prion protein and others hadnt. In the mice that lacked the prion protein, the beta amyloid had no effect on the flow of electrical current, suggesting beta amyloid isnt damaging without the prion protein.
Next Studies
The next step is to test the impact of the prion protein on living mice, Strittmatter said. He and his colleagues are mating mice engineered to lack the prion with others engineered to have a version of Alzheimers disease.
“Do the offspring preserve memory in spite of fact that they carry human Alzheimers disease genes?” Strittmatter asked. His hope is that “even though theyre making bad forms of amyloid beta, it has no place to attach to the neuron and do its bad thing.”
These studies are under way, and it will take at least six months to see if the mice will begin to show symptoms of the disease or be spared because they lack the prion, Strittmatter said.
Healthy Men Should Consider Taking Prostate Drug, Doctors Say
The new guidelines from cancer specialists and urologists dont recommend men definitely take the drug, sold generically as finasteride and by Merck & Co. under the brand Proscar. Rather, it advises men to discuss with their doctors the benefits and the risks of the treatment, according to a study published today in the Journal of Clinical Oncology.
An estimated 186,000 U.S. men were diagnosed with prostate cancer in 2008 and nearly 29,000 people died from the disease, according to the National Cancer Institute. It is the second- leading cause of cancer-related death in men and occurs more frequently in African-Americans.
The Prostate Cancer Prevention Trial, conducted from 1993- 2003, found that men who took the drug finasteride cut their risk of developing prostate cancer by 25 percent compared with those who didnt take the drug. Doctors had worried the drug would lead to faster-spreading tumors in men who developed prostate cancer. Now most physicians who reviewed the trial data have determined the risk of aggressive cancers is “unlikely,” though it could “not be excluded with certainty,” according to the study.
Octuplets Mother Descended Quickly From Miracle Mom to Internet Target Of Scorn,
But in short order the public learned that Miracle Mom was also Single Mom, Unemployed Mom and Welfare Mom. And as fast as you could Twitter “I hate Nadya Suleman,” scores of Web sites were dedicated to denouncing the so-called Octomom, others to making fun of her, a rap music video lampooned her (“pops em out like a toaster/needs a pacifier holster”) and angry citizens threatened to kill her publicists.
“In terms of reaction to her, I would say not in my experience have I ever seen anything like it. And I would add that I was involved in public relations for Three Mile Island after the accident,” said publicist Mike Furtney, who quit representing Suleman after receiving death threats. (Lest anyone forget, the Three Mile Island accident of 1979 involved the partial meltdown of a nuclear reactor that for a time threatened to prompt the evacuation of a wide swath of Pennsylvania.)
Not that Suleman is the first person to go radioactive overnight. Dont forget O.J. Simpson.
But as pop culture historian Leo Braudy points out, Suleman has never been accused of killing anybody.
“This is not something that is usually considered a crime,” Braudy, who teaches at University of Southern California, said of giving birth to children. “Its something that in the past was celebrated. People would say congratulations.”
Of the nearly 50 Suleman discussion groups found on facebook.com this week, however, not one was headlined “Congratulations, Nadya!”
Instead there were titles like, “Nadya Suleman Should Be Sterilized,” “Nadya Suleman Disgusts Me,” and “Stop Idiot Moms Like Nadya Suleman.” (And those were the printable ones.)
To be fair, there were also a handful of pro-Suleman groups, although the “Leave Nadya Suleman Alone” one had only 64 members on Tuesday compared with the 3,530 people who had joined the “What Nadya Suleman Did Was Totally Wrong” group.
Although never venerated as a candidate for mother of the year, Suleman was, for about two days after the Jan. 26 birth of her octuplets, more the subject of curiosity than of ridicule and scorn.
That began to change as it became known she was a single mother with 14 children who was living on a combination of food stamps, student loans and disability claims while her elderly mother, who was caring for Sulemans six older children, couldnt make her mortgage payments.
It didnt help, either, that Sulemans own parents have publicly criticized her decision to have so many kids, or that Suleman bears a striking resemblance (some speculate a plastic-surgery-enhanced one) to that other famous mother, Angelina Jolie, and that shes been said to be looking for book, TV and movie deals.
That prompted Los Angeles Times blogger Elizabeth Snead to joke that Suleman, like Jolie, might someday become a U.N. goodwill ambassador.
Elsewhere on the Web, Jodie Rivera, a popular YouTube parody singer known as VenetianPrincess, put up a video of herself looking eerily like Suleman. As she sang, a doctor in scrubs (also Rivera) used a baseball glove to catch flying newborns.
“It was all in good fun, to bring a laugh to a situation people are taking very seriously,” said Rivera who herself acknowledges she doubts Suleman is capable of caring for 14 children and perhaps should give some up for adoption.
The site momlogic.com, which provides both lighthearted and serious reports on motherhood, also got into the act, offering eight suggestions for reality shows Suleman might do. One example: “Fear Factor: Octuplets Edition,” in which contestants are lowered by harness into the Suleman home.
“Whoever can demonstrate the guts and determination to endure one round of octuplet diaper changes wins the grand prize – a lifetime supply of birth control.”
Some people have offered to help Suleman, including a church pastor, a nonprofit and even the man who says he was a sperm donor for her when they were dating in the 1990s. Although Suleman has denied that Denis Beaudoin is the sperm donor who fathered her children, he told ABC he still stands ready to help.
Men Receiving Regular Psa Tests Should Consider Drug to Prevent Prostate Cancer, Say
The advice stops short of saying men should take the drug finasteride, sold in generic form and as Proscar. It has risks and benefits each man must weigh, they say.
Thats bound to be confusing, doctors admit.
The drug can cut the odds of being diagnosed with prostate cancer by about 25 percent. Earlier worries that it might spur aggressive tumors have largely faded with further study, making doctors more willing to recommend it now.
“If a man is interested enough in being screened, then at least he ought to have the benefits of a discussion” about taking the drug, said Dr. Barnett Kramer, a National Institutes of Health scientist and one of the authors of the new guidelines.
They were published in two medical journals and discussed in a news briefing Tuesday in connection with a cancer conference in Florida. They were written by doctors with American Society of Clinical Oncology and the American Urological Association.
Cost could be a big issue for many men. Finasteride, which must be taken daily, costs $2 to $3 a pill and insurers may not cover it for cancer prevention. Also, to prevent a single additional case of cancer, 71 men would have to take the drug for seven years – another reason this is an individual decision, doctors say.
“There probably would be millions of different attitudes about taking a pill a day to prevent a condition that may or may not occur,” said the University of Michigans Dr. Howard Sandler.
About 186,000 American men this year will be told they have cancer of the prostate. The disease often is diagnosed from a biopsy after a suspicious PSA blood test, which measures a protein. PSA can be high for many reasons, and theres no proof that screening saves lives – the reason no major cancer groups recommend it.
Most men over 55 get the test anyway, then face a dilemma if cancer is found. It usually grows so slowly it is not life-threatening, but it can prove fatal. Treatments often cause sexual or bladder control problems.
“We still dont know if screening and aggressive treatment is a good thing,” but if men are getting PSA tests, taking finasteride is reasonable, said the American Cancer Societys chief medical officer, Dr. Otis Brawley.
Finasteride shrinks the prostate and curbs testosterone, a hormone that helps cancer grow. The drug already is used for urinary problems from prostate enlargement as men age. At a lower dose, its sold as the baldness drug Propecia.
A similar drug, dutasteride, sold as Avodart, is being tested to see if it, too, prevents prostate cancer. The guideline covers the whole class of drugs but for now, doctors are focused on finasteride.
More study found that that wasnt the case. It was just that the tumors were more easy to detect among men taking the drug because it helped reduce prostate size.
The new advice to consider finasteride “is long overdue,” said Dr. Eric Klein, prostate cancer chief at the Cleveland Clinic. When men are given a full picture of the drugs effects, “its not a tough sell,” he said.
Finasteride has been linked to lower sexual desire and difficulty having an erection. However, in a study of older men, those were problems for most who werent taking the drug as well. Finasteride also gave benefits: fewer urinary problems and less incontinence.
“The overall quality of life was identical,” and most side effects go away after a few weeks of use, Kramer said.
Three of the 15 guideline writers have consulted for Merck & Co., which makes Proscar, or GlaxoSmithKline PLC, which makes Avodart.
Million-woman Study Provides More Evidence Linking Moderate Drinking And Certain Cancers
A quarter of the women reported no alcohol use. Nearly all the rest reported fewer than three drinks a day; the average was one drink a day. Researchers compared the lightest drinkers – two or fewer drinks a week – with people who drank more.
Each extra drink per day increased the risk of breast, rectal and liver cancer, University of Oxford researchers reported Tuesday in the Journal of the National Cancer Institute. The type of alcohol – wine, beer or liquor – didnt matter.
That supports earlier research, but the new wrinkle: Alcohol consumption was linked to esophageal and oral cancers only when smokers drank.
Also, moderate drinkers actually had a lower risk of thyroid cancer, non-Hodgkins lymphoma and renal cell cancer.
For an individual woman, the overall alcohol risk is small. In developed countries, about 118 of every 1,000 women develop any of these cancers, and each extra daily drink added 11 breast cancers and four of the other types to that rate, the study found.
But population-wide, 13 percent of those cancers in Britain may be attributable to alcohol, the researchers concluded.
Moderate alcohol use has long been thought to be heart-healthy, something the new research doesnt address but that prompts repeated debate about safe levels. U.S. health guidelines already recommend that women consume no more than one drink a day; two a day for men, who metabolize alcohol differently.
“You have to balance all those things out,” said Dr. Philip J. Brooks, who researches alcohol and cancer at the National Institutes of Health. “This kind of information is important for people to know and to consult with their physician about the various risk factors they have.”
Pfizer Future With Wyeth Is Tiny Units Like J&j, Kindler Says
Kindler is dividing Pfizer into independent divisions similar to those at Johnson & Johnson and Abbott Laboratories as he plans how Pfizer, already the worlds largest drugmaker, will digest the $64 billion purchase of Wyeth. The strategy should keep Pfizer growing in spite of its size and dependence on a single product, Kindler said in an interview yesterday.
The combined companies will have businesses as diverse as vitamins, vaccines and veterinary medicine, Kindler said. Adding Wyeth will make Pfizer a $70 billion company, 50 percent larger than its closest competitor, London-based GlaxoSmithKline Plc.
“Once you reach a certain size, if you are dependent on one or two huge blockbusters to move the needle, you are raising the bar on R&D productivity beyond an amount anyone can deliver,” Kindler said. “We arent necessarily going to be exactly like J&J, but I admire their business model, I admire Abbotts business model. This transaction with Wyeth will give us the assets to have so many of those different kinds of businesses.”
Pfizer, of New York, last month agreed to buy Wyeth, based in Madison, New Jersey, to gain the companys Prevnar pneumonia vaccine and Enbrel arthritis drug in order to offset the loss of cholesterol drug Lipitor when its patent expires in 2011. The deal will close in the second half of the year, Pfizer said.
Pfizer, which sold its consumer products division to Johnson & Johnson for $16 billion in 2006, also would get Wyeths over- the-counter drugs. Pfizer sold its medical device business in the 1990s.
Shares Swoon
Since the deal was announced, Pfizer shares have declined 24 percent. Kindler attributed the drop to the company cutting its shareholder dividend by half. Pfizer fell 43 cents, or 3.1 percent, to $13.28 yesterday in New York Stock Exchange composite trading, the lowest price since 1996.
Investors are skeptical of Kindlers reorganization plan.
“There is only so much corporate-speak I can take,” Mike Krensavage, founder of Krensavage Asset Management in New York, said in a telephone interview. “It sounds like a bad project from a group of MBA students. It is all just talk. You have to look at the drugs the company produces and that is horrific.”
Pfizer will rebuild its cash by 2012 and can then return capital to investors, Kindler said. Even with the acquisition and changes in the business model, “I dont foresee anybody making double-digit top line growth in the industry,” Kindler said.
Kindler, 53, General Electric Co.s senior counsel under Chief Executive Jack Welch, said Pfizer will rely on many products overseen by smaller units, giving the company less volatile swings in sales and earnings. For example, no research group will have more than 150 scientists, enabling quicker decisions, Kindler said.
“Theyve dropped $6 billion every year in R&D and I cant for the life of me find a great sign that they got any return for that,” said David Heupel, a portfolio manager at Thrivent Financial for Lutherans in Minneapolis, in an interview. “As I watch this combined company evolve, that is where I want to see some sense of improvement. I think they will more than adequately cut costs. The real question is now, what are you? — just a larger, more protected company that will watch their assets dwindle away over time?”
Thrivent doesnt own Pfizer shares, Heupel said.
Kindler has been preparing Pfizer for an acquisition since he took the helm 2½ years ago. He replaced top management and restructured the company into six smaller units focused on diseases, including cancer, with high profit potential.
With smaller divisions, Kindler said integrating the Wyeth acquisition will be faster than when Pfizer digested its purchases of Warner-Lambert Co. and Pharmacia Corp.
Health Care Reform
Kindler said hes been meeting in Washington, D.C., with members of Congress, including Sen. Edward Kennedy, to press for comprehensive health care reform that expands insurance coverage to more Americans. Unlike the 1992 effort to enact reform that was plagued with disagreements, there is about 80 percent to 90 percent agreement how to increase access to health insurance, he said.
Kindler said a consensus is building to expand eligibility for public programs, health care information technology and comparing the effectiveness of medicines. He also said the drug industry needs to do more to improve its public image.
Drug Regulators Admit Error Tossing Lilly Critic From Panel
The Food and Drug Administration decided to eject panel member Sanjay Kaul after Lilly contacted the agency, said Janet Woodcock, director of the FDAs Center for Drug Evaluation and Research. The Indianapolis-based drugmaker complained about research articles written by Kaul that questioned the safety and effectiveness of the drug, called prasugrel, she said.
The FDA “disinvited” Kaul because of concerns he might be biased against the drug, said Woodcock, who called the dismissal a “mistake.” The panel on Feb. 3 backed prasugrels approval in a 9-0 vote, after the advisers in attendance downplayed the potential risks of bleeding and cancer. John LeCroy, an analyst with Nataxis Bleichroeder in New York, described the meeting as a “love fest” in a note to investors.
Kaul “would have been a very valuable member of the committee,” said John Jenkins, director of the FDAs Office of New Drugs, in a telephone interview yesterday. “He was asking the right questions.”
Sandy Van, a spokeswoman for Kaul, director of a heart research laboratory at Cedars-Sinai Medical Center in Los Angeles, said he wasnt available to comment. Lilly spokesman Mark Taylor didnt return a telephone call for comment.
Prasugrel, if approved, may take up to 20 percent of market share from Plavix, which generated $8.1 billion in 2007 for Bristol-Myers Squibb Co. and Sanofi-Aventis SA. Prasugrel was cleared by European regulators yesterday to be sold under the name Efient. Lilly will split revenue from the drug with Daiichi Sankyo Co. in Tokyo.
Not Invalidated
The FDAs Woodcock said the agency doesnt believe Kauls absence from the meeting “invalidates the results.”
The controversy over Kauls dismissal may mean “a small delay” in prasugrels final approval, said Tim Anderson, an analyst at Sanford C. Bernstein & Co. in New York, in a note to clients yesterday. “It would seem to be perfect material” for investigation by critics of the FDA in the U.S. Congress.
“It is unclear how the conclusions Dr. Kaul came to regarding the efficacy and safety of prasugrel suggest any bias, as opposed to well-reasoned scientific inquiry,” said Sidney Wolfe, director of Washington-based Public Citizens health- research group, in a letter to the FDAs Center for Drug Evaluation and Research on Feb. 19. “On the contrary, he is free from any financial conflicts of interest, which are not uncommon on FDA Advisory Committees.”
Several small mistakes led to the decision to keep Kaul off the committee, which was made during the weekend before the meeting without the knowledge of senior FDA staff, Woodcock said.
“This is not the correct procedure,” she said. “This is not going to happen again.”
How Heart Handles Anger Predicts Irregular Beat
But research released Monday goes a step farther, uncovering a telltale pattern in the EKGs of certain heart patients when they merely recall a maddening event – an anger spike that foretold bad news.
In already vulnerable people, “anger causes electrical changes in the heart,” said Dr. Rachel Lampert, a Yale University cardiologist who led the work. When that happens even in the doctors office, “that means theyre more likely to have arrhythmias when they go out in real life.”
At issue is cardiac arrest, when the hearts electrical system goes haywire and heartbeat abruptly stops. Survival requires a fast electrical shock from a device called a defibrillator.
To track angers effect, Lampert gave EKGs to 62 patients who had defibrillators implanted in their chests because of preexisting heart disease. When they recounted something that had made them angry, some patients experienced beat-to-beat EKG alterations that were similar to irregular heartbeat-predicting alterations that doctors can spot during treadmill testing.
In other words, the emotional stress was producing a red flag like physical stress can. But it did so without causing the jump in heart rate that exercise does, suggesting angers Adrenalin rush may act directly on heart cells.
The result: People whose EKGs showed a big anger spike were 10 times more likely to have their defibrillators fire a lifesaving shock in the next three years than similarly ill patients whose hearts didnt react to anger, Lampert reported in the Journal of the American College of Cardiology.
Next shes studying whether anger-reducing techniques might help those high-risk patients avoid irregular heartbeats.
Dont race out for an EKG. Nobody knows if anger has a similar electrical effect in people whose hearts arent already diseased.
But that question should be studied, said Dr. Nieca Goldberg, a spokeswoman for the American Heart Association who wasnt involved with the research.
Theres a clear connection between the heart and the head, that chronic negative emotions are somehow heart-damaging. “But we havent been able to explain why that happens,” said Goldberg, a cardiologist at New York University School of Medicine. “This is a step in the right direction.”
The question of the still-healthy aside, this is a small study and researchers must test the anger spikes predictive ability in many more heart patients to be sure of its value.
But if it pans out, the finding could affect a huge population: About 100,000 defibrillators are implanted each year in people at risk of irregular heartbeats because of damage from a survived heart attack, genetic disorders and other conditions. Scientists are searching for ways to tell which patients most need the implants, and the anger spike may offer help.