Though heart attacks continue to be the number one cause of death in the United States, the news for treatment and prevention of heart disease keeps getting better. An article in this issue of The Journal of the American Medical Association examines the rates of death in a multinational study of heart attacks and heart-related acute chest pain. The study was also covered in this Reuters article.
The news is very encouraging. As hospitals increasingly adopt evidence-based best practices for treating heart attacks, the rates of death and heart failure have dropped dramatically. Best practices include immediate angioplasty for heart attacks and medications like beta blockers and aspirin that have been proven to improve survival.
As best practices spread, we can hope that these statistics will continue to improve and that the tragedy of sudden death in middle age from a heart attack will be almost unheard of.
This LA Times article discusses the new FDA warning that will be applied to every antidepressant medication, warning of the potential for increased suicidal thoughts or behavior in patients between the ages of 18 and 24 taking antidepressants. There are two striking things about this story. This is the first FDA warning that will include explicit consideration of the benefit of the medications. The warning will state â€œthat depression and certain other serious psychiatric disorders are themselves the most important causes of suicideâ€ and that the benefit of treating depression must be weighed against the risks. The other surprising issue is that, as far as I know, this is the only time a warning has been issued for multiple different families of medications whose only common characteristic is that they are used to treat the same disease. Different families of antidepressants work through different mechanisms, and have different side effects, but all of them will carry the new warning.