CLINICAL
NEWS JOURNAL WRAP
Kim Eagle, MD, and the editors of ACC.org, present relevant
articles taken from various journals.
Do Women-Only
Cardiac Rehab
Programs Benefit
Female Patients?
with warfarin, which was particularly
evident in elderly populations.
These findings are comparable
to the previously reported findings
from the RE-LY trial, which found a
60% and 9% lower risk of intracranial
bleeding with dabigatran-150 mg
and dabigatran-110 mg, respectively,
compared with warfarin. Patients
taking dabigatran-150 mg were also
at a 50% increased risk of gastrointestinal bleeding with no increased
risk observed for dabigatan-110 mg.
RE-LY also showed the effect of age
on gastrointestinal bleeding risk.
The authors suggest that additional studies are needed to assess
the long-term benefits and risks of
dabigatran compared with warfarin.
Because dabigatran-110 mg has not
been approved by the U.S. Food and
Drug Administration and therefore
is not available in the United States,
there are few studies evaluating the
drug. Future registry data will also
provide valuable information on the
real-world outcomes of dabigatran.
Women-only cardiac rehabilitation
(rehab) participation may improve
diet and lower symptoms of depression and anxiety in female cardiac patients, according to a study
published in the Canadian Journal of
Cardiology.
In the CR4HER trial—a singleblind randomized trial with three
parallel arms—researchers assessed the physical activity, diet,
medication adherence, smoking and
psychological well-being in 116 lowrisk cardiac patients at six sites in
Ontario, Canada. Participants were
randomized into mixed-sex, womenonly or home-based cardiac rehab
programs.
Results showed that self-reported
physical activity increased and quality of life improved among women
who attended the mixed-sex and
women-only programs. However,
overall women were not getting the
recommended 150 minutes per week
of exercise. Further women who had
attended mixed-sex programs exhibited higher levels of anxious and
depressive symptoms than patients
in women-only programs.
“Physical activity and quality of
life improved with all supervised
cardiac rehabilitation participation
and the overall adjusted results of
this trial suggest that women’s outcomes are equivalent regardless of
participation in women-only, mixedsex or home-based cardiac rehab,”
explains lead investigator Sherry L.
Grace, PhD. “Therefore, we need to
get more women to cardiac rehab,
and let them choose the type of
program they will be most likely to
stick with.”
Romanelli RJ, Nolting L, Dolginsky M, et al.
Circ Cardiovasc Qual Outcomes. 2016;doi:
10.1161/CIRCOUTCOMES.115.002369.
Midence L, Arthur HM, Oh P, et al.
Can J Cardiol. 2016;doi:/10.1016/j.
cjca.2015.10.007.
Dabigatran vs. Warfarin for AF
A recent study has found that dabigatran is comparable with warfarin in
preventing ischemic stroke in patients
with nonvalvular atrial fibrillation
(NVAF), but dabigatran is also associated with a lower risk for intracranial
bleeding and a higher risk of gastoenistinal bleeding.
In this study, published in Circulation: Cardiovascular Quality Outcomes,
researchers reviewed observation
studies comparing dabigatran and
warfarin. A total of 348,750 patients
made up the final cohort and 197,348
(56.6%) had taken warfarin, while
197,348 had taken dabigatran-150
mg and 11,305 (3.2%) had taken
dabigatran-110 mg. Overall mean
follow-up was 794 days.
The analysis showed no benefit
of either dabigatran dose in ischemic
stroke prevention compared to warfarin. However, both doses showed lower
hazards of intracranial bleeding compared with warfarin, but the hazard of
gastrointestinal bleeding was significantly greater for dabigatran-150 mg,
but not dabigatran-110 mg, compared
“We need to get more women into
cardiac rehab, and l WBF