WEDNESDAY, March 10 (HealthDay News) -- A thyroid-derived cholesterol-lowering drug that could be an alternative to the widely used statin medications has done well in a small, early trial, Swedish and American researchers report.

In the trial, various doses of the drug, eprotirome, a laboratory-engineered version of thyroid hormone, were added to statin treatment for 168 people whose high levels of LDL cholesterol had not been lowered by previous use of statins. The combination did lower cholesterol levels in the 12-week trial and, most importantly, did not cause the feared side effects on the heart and other organs that have plagued similar thyroid-based treatments.

"There was no doubt that eprotirome would lower LDL cholesterol. Thyroid hormone is nature's own statin," said Dr. Paul W. Ladenson, a professor of endocrinology and metabolism at the Johns Hopkins University School of Medicine and lead author of a report on the trial, published in the March 11 issue of the New England Journal of Medicine. "But this is a demonstration of lipid-lowering effect without thyroid toxicity."

Dr. Bo Angelin, a professor of clinical metabolic research at the Karolinska Institute in Stockholm, where the drug was developed, said that the trial demonstrated that careful targeting of the drug's effect within the body could obtain the benefits of thyroid hormone on blood cholesterol levels, without causing damaging side effects. The trial was funded in part by Karo Bio, a small commercial spinoff of the institute.

"We knew that thyroid hormone could lower lipid [cholesterol] levels but would have side effects on the circulation and bones and cause diarrhea," Angelin said. "Even if the lipid levels were OK, it would be overall negative for patients."

However, he added, "if we can get the thyroid effect in the liver [where cholesterol is metabolized] but not in other organs, we would be OK."

Frequent monitoring showed no ill effects on the hearts and bones of those taking the drug, the report said.

And though statins are widely used and most often successful, an alternative to them would be welcome, Ladenson said. Statins are not effective in up to a quarter of potential users because of unacceptable muscle pain or simple failure to lower cholesterol levels, he said.

"The first importance of the trial is that it shows hepatic [liver] targeting of hormonal action," Ladenson said. "The second exciting part is its impact on lipids other than LDL cholesterol."

Though statins lower LDL ("bad") cholesterol, they have no effect on other blood fats, such as lipoprotein A, which is believed to be equally damaging, Ladenson said. He said that significant reductions of blood levels of those fats were seen in the trial.

Larger and longer studies are needed to determine whether eprotirome will have the hoped-for effect on blood fat levels without side effects and will ultimately reduce the risk of heart attacks and other cardiovascular diseases, both Ladenson and Angelin said, adding that such trials now are in the planning stages.

At best, results would not be available for "at least two to three years," Angelin said.

If eprotirome does pass all the anticipated tests successfully, its use at first probably would be in combination with a statin, Angelin said. Use as a single drug treatment for elevated cholesterol levels could follow, first in selected patients, then more widely, he said.

It's best to move cautiously, agreed Dr. Robert M. Califf, vice chancellor for clinical research at Duke University.

"The effects on LDL cholesterol and lipoproteins are pretty exciting," Califf said. "But if there is one thing we've learned about drugs in this arena, it's that we need large trials to see how they measure up in terms of risk and benefit."

The trial's researchers were careful to list indications of possible harmful side effects, such as a reduction in levels of HDL ("good") cholesterol, Califf said. But he echoed the thought that a longer-term and larger test is needed to determine the incidence of some possible major side effects, such as impotence.

"I'm not sure I'd want to sign up for that one before I had longer-term results," Califf said. "Being impotent is no fun."

More information

The American Heart Association has more on cholesterol-lowering drugs  .

WEDNESDAY, March 10 (HealthDay News) -- If you walk into an emergency room complaining of chest pains, the odds are high that you will end up having cardiac catheterization, where a thin wire is snaked into your heart to determine whether a blood vessel is totally or partially blocked.

But if you do have the invasive procedure, the odds are even higher -- nearly two to one -- that it will show no significant blockage, a new study finds.

"To me, what this says is that we need to re-evaluate how we work these patients up from start to finish," said Dr. Manesh Patel, assistant professor of medicine at Duke University, and lead author of a report in the March 11 issue of the New England Journal of Medicine.

More than 10 million Americans each year experience chest pains that can lead to cardiac catheterization, Patel estimated.

He and his colleagues looked at data on nearly 400,000 people with no known heart disease who had cardiac catheterization at 663 U.S. hospitals between January 2004 and April 2008. Of those, just 37.6 percent had obstructed coronary arteries -- slightly less than the 39.2 percent in whom no significant artery blockage was found.

Catheterization is called an invasive procedure because it requires that something be inserted into the body, which always carries a degree of risk. So doctors usually want to do a less risky noninvasive procedure, such as a stress test, to decide whether catheterization is advisable.

But while five of every six people in the study -- 83.9 percent -- did have a noninvasive test before catheterization, those tests did not have an enormous predictive value. Artery blockage was found in 41 percent of those who had noninvasive testing before catheterization and 35 percent of those who didn't.

"We don't know that this finding substantiated the kind of noninvasive test we should be using," Patel said. "We don't know what the patterns are, and we need more research."

It's not enough to simply say that cardiac catheterization is overused, he said. "What we want to do is use it more efficiently," Patel said, "to determine the features that indicate catheterization is necessary."

The study "points out a problem, but is not suggesting a solution," he said. A national data bank on catheterization may provide information pointing toward a solution, as may some randomized trials that are now underway, Patel noted.

One of those trials, in which Patel is participating, is comparing the results of routine stress testing with computerized tomography angiography, which gives a three-dimensional view of the heart arteries, in 10,000 people.

The cardiac catheterization study results are not surprising, said Dr. Andrew Einstein, an assistant professor of clinical medicine at Columbia University Medical Center, whose specialty is cardiac imaging. An old rule of thumb is that one-third of cardiac catheterizations will show no artery blockage, he noted.

"This study does provide stronger data than we have ever had in the past," Einstein said. "The important takeaway message is that better risk stratification is needed to inform decisions about catheterization. If we have a good strategy, people will not be referred as often for these invasive procedures."

And cost is an inevitable issue in making those decisions, he added. "The cost of a diagnostic catheterization at our hospital is $2,600," Einstein said.

More information

The why and how of cardiac catheterization are explained by the U.S. National Library of Medicine.

TUESDAY, March 9 (HealthDay News) -- Botox (onabotulinumtoxin A) has been approved by the U.S. Food and Drug Administration to treat spasms (spasticity) in the flexor muscles of the elbow, wrist and fingers in adults who have had a stroke, the agency said Tuesday in a news release.

Spasticity is a common aftereffect of stroke, and can make performing daily activities difficult.

Botox temporarily stops the connection between nerves and muscles, ending spasms in affected muscles, the agency said. Adverse reactions to Botox may include nausea, fatigue, bronchitis, muscle weakness and limb pain.

Botox has a boxed label warning that because the drug is produced from the same bacterium that causes botulism, the toxic substance has the potential to spread beyond the intended area and cause symptoms similar to those of botulism. These may include life-threatening problems with breathing and swallowing.

Botox hasn't been proven effective in treating similar problems in other upper-limb muscles, the agency warned, and isn't meant to substitute for physical therapy.

The drug is produced by California-based Allergan Inc.

More information

To learn more about this drug, visit the U.S. National Library of Medicine.

FRIDAY, March 5 (HealthDay News) -- Conventional wisdom has dictated that fat from red meat is a risk factor for heart disease, but a new analysis from Harvard researchers finds it's eating processed meat -- not unprocessed red meat -- that increases the risk for heart disease and even diabetes.

The term "processed meat" refers to any meat preserved by smoking, curing or salting or with the addition of chemical preservatives. The researchers defined "red meat" as unprocessed meats such as beef, hamburger, lamb and pork.

"To lower risk of heart attacks and diabetes, people should avoid eating too much processed meats -- for example, hot dogs, bacon, sausage or processed deli meats," said lead researcher Renata Micha, a research fellow at the Harvard School of Public Health. "Based on our findings, eating up to one serving per week would be associated with relatively small risk."

Micha was scheduled to present the finding Friday at an American Heart Association conference on cardiovascular disease in San Francisco.

For the study, Micha's team analyzed data from 20 studies that included more than 1.2 million participants. Among them, 23,889 had coronary heart disease, 2,280 had had a stroke and 10,797 had diabetes.

The researchers found that people who ate unprocessed red meat did not significantly increase their chances of developing heart disease or diabetes. However, eating processed meat was linked to an increased risk for the two conditions.

In fact, for every 50-gram (1.8-ounce) serving, the risk for heart disease jumped 42 percent and the risk for diabetes increased 19 percent.

Though neither unprocessed red meat nor processed meats were linked to an increased risk for stroke, the researchers pointed out that just three studies looked at the connection between eating meat and stroke, so the data was insufficient to draw a valid conclusion.

"When we looked at average nutrients in unprocessed meats and processed meats eaten in the U.S., we found that they contained similar amounts of saturated fat and cholesterol," Micha said. "In contrast, processed meats contained, on average, four times higher amounts of sodium and two times higher amounts of nitrate preservatives."

This suggests that salt and other preservatives, rather than fats, probably explain the higher risk for heart attacks and diabetes seen with processed meats, Micha said.

"Health effects of unprocessed red meats and processed meats should be separately considered," she said. "More research is needed into which factors in meats -- especially salt or other preservatives -- are most important for health effects."

Samantha Heller, a registered dietitian, clinical nutritionist and exercise physiologist in Fairfield, Conn., said that "scientists are looking into why processed meats are so hazardous to our health."

"They may never know the exact reason, but we do know that people should limit their consumption of foods such as bacon, hot dogs, salami and pepperoni to reduce the risk of chronic diseases," Heller said.

"In addition, studies show that eating unprocessed red meat does increase the risk for disease as well," she said. "A study of over 500,000 people found that people who ate the most both red and processed meats had a higher risk of mortality, cancer and cardiovascular disease than those who ate lesser amounts of these foods."

Both red and processed meat and other foods, such as butter and cheese, that are high in saturated fat have been linked to chronic disease, Heller said, adding that people should limit consumption of them as well.

"Going low- or no-fat with dairy products helps lower our intake of saturated fat," she said. "Choosing healthy protein sources -- such as white-meat poultry, low-mercury fish, soy, nuts and beans -- and focusing on moving in the direction of a more plant-based diet will help us all live longer, healthier lives."

Dr. Gregg Fonarow, a professor of cardiovascular medicine at the University of California, Los Angeles, said that "various studies have suggested that higher levels of consumption of red and processed meat is associated with higher risk of heart disease, stroke, diabetes, cancer and premature death."

However, the results have not always been consistent, and some earlier studies have suggested there may be differences in health risk between unprocessed red meat and processed meat, he said. More study is needed to verify the link and explore the mechanisms behind it, Fonarow said.

Although unprocessed red meat might not increase the risk for heart disease or diabetes, it might increase the risk for some cancers, according to a 2007 report from researchers at the U.S. National Cancer Institute.

They found elevated risks for colorectal and lung cancer with high consumption of both processed and unprocessed meats, along with borderline higher risks for advanced prostate cancer. High intake of red meat was also associated with an increased risk for esophageal and liver cancer and a borderline increased risk for laryngeal cancer. And high consumption of processed meat was linked to a borderline increased risk for bladder cancer and myeloma, a kind of bone cancer.

More information

For more on heart disease  , visit the American Heart Association.