Morning Rounds: When Painkillers Kill

by Deborah Franklin

As L.A. coroners continue to hunt down the cause of pop star Michael Jackson's death, prescription drugs are under suspicion, according to the Los Angeles Times, which notes this morning that investigators have been carting away bags of pills from the late singer's house. Among the drugs mentioned: powerful sedatives and "prescription painkillers" -- though none were named.

Meanwhile, coincidentally, a panel of FDA advisors voted yesterday 20 to 17 to recommend that several of the world's leading prescription painkillers -- including best-selling Percocet and Vicodin -- be taken off the market. The drugs consist of a narcotic bundled with acetaminophen, the active ingredient in Tylenol. That's a particularly dangerous combo, as the New York Times observes:

High doses of acetaminophen are a leading cause of liver damage and the panel notes that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect.

Note: The FDA isn't required to follow the advice of its advisory committee, though it usually does. And though Jackson's toxicology reports are still pending, early evidence suggests he died because his heart stopped, not his liver.

In other news, "C-reactive protein," a blood marker of inflammation that many cardiologists thought might be a key contributor to heart disease, now looks like more of a spectator than a player, according to a study in this week's Journal of the American Medical Association.

The study looked into the genetics of CRP and found that a big group of people who happened to produce a lot of the protein throughout their lives were no more likely to have heart disease than those who happened to produce less.

A second study in the journal suggests that the usefulness of the protein and other trendy biomarkers, even as just an early warning sign of heart disease, was also minimal-- especially in comparison to time-worn indicators like smoking, diabetes, and high blood pressure.

"I don't feel we currently have evidence for the routine use of these biomarkers in screening people for heart disease," the study's author, Thomas Wang, told the Wall Street Journal.

The Los Angeles Times points out that if you really want to know your risk of heart disease, the American College of Cardiology has a handy online tool that won't cost you or your health insurer a penny.