It's never too late for smokers to do their hearts good by kicking the habit -- even after a heart attack has left them with significant damage to the organ's main pumping chamber, a new study suggests.

Past studies have found that smokers who kick the habit after suffering a heart attack have a lower rate of repeat heart attacks and live longer than their counterparts who continue to smoke.

But little has been known about the benefits of quitting among heart attack patients left with a complication called left ventricular (LV) dysfunction -- where damage to the heart's main pumping chamber significantly reduces its blood-pumping efficiency.

So it has been unclear whether that dysfunction might "drown out" the heart benefits of smoking cessation, said Dr. Amil M. Shah, the lead researcher on the new study and a staff cardiologist at Brigham and Women's Hospital in Boston.

But in their study, Shah and his colleagues found that heart attack survivors with LV dysfunction may stand to benefit as much from smoking cessation as other heart attack patients do.

The researchers found that among 2,231 patients with LV dysfunction, those who quit smoking within six months of their heart attack were less likely to die within five years or suffer a repeat attack than smokers who continued the habit.

Of all patients, 463 were smokers at the time of the heart attack but had quit six months later; 268 were still smoking at the six-month mark. Among quitters, 15 percent died or suffered another heart attack by the end of the study, which followed the patients for up to five years.

That compared with a rate of 23 percent among patients who were still smoking six months after their initial heart attack.

When Shah's team accounted for a number of other factors -- including age, medical history and body weight -- smoking cessation itself was linked to a 40 percent reduction in the risk of death compared with persistent smoking.

Quitters were about 30 percent less likely to die, suffer a repeat heart attack or be hospitalized for heart failure during the study period.

"The findings aren't completely surprising," Shah told Reuters Health. But, he said, they offer reassurance to patients with LV dysfunction that they can benefit from smoking cessation -- and the magnitude of that benefit is similar to what has been seen among heart attack survivors without LV dysfunction.

"I've had patients who say, 'What's the point of quitting now?'" Shah noted. "But it's never too late to benefit from smoking cessation."

Some studies have found that smoking-cessation counseling begun in the hospital, and continued after discharge, may be particularly effective for heart attack patients.

Patients at hospitals that do not offer such counseling should speak with their cardiologist or primary care doctor about smoking cessation, Shah advised. Behavioral counseling will generally be the first step, he noted -- though for patients who ultimately need more, nicotine-replacement products or medications such as Zyban or Chantix may be options.

A number of studies have suggested that these products are generally safe for people with heart disease -- though, Shah pointed out, most of the data come from patients with stable heart disease, and not those who have just recently suffered a heart attack or other complication.

SOURCE: http://link.reuters.com/dew47n American Journal of Cardiology, published online August 13, 2010.

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BOSTON (Reuters) - An experimental targeted cancer drug shrank advanced melanoma tumors in 81 percent of patients with the deadly and hard-to-treat cancer, doctors said on Wednesday.

The findings were part of an early phase study used to determine the best dose of the experimental drug PLX4032, now in late-stage clinical trials. The drug, from Roche and privately held Plexxikon, is designed to target tumor cells with a mutation in a gene called BRAF.

In two patients, tumors went away completely. In 24 others, the tumors shrank by more than 30 percent, the team reported in the New England Journal of Medicine.

The team said 81 percent of 32 patients with a BRAF mutation showed complete or partial shrinkage of their tumors.

"We can see the improvement in patients and it's happening quite rapidly, within a week or two of starting treatment," Dr. Keith Flaherty of the Massachusetts General Hospital in Boston said in a telephone interview.

"For patients without symptoms, the hope is that it delays the time it takes for them to develop symptoms, and we have some belief that that is happening as we speak," said Flaherty, who worked on the study.

But the effect appears to be fleeting.

In all but two cases, where the cancer has stayed away for at least a year, the benefits have been temporary, typically lasting about six months, Flaherty said.

The hope is that the drug can be combined with other treatments to produce a long-lasting effect, comparable to the AIDS cocktail that maintains the health of many people with HIV, he said.

Preliminary findings with the new drug were reported in September 2009, but the data from more patients have been added, boosting confidence in its prospects.

Tumors shrank at all sites where the tumor had spread, including the bone, liver and small bowel.

Cancer-causing mutations in the BRAF gene occur in 50 percent to 60 percent of melanoma patients.

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Researchers are eager to test the drug with Bristol-Myers Squibb's experimental drug ipilimumab, the first treatment shown to extend lives of patients with advanced melanoma.

In June, researchers reported that more than 20 percent of patients with advanced melanoma were alive two years after treatment with ipilimumab - compared with a usual nine months.

Ipilimumab or "ipi" is a monoclonal antibody, an engineered version of a human protein that targets CTLA-4, a molecule that acts like a brake on the immune system.

"The data provided by Flaherty and colleagues represent a major advance in the treatment of metastatic melanoma," Keiran Smalley and Dr. Vernon Sondak of Moffitt Cancer Center and Research Institute in Tampa, Florida, said in a commentary in the same journal.

Side effects included rash, fatigue, joint pain and a high risk of a different type of skin cancer known as cutaneous squamous-cell carcinoma. Of 87 patients enrolled in both stages, 18 developed such tumors, which are easier to treat.

The BRAF mutation is also found in about 8 percent of solid tumors, suggesting the drug might be effective in other forms of cancer.

Melanoma is the most aggressive form of skin cancer, affecting 160,000 people worldwide each year. When melanoma has spread, conventional chemotherapy is typically effective only in 10 percent to 20 percent of the cases.

SOURCE: http://link.reuters.com/fyg37n New England Journal of Medicine, August 26, 2010.