This week’s topics include lifetime cardiovascular risks, anticoagulation self-monitoring, opting for thrombolytics over late transfer for PCI, exercise’s antidepressant effect, and the worry that statins can induce diabetes.
Archives for January 2012RSS
Sizing Up Clinical Trials — Quickly and Intuitively (26 Jan 2012)John E Brush, MD
A pharmaceutical sales rep comes to your office bringing lunch. He shows you a graphic stating that Multaq (dronedarone) reduced the primary endpoint in the ATHENA trial by 24%. The fine print shows an impressive P value: <0.0001. You come away satisfied that this drug looks good. You may not realize it, but you also feel a sense of obligation to the rep for the lunch. Nevertheless, you go to the New England Journal of Medicine paper to look into this for yourself. There you find that the primary endpoint —… Continue Reading
This week’s topics include bridging antiplatelet therapy in patients undergoing CABG, cognitive and neurologic outcomes after CABG, using IV beta-adrenergic agonists
during acute respiratory distress syndrome, and pulmonary embolism risk in those admitted to the hospital for an auto-immune disorder.
With the advent of ATPIV, should we stick with determining treatment based on LDL levels or is time for a new paradigm based on a more nuanced understanding of risk?
This week’s topics include acute MI and potassium levels, cardiac arrest during long-distance running, the anticoagulant idrabiotaparinux, and managing hypertension in the very elderly.
This week’s topics: bariatric surgery, length of stay and MI, secondary prevention after ACS, and vorapaxar
Tell us the one test or procedure that you think should be carefully examined to make the biggest dent on waste in cardiac care.
Missing Data: The Elephant That’s Not in the Room (4 Jan 2012)Harlan M. Krumholz, MD, SM
There is a problem so grave that it threatens the very validity of what we learn from the medical literature. Bad data? Not exactly. Actually, it’s missing data — information, relevant to the risks and benefits of treatments, that is simply not published. In some cases, these data would make a critical difference in the inferences that readers draw from the literature. The absence of the data renders meta-analyses, systematic reviews, and book chapters suspect. Conclusions are made on the basis of incomplete science. In short, publication bias and selective… Continue Reading
A Look Back at 2011 (3 Jan 2012)CardioExchange Editors, Staff
CardioExchange invited several members and participants to give us a list of what they consider the top three most important developments in cardiology in 2011. The same CardioExchange members offer predictions for 2012, which you can view here. Also, for comparison, check out last year’s predictions for 2011 to see which came to fruition. What would your choices have been? Any sins of inclusion or exclusion here in your opinion? Join the conversations. Steven E Nissen, MD 1. Approval by FDA of the transcutaneous aortic valve implantation (TAVI) device 2…. Continue Reading
A Look Forward to 2012 (3 Jan 2012)CardioExchange Editors, Staff
CardioExchange invited contributors and members to offer predictions for 2012. Several of these folks also offered predictions for last year and helped assess the most important developments in cardiology in 2011. What are your predictions for the year? Where have our Nostradamus’ gone wrong? Steven E Nissen, MD 1. In a 5:4 vote, the U.S. Supreme Court will overturn portions of the Affordable Care Act. 2. Publication of the new BP and lipid Guidelines (JNC 8 and ATP IV) 3. Under FDA pressure, the manufacturer of dronedarone will withdraw the… Continue Reading