This week’s topics include epinephrine in ED response to cardiac arrest, a thrombolytic that’s possibly twice as effective as alteplase, and a Phase I study of monoclonal antibodies for reducing LDL-C.

With all of the hullaballoo about statins and diabetes last week I wanted to point out a paper that was published online this week in Circulation: Cardiovascular Quality and Outcomes. This study examined the long-term effects of incident diabetes on cardiovascular outcomes in patients enrolled in ALLHAT. As you may remember, this trial included more than 20,000 subjects and compared different strategies to treat hypertension. They reported that chlorthalidone therapy was associated with a lower risk of clinical cardiovascular outcomes than amlodipine and lisinopril. As expected, incident diabetes was higher… Continue Reading

This week’s topics include percutaneous PFO closure and dabigatran risks.

After the Topol op-ed in the New York Times last week I began to get a lot of inquiries about the safety of statins. At the beginning of his piece he emphasizes that our use of statins could cause a “sharp increase in the incidence of Type 2 diabetes.” At the end, he states emphatically that “the problem of statin-induced diabetes cannot be underplayed.” Many patients reading these words were worried about their decision to take statins. I decided to write a missive to patients to help them sort through all the… Continue Reading

Want to calculate the risk of readmission for MI, heart failure, or pneumonia? There’s an App for that!

Join our get together in Chicago and learn about board exam and MOC prep!

For ages, myocardial infarction (MI) has been dismissed as an ‘old man’s disease’. However, not only is it one of the leading causes of mortality in old women, it also afflicts a sizeable proportion of young women. Data from the American Heart Association and the Centers for Disease Control and Prevention suggest that more than 10,000 women under 45 years of age are diagnosed with a heart attack and nearly 700 die annually in United States, a number that closely parallels the 19,000 women newly diagnosed with malignant breast cancer in… Continue Reading

Some people critique Continuous Medical Education (CME) programs as spoon-feeding. As a young physician struggling to learn a lot of material, I actually appreciate a bit of ready-to-consume content that I can learn quickly and effectively. The American College of Cardiology (ACC) and other reputable institutions provide CME programs that, overall, help to keep physicians up on the literature and integrate new findings with existing knowledge. However, despite the basic advantages of these programs, several limitations stand out to me as a frequent user of CME. Here are the key… Continue Reading

This week’s topics include stem cells for the heart, BP in both arms and vascular disease, and how patients and caregivers interpret prognostic information.

The evaluation of the care and outcome of patients with venous thromboembolism is often focused on the visible short-term effects of a clot, such as: Has the acute clotting episode resolved? Are chronic pain, swelling, or other post-thrombotic issues well managed? Has there been any bleeding associated with anticoagulation? Has there been a VTE recurrence? Often overlooked is consideration of a patient’s emotional state and the impact VTE has on the patient’s quality of life. I direct a program at the University of North Carolina at Chapel Hill that provides… Continue Reading