October 29th, 2010
Is the Time Right for a Preprint Archive for Clinical Trials?
Larry Husten, PHD
Here’s a great idea: a preprint archive for clinical trials. Taking inspiration from the well-established use of preprint archives in physics, math, and other scholarly areas, Martin Fenner, a cancer researcher, proposes the establishment of a preprint archive for clinical trial research papers. Fenner points out that “the results of clinical trials are rarely first reported […]
October 28th, 2010
Drs. Clueless and Apathetic: The State of Imaging Referrals
Shanti Bansal, MD
Editors’ Note: This text has been modified from its original form. Key elements of the case represent a composite of people and events. On a bright Saturday morning, I was the fellow on duty in the chest pain center. That meant I was responsible for evaluating and stress-testing patients who had been admitted from the […]
October 27th, 2010
Meta-Analysis Examines Risk Associated with CYP2C19 Genotypes
Larry Husten, PHD
There has been widespread debate and disagreement over the clinical significance of people with reduced function CYP2C19 genotypes who take clopidogrel. In an effort to shed light on the topic, Jessica Mega and colleagues analyzed data from 9685 patients enrolled in nine clinical trials. Some 26% of patients had 1 reduced-function allele, and 2% had […]
October 26th, 2010
Dabigatran to Cost $237 per Month at the Drugstore
Larry Husten, PHD
It looks like Pradaxa (dabigatran) will cost about $237 a month at the drugstore counter. A Boehringer Ingelheim representative says the wholesale acquisition cost (WAC) of the drug is set at $6.75 per day for 2 pills. The price will apply to both the 150-mg and the 75-mg capsules. According to knowledgeable experts, the retail […]
October 26th, 2010
Updated Appropriate Use Criteria for Cardiac CT Published
Larry Husten, PHD
An alphabet soup of medical organizations (ACCF, SCCT, ACR, AHA, ASE, etc.) have updated their appropriate use criteria for cardiac CT. The lengthy document includes an evaluation of 93 clinical scenarios and finds that cardiac CT is appropriate in 38% of them. Use of cardiac CT in the rest of the scenarios is deemed inappropriate […]
October 25th, 2010
CardioExchange Breakfast at AHA, Chicago
CardioExchange Editors, Staff
Monday, November 15, 7:00 – 9:00 am Going to AHA next month? We invite you to join us for breakfast before sessions on Monday, November 15 at McCormick Place. We’re hosting an informal breakfast where you can meet Editor Harlan Krumholz and other CardioExchange contributors and members. A photographer will be on hand to take […]
October 25th, 2010
Can Barbers Help Fight High Blood Pressure in Black Men?
Larry Husten, PHD
A very long time ago, barbers performed surgical procedures. Now, once again, barbers may have a role to play in the health care of their community. In the BARBER-1 trial, published in the Archives of Internal Medicine, Ronald Victor and colleagues compared two hypertension monitoring and referral programs based in 17 black-owned barbershops in Texas. […]
October 25th, 2010
The Empty Room
Westby G Fisher, MD
CardioExchange welcomes this guest post reprinted with permission from Dr. Westby Fisher, an electrophysiologist practicing at NorthShore University HealthSystem, Evanston, IL and a Clinical Associate Professor of Medicine at University of Chicago’s Pritzker School of Medicine. This piece originally appeared on his blog, Dr. Wes. It stands as a monument to a bygone era; clean, quiet, spacious. Mail cubbies […]
October 22nd, 2010
Warfarin or Dabigatran? The Thick and Thin of Deciding on an Anticoagulant
Anju Nohria, MD
These four patients are receiving chronic anticoagulation therapy. Read the descriptions of their cases and decide which, if any, of them you would switch to dabigatran. Case 1 A 69-year-old man with a history of hypertension and colon cancer was found to be in atrial fibrillation during a preoperative assessment for colon resection. Metoprolol was […]
October 22nd, 2010
What Do I Plan to Do with Dabigatran?
Richard A. Lange, MD, MBA
1. Discuss its pros (no need for INR monitoring, less bleeding than coumadin) and cons (cost, dyspepsia) with my atrial fibrillation patients 2. Avoid its use in patients with renal dysfunction (CrCl <60), liver disease, pregnancy or stroke within the past 6 months 3. Lament the absence of the INR monitoring requirement, which I currently […]