November 9th, 2010
Statement from AHA, ACC, and ACG Reaffirms Use of PPIs with Antiplatelet Therapy
Larry Husten, PHD
Despite recent warnings by the FDA, an expert consensus document released jointly by the AHA, the ACC, and the American College of Gastroenterology states that it is acceptable to use proton pump inhibitors (PPIs) with thienopyridines like clopidogrel in patients at high risk for upper GI bleeds. The statement does not recommend routine use of […]
November 9th, 2010
Intensive Statin Therapy Examined in Meta-Analysis and SEARCH Trial
Larry Husten, PHD
A new meta-analysis and a large clinical trial shed new light on the additive effects of intensive statin therapy over standard therapy. The meta-analysis from the Cholesterol Treatment Trialists’ Collaboration and the results from SEARCH (Study of the Effectiveness of Additional Reductions in Cholesterol and Homocysteine) are published online in the Lancet. The meta-analysis examined […]
November 8th, 2010
Non-STEMI Patients Delay Seeking Help Just As Long as STEMI Patients
Larry Husten, PHD
Non-STEMI patients delayed going to the hospital for as long in 2006 as they did in 2001, according to a report published in the Archives of Internal Medicine. Henry Ting and colleagues analyzed data from 104,622 non-STEMI patients enrolled in the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of […]
November 8th, 2010
AHA 2010 Coverage Headquarters
CardioExchange Editors, Staff
CardioExchange has been dedicated to bringing you the latest from AHA 2010, and even though the meeting has ended, the buzz has just begun! Check out our coverage below ─ and the great debates these posts have sparked ─ then tell us what you think! Previews: AHA Preview: What Is Clyde Yancy Looking Forward to […]
November 8th, 2010
Up-Front Clopidogrel Loading Versus Common Sense
John E Brush, MD
From time to time, a sales representative visits my office promoting clopidogrel (Plavix) as a drug that patients who present with unstable angina/non–ST-segment-elevation MI (UA/NSTEMI) should start immediately as an up-front load. That strategy hasn’t been uniformly accepted in my clinician community because of concern about using an irreversible antiplatelet agent to treat patients who […]
November 7th, 2010
RE-LY Substudy Finds Dabigatran Effective in Secondary Stroke Prevention
Larry Husten, PHD
A substudy of the RE-LY (Randomized Evaluation of Long-Term Anticoagulation Therapy) trial demonstrates that dabigatran is as effective in AF patients for secondary stroke prevention as it is for overall stroke prevention. In their paper in the Lancet Neurology, Hans-Christoph Diener and the RE-LY study group report the results of the trial in the predefined […]
November 5th, 2010
Independent doctors?
John Mandrola, MD, FACC
John Mandrola is a cardiac electrophysiologist and blogger on matters medical and general. Here is a recent post from his blog Dr John M. In response to my story on how physician consolidation and hospital ownership of doctors is affecting patient referral patterns, I received an email with this attached PDF file. (Smudges mine) It […]
November 5th, 2010
Meta-Analysis Turns Up Mixed Results for Vitamin E on Stroke Subtypes
Larry Husten, PHD
In a meta-analysis appearing in BMJ, vitamin E supplements had no effect on the overall rate of stroke but were associated with a small reduction in the risk of ischemic stroke and a slightly larger increase in the risk of hemorrhagic stroke. Markus Schürks and colleagues analyzed data from 9 trials including 118,765 subjects. Although […]
November 4th, 2010
CardioExchange and the Ethos of Community
Harlan M. Krumholz, MD, SM
We recently posted a blog that described the experience of a Fellow whose assessment of a patient and the need for a test was not seemingly given the fullest attention by the attending physician. Many of us remember such experiences in our training and the sense that there were issues beyond the patient that were […]
November 4th, 2010
Clopidogrel and CYP2C19: What’s All the Fuss About?
Richard A. Lange, MD, MBA and L. David Hillis, MD
You’ve heard a lot lately about so-called “clopidogrel resistance.” That sounds straightforward, but the underlying reason can be complex, possibly related to how the drug is metabolized by subjects with a certain genetic profile. We seek here to provide some perspective about clopidogrel’s metabolic and gene-related complexities. First, some brief background: Clopidogrel, a thienopyridine, is […]