December 18th, 2013
Missing High Blood Pressure Guideline Turns Up in JAMA
Larry Husten, PHD
After years of delay and many twists and turns, the hypertension guideline originally commissioned by the NIH has now finally been published in JAMA. The evidence-based document contains a major revision of hypertension treatment targets and includes new and somewhat simplified recommendations for drug treatment. The previous U.S. hypertension guideline was published more than a decade ago. […]
December 18th, 2013
Doc, Do I Really Need a New Battery?
Tariq Ahmad, MD, MPH and James Fang, MD
A 45-year-old man with nonischemic cardiomyopathy, diagnosed 8 years ago, presents for annual follow-up. A transthoracic echocardiogram (TTE), taken 3 years ago, showed an LV ejection fraction of 25%. Since then, the patient has improved a great deal and now has barely any signs or symptoms of heart failure. Repeat TTE right before the current visit showed an […]
December 16th, 2013
Case Closed: Multivitamins Should Not be Used
Larry Husten, PHD
The editorialists are fed up: “Enough is enough.” Writing about three new papers in the Annals of Internal Medicine that find no benefits for the use of multivitamins — only the latest in a long line of negative findings — Eliseo Guallar and colleagues write: …we believe that the case is closed — supplementing the diet of well-nourished adults […]
December 16th, 2013
Three Cases of Sudden Cardiac Death Linked to Lyme Carditis
CardioExchange Editors, Staff
Three cases of sudden cardiac death associated with Lyme carditis were reported in 2012 and 2013 and are described in MMWR. Only four such deaths have previously been reported. The three patients, aged 26 to 38, lived in states with a high incidence of Lyme disease. None had rash; two had pre-existing heart conditions. Postmortem […]
December 16th, 2013
Selections from Richard Lehman’s Literature Review: December 16th
Richard Lehman, BM, BCh, MRCGP
This week’s topics include several trials of genotyping to guide starting doses of vitamin K antagonists, statins for primary prevention of CVD, and more.
December 16th, 2013
Possible New Lease on Life for Vorapaxar and Rivaroxaban for ACS
Larry Husten, PHD
Early next year an FDA panel will review a new drug from Merck and a new indication for Xarelto (rivaroxaban), Johnson & Johnson’s highly successful new oral anticoagulant. Both drugs have had a rocky road getting to this stage and their success is by no means assured, but the announcement of the meeting of the FDA’s Cardiovascular and […]
December 16th, 2013
Examining the Value of My Medical Training
Nicholas Bergfeld, BS, BA
Medical student Nicholas Bergfeld reflects on whether the training we give to medical students is changing adequately to meet the new realities of healthcare delivery.
December 13th, 2013
Dispatch From the Wild Frontier of the Statin Wars
Larry Husten, PHD
The long simmering controversy over the relative benefits and harms of statins has heated to a high boil with the release of the new AHA/ACC U.S. guidelines. But nowhere is the battle more intense right now than in Australia, where, according to the National Heart Foundation, a TV show may be the cause of 2,000 heart attacks […]
December 12th, 2013
FDA Panel Gives Support to Left Atrial Appendage Closure Device
Larry Husten, PHD
The FDA’s Circulatory System Devices Panel yesterday gave a vote of confidence to Boston Scientific’s Watchman left atrial appendage closure device for the prevention of stroke in atrial fibrillation patients. By a large majority, the panel agreed that the device was effective, that it was safe, and that the benefits outweighed the risks. In each case the […]
December 11th, 2013
Inside The KDIGO Guideline On Lipid Management In Patients With CKD
Marcello Tonelli, MD, SM and Harlan M. Krumholz, MD, SM
Recently the Kidney Disease Improving Global Outcomes (KDIGO) Lipid Management in Patients with Chronic Kidney Disease Guideline was published in Kidney International. Now a synopsis has appeared in the Annals of Internal Medicine. Harlan Krumholz spoke with the co-chairman of the guideline, Marcello Tonelli. Krumholz: Like the new US Guidelines, the KDIGO Guideline abandons targets. Were you aware of the US Guidelines or […]