{"id":36287,"date":"2013-04-22T16:57:57","date_gmt":"2013-04-22T20:57:57","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=voices&p=36287"},"modified":"2013-04-22T16:57:57","modified_gmt":"2013-04-22T20:57:57","slug":"selections-from-richard-lehmans-literature-review-april-22nd","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2013\/04\/22\/selections-from-richard-lehmans-literature-review-april-22nd\/","title":{"rendered":"Selections from Richard Lehman\u2019s Literature Review: April 22nd"},"content":{"rendered":"

CardioExchange is pleased to reprint selections from Dr. Richard Lehman\u2019s\u00a0weekly journal review blog<\/a>\u00a0at\u00a0BMJ.com<\/a>. Selected summaries are relevant to our audience, but we encourage members to engage with the\u00a0entire blog<\/a>.<\/em><\/p>\n

JAMA\u00a0 17 Apr 2013\u00a0 Vol 309<\/strong><\/p>\n

Prevalence of a Healthy Lifestyle Among Individuals with CV Disease in High-, Middle-, and Low-Income Countries (pg. 1613):<\/strong> As the saying goes, death is Nature\u2019s way of telling you to slow down. Short of death, coronary heart disease and stroke could be thought of as timely reminders to get fit. But people who have CHD or stroke seem remarkably resistant to heed Nature\u2019s warning: in rich countries and poorer countries alike, they continue to have sedentary lifestyles, and few alter their diet<\/a>. But at least 50% of them give up smoking.<\/p>\n

NEJM\u00a0 18 Apr 2013\u00a0 Vol 368<\/strong><\/p>\n

Nonemergency PCI at Hospitals with or without On-Site Cardiac Surgery (pg. 1498):<\/strong> Many hospitals in the USA offer percutaneous coronary intervention although they lack on-site cardiac surgery facilities should things go wrong. This study<\/a> of Massachusetts hospitals shows that non-emergency PCI has now become such a safe procedure that it there is no difference in outcomes between hospitals with or without on-site surgical rescue.<\/p>\n

BMJ\u00a0 21 Apr 2013\u00a0 Vol 346<\/strong><\/p>\n

Coronary Artery Calcium Score Prediction of All Cause Mortality and CV Events in People with Type 2 Diabetes:<\/strong> Here\u2019s a systematic review of coronary calcium scoring in type 2 diabetes<\/a>. The BMJ<\/em> likes to publish systematic reviews, which are supposed to tell us what to believe from close study and aggregation of the best randomized trials. To read what I think about that, you\u2019ll need to look at a piece of mine called Nullius in Verba<\/em> which is out in the forthcoming issue of JAMA Internal Medicine. Systematic reviews need taking with a pinch of salt, as last week\u2019s BMJ<\/em> offerings proved. But back to coronary calcium scoring in diabetes: why do it in the first place? The obvious answer is to select high risk patients for more intensive treatment\u2014the excuse always given for doing all sorts of futile prognostic testing. Coronary calcium scoring is useless for this\u2014it has high sensitivity, but low specificity. Right then, don\u2019t despair\u2014let\u2019s use it for identifying low risk patients for less intensive treatment. In theory, you could do this\u2014but in practice, would you really want to subject all your diabetic patients to an expensive, high radiation procedure which would cause unnecessary anxiety in 20 for every lucky one who could then be offered one (statin) tablet less a day?<\/p>\n","protected":false},"excerpt":{"rendered":"

This week’s topics include the prevalence of a healthy lifestyle among those with CV disease in high-, middle-, and low-income countries, nonemergency PCI at hospitals with or without on-site cardiac surgery, and coronary artery calcium score prediction of all-cause mortality and CV events in those with type-2 diabetes.<\/p>\n","protected":false},"author":475,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[1779,1224,1777,1778,469],"class_list":["post-36287","post","type-post","status-publish","format-standard","hentry","category-general","tag-coronary-artery-calcium-score-prediction","tag-cv-disease","tag-healthy-lifestyle","tag-nonemergency-pci","tag-type-2-diabetes"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/36287","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/475"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=36287"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/36287\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=36287"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=36287"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=36287"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}