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Incidence of death and MI associated with stopping clopidogrel after ACSRates of death and myocardial infarction were assessed for a national sample of acute coronary syndrome patients after stopping clopidogrel. In the first 90 days after stopping treatment, patients experienced a nearly twofold increased risk of adverse events compared with subsequent follow-up intervals for patients treated medically without stents and for patients treated with coronary stents. This suggests a possible clopidogrel rebound effect, but additional studies are needed to support this hypothesis and to identify strategies to reduce early events after clopidogrel cessation.
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Judge Neil Gorsuch Confirmed by SenateGorsuch on SCOTUS: likely to influence many health policies.
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Etranacogene Dezaparvovec Significantly Improves Hemophilia B Past 2 YearsPhase 3 data presented at ASH 2023 show the gene therapy significantly reduced annualized bleeding rates and the number of total bleeds.
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Waging peace: A medical military mission to Bosnia-HerzegovinaSeventeen years after a brutal 3-year civil war, many citizens of Bosnia-Herzegovina remain without even rudimentary health care. Read what makes medical missions to such areas so memorable and fulfilling.
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Sex-related differences in treatment and outcome in patients with ACSThe AMIS (Acute Myocardial Infarction in Switzerland) Plus prospective cohort study compared treatment and in-hospital outcomes between men and women with acute coronary syndrome (N = 26,452) admitted to Swiss hospitals between 1997 and 2007. The study reached several important conclusions: women had different baseline characteristics than men at admission, were treated with different drug regimens, and were significantly less likely to undergo percutaneous coronary intervention. After adjusting for these differences, researchers found no significant difference in the rates of in-hospital mortality between men and women, except for women aged 51 to 60 years, who were more likely to die in-hospital.
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Anomalous origin of the right coronary artery in an asymptomatic athlete: What if he did not have a murmur?Sudden death in young athletes is shocking because it is unexpected in these seemingly healthy individuals. We present the case of an athlete who was found to have an incidental murmur during a screening physical, which led to a diagnosis of an anomalous origin of the right coronary artery with an intramural course. This congenital anomaly has been well recognized to result in sudden death; thus, it was fortunate that the condition was identified in our patient. We provide a brief overview of the literature, discuss the challenges faced in diagnosing such coronary abnormalities, and review the various management options that are available.
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Alcohol consumption in men with hypertensionWe assessed the association between the incidence of coronary heart disease and alcohol consumption among hypertensive men enrolled in the Health "Professionals" Follow-Up Study. Moderate alcohol consumption (1 to 2 drinks per day) was associated with a lower risk of myocardial infarction, as in the general population, but was not associated with the risks of stroke, total mortality, or mortality from cardiovascular causes. These results show that men with hypertension who drink moderately may not need to change their drinking habits.
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How Should I Approach the Management of This Man's Hepatitis C?A 55-year-old married university professor has past medical history notable only for hypertension treated with hydrochlorothiazide, and no history of intravenous drug abuse or blood transfusions. Should this patient still be screened for hepatitis C?
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Waging peace: A medical military mission to Bosnia-HerzegovinaSeventeen years after a brutal 3-year civil war, many citizens of Bosnia-Herzegovina remain without even rudimentary health care. Read what makes medical missions to such areas so memorable and fulfilling.
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Prediction of coronary artery disease in patients with diabetes and albuminuriaWe developed a set of equations to predict the risk or probability of developing coronary artery disease (CAD) in 10 years among American Indians. The equations are based on the significant risk factors identified in the Strong Heart Study, a longitudinal study of cardiovascular disease in American Indians. The equations can be used in patient education and to evaluate the efficacy of CAD prevention and intervention programs.
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Leadless Trial: The First Leadless Self-Contained Pacemaker in HumansA review of a trial of a self-contained leadless cardiac pacemaker
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Management of Acute GI Bleeding in Primary Care: An UpdateUpper gastrointestinal bleeding is a common medical emergency that continues to be a significant cause of morbidity and mortality. It requires rapid and appropriate intervention to control the associated hemodynamic instability and prevent continued or recurrent bleeding. Etiology is the key to prognosis. Lower gastrointestinal bleeding usually ceases spontaneously but may also result in hemodynamic instability or symptomatic anemia. Recognizing the signs and symptoms of upper versus lower gastrointestinal bleeding is crucial for prompt and appropriate treatment.
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Those Privacy-invading Pediatricians, Silenced!Florida may become the first state to prohibit doctors from asking patients, or their parents, if they own guns.
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VentingThis editorial was stimulated one morning when I saw a patient with congestive heart failure and rapid atrial fibrillation (AF).
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NOW Initiative: Payer & Provider Collaborations in Oncology Benefits ManagementPayers recognize the need to expand benefits management for oncology but struggle to find effective solutions amid the complexity of available therapies and skepticism from oncologists, who are facing their own set of economic pressures. The National Oncology Working Group (NOW) Initiative is trying to change the sometimes adversarial relationship between payers and oncologists through a collaborative model.
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Monomethyl Fumarate Challenges Multiple SclerosisA novel bioequivalent of dimethyl fumarate (Tecfidera) may soon be offering another treatment option for patients with multiple sclerosis.
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Security Rules Put Providers on NoticeHITECH says covered entities must be able to monitor and record every time that patient data is accessed, enabling the entity to comply with the new notification requirements should unauthorized access occur. Will the new rules end up restricting the efficient exchange of data that is crucial to providing high-quality healthcare?
