Burning Bridges: Must Warfarin Be Stopped for Device Implantation?
Cardiology Summary and Comment
Free
In a randomized trial, heparin bridging for implantation of a pacemaker or implantable cardioverter-defibrillator was associated with an increase in device-pocket hematoma.
By Mark S. Link, MD
May 22, 2013
Covering:
Birnie DH et al., N Engl J Med 2013 May 9
A Secondary-Prevention Alarm Bell for Lower-Income Countries
Cardiology Summary and Comment
Among survivors of coronary heart disease and stroke, those in lower-income countries were even less likely to observe key elements of a healthy lifestyle than survivors in wealthier countries.
Reducing Salt Intake Lowers Blood Pressure and Is Associated with Lower Cardiovascular-Related Mortality
General Medicine Summary and Comment
Lower salt intake is linked to lower risk for stroke, stroke-related mortality, and coronary heart disease–related mortality.
Higher Potassium Intake Lowers Blood Pressure and Is Associated with Less Risk for Stroke
General Medicine Summary and Comment
A BP-lowering effect was noted in hypertensive people and those with high sodium intake.
A First Look at Cardioversion or Ablation for AF in Rivaroxaban Recipients
Cardiology Summary and Comment
In a subset of ROCKET AF participants who underwent cardioversion or catheter ablation procedures, rivaroxaban was as safe as warfarin.
By Mark S. Link, MD
April 17, 2013
Covering:
Piccini JP et al., J Am Coll Cardiol 2013 Mar 13
Dabigatran Bleeding Complications Are Not More Common than Expected
Emergency Medicine Summary and Comment
Dabigatran is safer than warfarin, and reporting bias explains high numbers of reported complications.
By Daniel J. Pallin, MD, MPH
April 12, 2013
Covering:
Southworth MR et al., N Engl J Med 2013 Apr 4; 368:1272
Berger R et al., Ann Emerg Med 2013 Apr; 61:475
Patent Foramen Ovale Closure for Cryptogenic Stroke: Two More Studies
General Medicine Summary and Comment
Results were negative in one study and ambiguous in another.
By Allan S. Brett, MD
April 9, 2013
Covering:
Meier B et al., N Engl J Med 2013 Mar 21; 368:1083
Carroll JD et al., N Engl J Med 2013 Mar 21; 368:1092
Long-Term Mortality in Young Patients with Stroke or TIA
Neurology Summary and Comment
Mortality was higher in patients aged 18 to 50 than in their population-based peers in a prospective study.
What Is the Best Thrombolytic Strategy for Prosthetic Valve Thrombosis?
Cardiology Summary and Comment
In a large single-center study, slow, low-dose tissue plasminogen activator infusions yielded good results with low complication rates.
By Joel M. Gore, MD
March 27, 2013
Covering:
Özkan M et al., JACC Cardiovasc Imaging 2013 Feb; 6:206
More Inconclusive Results from PFO-Closure Trials
Cardiology Summary and Comment
Free
Two new studies fail to provide strong evidence either for or against PFO correction to prevent recurrent cryptogenic stroke.
By Harlan M. Krumholz, MD, SM
March 20, 2013
Covering:
Meier B et al. for the PC Trial investigators., N Engl J Med 2013 Mar 21; 368:1083
Carroll JD et al. for the RESPECT investigators., N Engl J Med 2013 Mar 21; 368:1092
Immediate Fibrinolysis Compared with Delayed Primary PCI
Cardiology Summary and Comment
A proof-of-concept study suggests that early initiation of a lytic is an acceptable alternative to primary PCI in patients who present to non–PCI-capable hospitals.
By Howard C. Herrmann, MD
March 10, 2013
Covering:
Armstrong PW et al., N Engl J Med 2013 Mar 10
Bhatt DL., N Engl J Med 2013 Mar 10
Endovascular Stroke Therapy Remains Unproven
Neurology Summary and Comment
Endovascular treatments for ischemic stroke did not improve clinical outcomes compared with medical therapy, despite higher recanalization rates, in two new studies.
By Hooman Kamel, MD
March 5, 2013
Covering:
Ciccone A et al., N Engl J Med 2013 Feb 6
Broderick JP et al., N Engl J Med 2013 Feb 6
Imaging-Based Endovascular Stroke Treatment: Another Beautiful Hypothesis Slain
Neurology Summary and Comment
Endovascular stroke treatment did not provide greater benefit in patients with versus those without a favorable penumbral pattern.
Who Is at Higher Risk of Stroke with Antipsychotic Drugs?
Psychiatry Summary and Comment
Risk is associated with new use of antipsychotics, dementia, old age, high doses, and antipsychotics with high affinity to certain receptors.
By Steven Dubovsky, MD
March 4, 2013
Covering:
Wu C-S et al., Biol Psychiatry 2013 Mar 1; 73:414
Sorry, Can't Stop Doing Lumbar Puncture to Rule Out Subarachnoid Hemorrhage
Emergency Medicine Summary and Comment
Free
A clinical decision rule performed well, but CT within 6 hours missed 20% of cases.
Another Inflammatory Disease Linked to Thrombosis?
Dermatology Summary and Comment
Dermatomyositis may be associated with increased risk for cardiovascular and cerebrovascular events, but sketchy data preclude a definitive conclusion.
Estimating Bleeding Risk with Anticoagulation in Patients with Atrial Fibrillation
General Medicine Summary and Comment
The HAS-BLED score outperformed the ATRIA score.
Discontinue Aspirin After Hospitalization For Bleeding Peptic Ulcer?
Gastroenterology Summary and Comment
Not in patients with cardiovascular comorbidities, who are at elevated short-term risk for death and acute cardiovascular events.
Use of rtPA for Acute Ischemic Stroke Within 3 to 4.5 Hours Is Cost Effective in Most Instances
Emergency Medicine Summary and Comment
. . . but may not be for patients with diabetes or atrial fibrillation.
Is Rhythm Control Better Than Rate Control for Atrial Fibrillation?
Cardiology Summary and Comment
In a very large observational study, rhythm-control strategies resulted in fewer strokes and transient ischemic attacks than did rate-control strategies.
By Mark S. Link, MD
January 9, 2013
Covering:
Tsadok MA et al., Circulation 2012 Dec 4; 126:2680
A Cardiovascular Quartet
Four important new studies in cardiovascular medicine
Warfarin May Be Beneficial for up to 6 Months After Bioprosthetic AVR
Cardiology Summary and Comment
Data from a Danish registry supports current recommendations for 3 months of anticoagulation and suggests that extending therapy confers additional benefit.
By Howard C. Herrmann, MD
December 12, 2012
Covering:
Mérie C et al., JAMA 2012 Nov 28; 308:2118
Mehta SR and Weitz JI., JAMA 2012 Nov 28; 308:2147
Low-Dose Aspirin and Dementia in Older Women
Neurology Summary and Comment
Does low-dose acetylsalicylic acid prevent cognitive decline in women with high cardiovascular risk?
By Jon Brillman, MD, FRCPI
December 11, 2012
Covering:
Kern S et al., BMJ Open 2012 Oct 3; 2:e001288
Are There Real Differences Among the New Anticoagulants?
Neurology Summary and Comment
An indirect comparison suggests few differences in secondary prevention of stroke, but such analyses are generally unreliable.
Fish Consumption Is Associated with Lower Cerebrovascular Risk
General Medicine Summary and Comment
But supplementation with long-chain
