Predicting Stroke in Patients with Asymptomatic Carotid Stenosis?
General Medicine
Summary and Comment
Patients who already have CT evidence of silent embolic infarcts are most likely to benefit from surgery.
By Allan S. Brett, MD
April 28, 2009
Covering:
Kakkos SK et al., J Vasc Surg 2009 Apr; 49:902
USPSTF Recommends Aspirin to Prevent MI in Men, Stroke in Women
General Medicine
Clinical Practice Guideline Watch
The task force revised its 2002 recommendations, primarily based on new data for women.
By Richard Saitz, MD, MPH, FACP, FASAM
April 14, 2009
Covering:
Wolff T et al., Ann Intern Med 2009 Mar 17; 150:405
U.S. Preventive Services Task Force., Ann Intern Med 2009 Mar 17; 150:396
Statins and Venous Thrombosis
Oncology and Hematology
Summary and Comment
Free
Recent studies confirm that statins lower risk for VT and suggest that the agents could aid in managing venous disease.
By David Green, MD, PhD
April 14, 2009
Covering:
Ramcharan AS et al., J Thromb Haemost 2009 Apr; 7:514
Sørensen HT et al., J Thromb Haemost 2009 Apr; 7:521
Cushman M., J Thromb Haemost 2009 Apr; 7:511
Dronedarone — A New Option for Atrial Fibrillation?
General Medicine
Summary and Comment
A new drug promises efficacy and safety for AF patients.
Recanalization of Spontaneous Carotid Artery Dissection
Neurology
Summary and Comment
Patients with no symptoms or signs of ischemia or without complete occlusions fared better than those with ischemia or occlusions.
By Louis R. Caplan, MD
April 7, 2009
Covering:
Nedeltchev K et al., Stroke 2009 Feb; 40:499
Pregnancy-Associated Migraines Linked to Stroke
Women's Health
Summary and Comment
Free
Peripartum migraines were strongly associated with incidence of ischemic stroke.
By Wendy S. Biggs, MD
April 2, 2009
Covering:
Bushnell CD et al., BMJ 2009 Mar 10; 338:b664
Got Atrial Fibrillation? Pick Your Poison and Your Endpoint
Cardiology
Summary and Comment
In ACTIVE A, clopidogrel plus aspirin reduced the risk for stroke compared with aspirin alone, but at a cost of increased major hemorrhage.
By Mark S. Link, MD
March 31, 2009
Covering:
The ACTIVE Investigators., N Engl J Med 2009 Mar 31
TIPS for Reducing Cardiovascular Risk
Cardiology
Summary and Comment
Free
In a large feasibility trial, one small pill had favorable effects on many important risk markers.
By JoAnne M. Foody, MD
March 30, 2009
Covering:
Yusuf S et al for The Indian Polycap Study (TIPS)., Lancet 2009 Mar 30
Cannon CP., Lancet 2009 Mar 30
At Risk for Stroke? Not Me!
Women's Health
Summary and Comment
Free
Women at excess risk for stroke were unable to list most stroke warning signs and considered their own risk to be comparable to that of other women.
What Dose of Aspirin Should I Be Taking?
Cardiology
Summary and Comment
A post hoc trial data analysis suggests that low doses are better than high doses, especially in patients taking clopidogrel.
By Joel M. Gore, MD
March 25, 2009
Covering:
Steinhubl SR et al., Ann Intern Med 2009 Mar 17; 150:379
Mehta SR., Ann Intern Med 2009 Mar 17; 150:414
Scoring System to Stratify 10-Year Risk for Atrial Fibrillation
General Medicine
Summary and Comment
An online scoring system and online interactive risk calculator can be applied readily in primary care practices.
By Bruce Soloway, MD
March 24, 2009
Covering:
Schnabel RB et al., Lancet 2009 Feb 28; 373:739
Strokes in Patients with Cancer
Neurology
Summary and Comment
This broad review provides a solid framework for evaluating stroke in cancer patients but finds insufficient evidence to guide prevention and treatment.
By Jan Drappatz, MD
March 24, 2009
Covering:
Grisold W et al., Acta Neurol Scand 2009 Jan; 119:1
Treatment-Mediated Change in HDL Cholesterol Levels and CHD Risks
General Medicine
Summary and Comment
Free
Lowering LDL levels yielded benefit; raising HDL levels did not.
Health-Related Behaviors and Stroke Risk
General Medicine
Summary and Comment
Stroke prevention involves not only treating risk factors, but also encouraging patients to embrace health-related behaviors.
Prasugrel vs. Clopidogrel After Myocardial Infarction
Prasugrel was more effective for preventing ischemic events in patients who underwent percutaneous coronary interventions.
Emerging Perspectives: Diabetes and the Brain
Recent studies examine the importance of glucose to brain functioning in elders.
Benefits of Urgent Evaluation and Treatment for TIA and Minor Stroke
Emergency Medicine
Summary and Comment
Free
Early neurological assessment and treatment is cost-effective and prevents long-term disability.
Critical Role for a Particular Immune Cell in Acute Ischemic Stroke
General Medicine
Summary and Comment
Could the size of cerebral infarcts be limited by dampening the immune response?
By Anthony L. Komaroff, MD
February 24, 2009
Covering:
Liesz A et al., Nat Med 2009 Feb; 15:192
Planas AM and Chamorro A., Nat Med 2009 Feb; 15:138
Resting Heart Rate and Adverse Coronary Events in Women
General Medicine
Summary and Comment
Free
Higher resting heart rate was associated independently with incidence of MI or coronary death.
Behavioral Disturbance in CADASIL
Neurology
Summary and Comment
Free
Mood disorders are common in these patients but have been characterized inconsistently in published reports.
By Stephen Salloway, MD, MS
February 17, 2009
Covering:
Valenti R et al., Acta Neurol Scand 2008 Nov; 118:291
Outcome Following Warfarin-Associated Intracerebral Hemorrhage
Neurology
Summary and Comment
Free
What factors affect outcome, and which patients with WICH should be restarted on warfarin?
By Matthew L. Flaherty, MD
February 10, 2009
Covering:
Zubkov AY et al., Arch Neurol 2008 Oct; 65:1320
Claassen DO et al., Arch Neurol 2008 Oct; 65:1313
How Does HT Affect the Brains of Older Menopausal Women?
Women's Health
Summary and Comment
Subclinical cerebrovascular disease and regional decreases in brain volume could contribute to HT-associated cognitive decline.
By Andrew M. Kaunitz, MD
February 5, 2009
Covering:
Coker LH et al., Neurology 2009 Jan 13; 72:125
Resnick SM et al., Neurology 2009 Jan 13; 72:135
Review of Treatments for Cervical Artery Dissection
Neurology
Summary and Comment
A systematic review finds a lack of high-quality data; available evidence suggests no difference between anticoagulant and antiplatelet therapy.
By J. Donald Easton, MD
January 27, 2009
Covering:
Menon R et al., J Neurol Neurosurg Psychiatry 2008 Oct; 79:1122
Desmoteplase Shows No Benefit for Treatment of Ischemic Stroke
Emergency Medicine
Summary and Comment
When given within 3 to 9 hours after symptom onset, IV desmoteplase was no better than placebo.
By Kristi L. Koenig, MD, FACEP
January 16, 2009
Covering:
Hacke W et al., Lancet Neurol 2008 Dec 25
Hill MD., Lancet Neurol 2008 Dec 25
Gene Variants Affect Metabolism of Clopidogrel — And Clinical Outcomes
General Medicine
Summary and Comment
Alleles that lower metabolism of clopidogrel also are linked to adverse cardiovascular outcomes.
By Anthony L. Komaroff, MD
January 6, 2009
Covering:
Mega JL et al., N Engl J Med 2008 Dec 22
Simon T et al., N Engl J Med 2008 Dec 22
Collet J-P et al., Lancet 2008 Dec 23