Calculating Patients' Lifetime Risk for Cardiovascular Disease
Cardiology Summary and Comment
Is it more practical than the 10-year risk estimates we're accustomed to using?
SSRIs and Intracerebral Bleeds: A Small Risk
Psychiatry Summary and Comment
Free
Clinicians should remain aware of the possibility, but these medications are probably safe for almost all patients.
By Jonathan Silver, MD
November 5, 2012
Covering:
Hackam DG and Mrkobrada M., Neurology 2012 Oct 30; 79:1862
McGrath ER and O'Donnell MJ., Neurology 2012 Oct 30; 79:1844
Diabetes plus Multivessel Coronary Artery Disease: CABG or PCI?
Cardiology Summary and Comment
Free
The FREEDOM trial provides solid evidence that coronary artery bypass grafting leads to better long-term outcomes.
By Harlan M. Krumholz, MD, SM
November 4, 2012
Covering:
Farkouh ME et al. for the FREEDOM Trial Investigators., N Engl J Med 2012 Nov 4
Hlatky MA., N Engl J Med 2012 Nov 4
A Glimmer of Hope for Neuroprotection in Stroke?
Neurology Summary and Comment
A phase II trial suggests a novel neuroprotectant is safe and potentially effective in reducing strokes resulting from aneurysm repair.
Rising Incidence of Stroke Among Young Adults
Neurology Summary and Comment
The stroke incidence among adults aged 20 to 54 increased substantially during a 12-year period in a population-based study.
By Christine Fox, MD, MAS
October 30, 2012
Covering:
Kissela BM et al., Neurology 2012 Oct 23; 79:1781
Radiofrequency Ablation and Antiarrhythmic Drugs Fight to a Tie
Cardiology Summary and Comment
Free
In patients with paroxysmal AF, initial strategies of ablation and AADs led to similar outcomes.
By Mark S. Link, MD
October 24, 2012
Covering:
Nielsen JC et al., N Engl J Med 2012 Oct 25; 367:1587
Stevenson WG and Albert CM., N Engl J Med 2012 Oct 25; 367:1648
Do Patients' Stroke and Bleeding Risks Affect Apixaban's Advantage over Warfarin?
Cardiology Summary and Comment
In an ARISTOTLE subanalysis, apixaban maintained its edge across the range of risk scores in patients with atrial fibrillation, but stronger confirmation is needed.
By Beat J. Meyer, MD
October 24, 2012
Covering:
Lopes RD et al., Lancet 2012 Oct 2
Vassiliou VS and Flynn PD., Lancet 2012 Oct 2
Stroke Risk After TIA
General Medicine Summary and Comment
Seven-day risk was highest after small-vessel (lacunar) transient ischemic attacks.
By Allan S. Brett, MD
October 9, 2012
Covering:
Paul NLM et al., Neurology 2012 Sep 25; 79:1356
Brain Infarction Is Associated with Monocular Visual Loss
General Medicine Summary and Comment
Twenty-four percent of patients with retinal ischemia had concomitant brain ischemic lesions.
By Allan S. Brett, MD
October 4, 2012
Covering:
Helenius J et al., Ann Neurol 2012 Aug; 72:286
Even Minor Strokes Can Cause Long-Term Disability
Neurology Summary and Comment
In a prospective study, 15% of patients had not recovered full functioning 3 months after transient ischemic attack or minor ischemic stroke.
By Hooman Kamel, MD
October 2, 2012
Covering:
Coutts SB et al., Stroke 2012 Sep 13
Bleeding Risks with Triple Antithrombotic Therapy, Quantified
Cardiology Summary and Comment
Free
Compared with an anticoagulant plus antiplatelet monotherapy, triple antithrombotic therapy increased bleeding risk by
By Howard C. Herrmann, MD
September 26, 2012
Covering:
Lamberts M et al., Circulation 2012 Sep 4; 126:1185
Maggioni AP., Circulation 2012 Sep 4; 126:1176
Use of Imaging to Guide Endovascular Stroke Treatment
Neurology Summary and Comment
An observational study suggests that magnetic resonance imaging can be useful to guide patient selection for endovascular treatment up to 12 hours after stroke onset.
Late-Life Brain Effects of Childhood Adversity
Psychiatry Summary and Comment
Free
The likelihood of cerebral infarcts in old age was greater with higher levels of emotional neglect in childhood.
By Barbara Geller, MD
September 19, 2012
Covering:
Wilson RS et al., Neurology 2012 Oct 9; 79:1534
Barrett KM and Meschia JF., Neurology 2012 Oct 9; 79:1524
New Devices Reignite Hope for Endovascular Stroke Therapy
Neurology Summary and Comment
Free
Two randomized trials suggest (but do not prove) that mechanical thrombectomy improves functional outcomes.
By Hooman Kamel, MD
September 18, 2012
Covering:
Saver JL et al., Lancet 2012 Aug 26
Nogueira RG et al., Lancet 2012 Aug 26
Withdrawal of Life Support and Stroke Mortality
Neurology Summary and Comment
A review of stroke deaths at one hospital highlights the substantial effect that family decisions about life support have on stroke mortality.
Carotid Intima–Media Thickness for Cardiovascular Risk Assessment
Cardiology Summary and Comment
In a large meta-analysis, addition of the test did not substantially improve Framingham risk classification.
Discussion on CardioExchange: Low-Dose Methotrexate to Prevent Recurrent MI and Stroke?
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By The Editors
September 5, 2012
Patients Taking Antihypertensive Drugs Show Increase in Lip Cancer
Dermatology Summary and Comment
Free
Hydrochlorothiazide, HCTZ-triamterene, and nifedipine were associated with a higher incidence of lip cancer.
By Craig A. Elmets, MD
August 30, 2012
Covering:
Friedman GD et al., Arch Intern Med 2012 Aug 6
Lacunar Stroke Does Not Justify Long-Term Dual Antiplatelet Therapy
Neurology Summary and Comment
Free
In the SPS3 trial, clopidogrel added to aspirin increased bleeding and mortality without providing a compensatory benefit.
By Hooman Kamel, MD
August 29, 2012
Covering:
The SPS3 Investigators., N Engl J Med 2012 Aug 30; 367:817
HAS-BLED for Assessing Bleeding Risk with Anticoagulation: Best of the Mediocre
Cardiology Summary and Comment
Notwithstanding a lackluster performance, HAS-BLED beat two other scoring systems in a comparative analysis of trial data.
By Mark S. Link, MD
August 22, 2012
Covering:
Apostolakis S et al., J Am Coll Cardiol 2012 Aug 28; 60:861
Anticoagulation for AF in Patients with Renal Disease: Between a Rock and a Hard Place
Cardiology Summary and Comment
Patients with renal disease and AF have fewer strokes — but more bleeding — with warfarin treatment than without it.
By Mark S. Link, MD
August 22, 2012
Covering:
Olesen JB et al., N Engl J Med 2012 Aug 16; 367:625
Does Invasive Therapy for AV Malformations Affect Seizure Rates?
Neurology Summary and Comment
An observational study suggests no difference in seizure rates with invasive vs. conservative management of AVMs.
Restenosis Rates After Carotid Artery Stenting vs. Carotid Endarterectomy
Neurology Summary and Comment
Two-year follow-up of patients enrolled in the CREST trial shows that these procedures are equally durable.
By Hooman Kamel, MD
August 21, 2012
Covering:
Lal BK et al., Lancet Neurol 2012 Sep; 11:755
Reducing Door-to-Needle Time for Treatment of Acute Stroke
Emergency Medicine Summary and Comment
Median door-to-treatment time dropped to 20 minutes after a series of process improvement measures were implemented at a single center in Helsinki.
Antenatal Stroke: What Do We Know About This Uncommon Event?
Women's Health Summary and Comment
Histories of migraine, gestational diabetes, and hypertensive disorders are major risk factors.
