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Annals of Internal Medicine
A retrospective cohort study was conducted to investigate the effectiveness of glucagon-like peptide-1 receptor agonists (GLP1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) in preventing major adverse cardiac events (MACE) for individuals without preexisting cardiovascular disease. The study included US veterans aged 18 or older who were receiving care from the Veterans Health Administration. The cohort consisted of patients who added either GLP1RA, SGLT2i, or dipeptidyl peptidase-4 inhibitors (DPP4i) to their existing diabetes treatments. The outcomes measured were MACE and heart failure hospitalization. The results showed that the addition of GLP1RA was associated with a lower incidence of MACE and heart failure compared to DPP4i. However, the addition of SGLT2i did not show a significant association with primary prevention of MACE.
Cardiology May 18th 2023
Emergency Physicians Monthly
In this video, Zack Shinar, MD, discusses the future of cardiac arrest and the role of extracorporeal membrane oxygenation (ECMO) in the emergency department (ED). Dr. Shinar is a leading expert in ECMO and has been instrumental in developing new protocols for its use in the ED. Dr. Shinar begins by discussing the current state of CPR. He notes that CPR is only effective in about 10% of cases, and that even when it is successful, patients often suffer significant brain damage. He then discusses ECMO, which is a life-support machine that can oxygenate the blood outside of the body. ECMO has been shown to be effective in saving the lives of patients with cardiac arrest, and Dr. Shinar believes that it should be used more widely in the ED. Dr. Shinar then discusses the challenges of using ECMO in the ED. He notes that ECMO is a complex procedure that requires specialized training and equipment. He also notes that ECMO can be expensive, and that it is not always available in all hospitals.
Renal & Urology News
Phosphodiesterase-5 inhibitors (PDE5i) have been found to reduce the risk of major adverse cardiovascular events in men with both coronary artery disease (CAD) and erectile dysfunction (ED), with tadalafil showing greater cardiac benefits compared to sildenafil, according to a study presented at the American Urological Association’s annual meeting. The retrospective study analyzed over 41,000 men with CAD and ED and found that those who took tadalafil or sildenafil had significantly lower 5-year risks of heart failure, myocardial infarction, and overall mortality compared to those who received no PDE5i treatment. Tadalafil recipients had even lower risks than sildenafil recipients across all categories. The study suggests that understanding the specific differences among PDE5i medications is crucial for addressing cardiac outcomes in patients with ED and CAD, with tadalafil potentially offering superior benefits due to differences in pharmacokinetics and longer duration of efficacy. However, further research is needed before definitive conclusions can be made regarding preferential prescription of tadalafil over other PDE5i medications.
Cardiology May 11th 2023
British Medical Journal
In this meta analysis of 40 eligible trials involving 35,548 participants and seven diet programs, only the Mediterranean and low-fat diet showed effectiveness in in lowering all cause and CV mortality. Notably, their preventive value increased with increasing CV risk. Diets (with number of studies) included in the meta-analysis:
Cardiology April 12th 2023
MashupMD
A faulty control arm makes a new trial for tricuspid valve regurgitation intervention seem positive. But in reality, the results probably aren’t.
Cardiology March 23rd 2023
The New England Journal of Medicine
Bempedoic acid is currently approved for two patient subgroups. This 3-year, double-blind, randomized, placebo-controlled trial examined cholesterol-lowering and CV protective effects in a broader population of approximately 14,000 patients with elevated cholesterol who were unable or unwilling to take statins. The drug was 21% more effective than placebo at reducing LDL in this trial. There was a small but significant reduction in primary events of CV-related death, MI, stroke, or coronary revascularization.
Cardiology March 15th 2023