JNC-8 HTN guidelines finally released!

For more information, please see the following link.

How Good Is the New ACC/AHA Risk Calculator?

Is the new calculator for assessing the 10-year risk of atherosclerotic cardiovascular disease flawed, as suggested by a recent news article, or does it work exactly as the committee members of the risk-assessment guidelines expected it to?

In an article published November 18, 2013 in the New York Times, two physicians testing the accuracy of the new risk calculator developed by the American College of Cardiology (ACC) and American Heart Association (AHA) found that it vastly overestimated patient risk. Drs. Paul Ridker and Nancy Cook (Brigham and Women’s Hospital, Boston, MA) calculated the 10-year risk of cardiovascular events in three large-scale primary prevention cohorts—the Women’s Health Study(WHS), the Physicians’ Health Study (PHS), and the Women’s Health Initiative Observational Study (WHI-OS) — and found the new algorithm overestimated the risk by 75% to 150%.

Read the full article.

New cardio guidelines change statin use, CVD risk assessment

The American Heart Association (AHA) and American College of Cardiology (ACC) issued 4 new cardiovascular disease prevention guidelines last week on cholesterol treatment, cardiovascular risk assessment, lifestyle management and management of overweight and obesity.

The cholesterol guideline made substantial changes to recommendations about statin use, moving away from specific cholesterol targets and likely increasing the number of patients taking the drugs, according to a press release.

See the full article

Heart Groups, CDC Issue New Algorithm for Hypertension Control

A science advisory from the American Heart Association, American College of Cardiology, and CDC — designed as a “call to action for broad-based efforts to improve hypertension awareness, treatment, and the proportion of patients treated and controlled” — includes a new, simple algorithm for controlling hypertension in adults.

The algorithm emphasizes the importance of lifestyle modification as first-line therapy for all patients with stage 1 or 2 hypertension. In addition, a thiazide may initially be considered in certain stage 1 patients (e.g., those with heart failure or diabetes), while two drugs (e.g., a thiazide plus ACE inhibitor) are preferred for stage 2 patients.

The algorithm can be found on page 14 of the free PDF linked below.

– See more at Journal Watch

http://www.sbuim.com/blog/wp-content/uploads/2013/11/Hypertension-2013.pdf

Download this file

Afib May Spark MI

Atrial fibrillationAlthough myocardial infarction is a known risk factor for the development of atrial fibrillation, the relationship might work the other way around, too, researchers found.

Among patients without a history of coronary heart disease, those with atrial fibrillation were 70% more likely to have an MI through an average of about 7 years of follow-up after accounting for other potential risk factors (HR 1.70, 95% CI 1.26-2.30), according to Elsayed Soliman, MD, of Wake Forest School of Medicine in Winston-Salem, N.C., and colleagues.

That risk was greatest among women (HR 2.16, 95% CI 1.41-3.31) and black individuals (HR 2.53, 95% CI 1.67-3.86), they reported online in JAMA Internal Medicine.

Full article: http://www.medpagetoday.com/Cardiology/Arrhythmias/42696

Three vs Twelve Months of Dual Antiplatelet Therapy After Zotarolimus-Eluting Stents

In patients with stable coronary artery disease or low-risk ACS treated with zotarolimus-eluting stents, 3 months of dual antiplatelet therapy was noninferior to 12 months for NACCE, without significantly increasing the risk of stent thrombosis.

http://jama.jamanetwork.com/article.aspx?articleid=1765224

Which Antithrombotic Strategy Is Best in AF Patients Hospitalized for Coronary Artery Disease?

A large Danish registry study suggests that dual anticoagulant–antiplatelet therapy is as effective as triple therapy including aspirin.

The main finding from this large observational study is that outcomes with a combination of an anticoagulant and clopidogrel are comparable to those of triple therapy with regard to ischemic endpoints as well as bleeding. Possibly more important are the findings that dual antiplatelet therapy alone was associated with increased rates of ischemic stroke and all-cause mortality, and anticoagulant–aspirin therapy with increased mortality. The findings support the results of a small trial (NEJM JW Cardiol Feb 27 2013) suggesting that the optimal regimen for stent recipients with atrial fibrillation is an anticoagulant plus clopidogrel.

Click here for the full article

Medical Clearance How-To

ACC/AHA Preoperative screening guidelines

[gviewer file=”http://www.sbuim.com/blog/wp-content/uploads/2013/10/Circulation-2007-Fleisher-e418-500.pdf” width=677 height=450]

The Cardiology Anthem

By: Brian Wells

Bump on the page
P wave!
Spike going up
QRS!

T wave, T wave,
what the hell?
There’s one too many T waves,
this ringing some bells?

I’m living the cardio life
don’t be hatin’ my style
got echos to read, patients to see
places to be, you want to feed off my tree of knowledge?

Best get in line. Want to learn regurge?
Maybe I’ll have the time for you,
I’ll sit, I’ll dish, I’ll spill
we can talk about drugs, both IV and pill.

Losartan, Zocor, Lopressor, Lotrel
Coreg, Cardizem, Cozaar works well
for your pressure, your heart, we won’t let it fail
we’ll check your history, your personal clinical tale
that guides us to your problems,
your individual needs.
Hook you up to some leads so we can get your EKG.

Congrats, it’s normal! No need to feel frail.
Now come back in two months
and until then: Feel well!

Cardio life for realz, yo.

Later, gotsta to check out that V tach. Peace!

iPhone Medical Software Review, Part 2

See Part 1 of the iPhone Medical Software Review

Well, I just finished up Internal Medicine, so I’ll go over a few of the software programs that I found useful during the rotation. These are programs for the iPhone but there may be similar versions for Droid or other platforms. This review will cover three programs: Lab Tests, MedCalc and ECG Interpret. Continue reading

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