CardioExchange Archive

May 3rd, 2010

(Mis)Information on Fenofibrate in the Clinic

Allan Brett, MD

Several days ago, I — a general internist — saw a 70 year old diabetic woman with coronary disease who was stented 3 years ago and has been asymptomatic since then. During our office visit, I noted that a nurse practitioner who does lipid management in her cardiologist’s practice had added fenofibrate to her statin just a week […]

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April 29th, 2010

Do Hospital Rankings Have Any Good Use?

ashsehgal and Larry Husten, PHD

Hospital rankings now play an increasingly important role in the healthcare marketplace. In no field is the power of these rankings felt more than in cardiology. Ashwini Sehgal, the first author of a recent report in Annals of Internal Medicine, “The Role of Reputation in U.S. News & World Report‘s Rankings of the Top 50 […]

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April 27th, 2010

What are we testing for?

Andrew M. Kates, MD

I recently had to register to recertify for my echo boards and it got me thinking more about board exams, review courses and such.  What is it about exams?  Just what are we testing?  Is it basic knowledge, competency, advanced knowledge?  In addition, what do we expect our fellows to know as they take exams?  This is also an […]

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April 27th, 2010

COURAGE Two Years Later: Finding Common Ground

L. David Hillis, MD

Following is an exchange between Bill Boden and Gregg Stone, facilitated by Interventional Cardiology moderators Richard Lange and David Hillis. An audio file of the complete conversation from which this text was adapted is available here. Rick Lange: Given all the debate and controversy surrounding the COURAGE trial, what are the issues on which you find agreement? Gregg […]

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April 25th, 2010

Why I Don’t Recommend Statins for Primary Prevention in Women

Rita F Redberg, MD, MSc

For many treatment strategies, the highest-risk groups derive the most benefit. Prevention of cardiovascular disease is no exception: Secondary prevention is where the greatest benefits lie. With regard specifically to primary prevention of CVD in women, my review of the evidence has led me to conclude that statin use is not warranted as a broad-based […]

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April 13th, 2010

Are You Really a Cardiovascular Prevention Specialist?

Juan J. Rivera, MD, MHS

I call myself a “preventive cardiologist,” but what makes me different from other cardiologists? Many academic centers categorize cardiovascular prevention as a distinct field within cardiology that merits its own label, sub-department, and leadership. Outside the university, however, the distinction may seem, well, academic. But not to me. Although I’ve been in practice for only 1 […]

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March 24th, 2010

ACCORD: Bigger Issues for Our Patients

JoAnne M. Foody, MD

We are now at a point where it is increasingly difficult to demonstrate the incremental value of any preventive therapy, as we are successful in reducing CV risk to lower and lower levels. What is my take on the ACCORD BP study? It’s that we should focus on ensuring that all patients achieve at least the […]

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March 19th, 2010

“Doc, I’m so confused. Do I stop or continue the clopidogrel?”

Richard A. Lange, MD, MBA

A recent study suggested that clopidogrel can be discontinued 12 months after drug-eluting stent placement. What do I tell my patient who had a drug eluting stent placed a year ago?  He’s not the only one who’s confused.  I’m concerned that the study was underpowered and the duration of follow-up too short to provide a firm conclusion about the appropriate […]

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March 15th, 2010

As You Navigate Diabetes Prevention, Should Valsartan Be On Board?

John McMurray, MbChB MD

We welcome John J. McMurray, MD, lead author of the NEJM article on the valsartan component of the NAVIGATOR trial, to answer our questions about this angiotensin-receptor blocker (ARB). We encourage you to ask yours. Background: In the NAVIGATOR trial, 9306 patients with impaired glucose tolerance and established cardiovascular disease or CVD risk factors were randomized, […]

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March 14th, 2010

Does Fenofibrate ACCORD with the Treatment of Diabetes?

henrynginsberg and Andrew M. Kates, MD

CardioExchange welcomes Dr. Henry N. Ginsberg to discuss the findings of the ACCORD Lipid Study Group. In this paper, researchers randomized 5,500 diabetic patients to fenofibrate therapy versus placebo. All patients received simvastatin. Although triglyceride levels improved markedly with fenofibrate, the incidence of cardiovascular events was not affected.  CardioExchange Editors: Should we abandon fenofibrate for treating […]

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