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Adherence to oral anticoagulation in ischemic stroke patients with atrial fibrillation
CONCLUSIONS: Adherence was poor in half of AF patients who survived an ischaemic stroke. Independent patient-related factors, rather than composite scores, were associated with poor adherence in these patients.KEY MESSAGESAdherence was poor in half of the atrial fibrillation patients who survived an ischaemic stroke.Independent patient-related factors rather than composite scores were associated with poor adherence.The findings support the importance of recognising adherence support as a crucial part of holistic patient care recommended by recent AF guideline.PMID:34498537 | DOI:10.1080/07853890.2021.1968031
Source: Annals of Medicine - September 9, 2021 Category: Internal Medicine Authors: Paula Tiili Ioannis Leventis Janne Kinnunen Ida Svedjeb äck Mika Lehto Efstathia Karagkiozi Dimitrios Sagris George Ntaios Jukka Putaala Source Type: research

Metformin associated with better cardiovascular outcomes than other glycaemic therapies
Context A question exists as to whether the outcome of glycaemic treatment of diabetes varies with the agent used; speculation surrounds whether metformin might be preferable to other treatments. Methods Ghotbi and colleagues performed an epidemiological analysis of 8192 obese patients with diabetes at increased cardiovascular risk participating in the Sibutramine Cardiovascular OUTcomes (SCOUT) trial. Mortality and a combined cardiovascular outcome of non-fatal myocardial infarction, non-fatal stroke, resuscitation after cardiac arrest or cardiovascular death were compared among those receiving one of the following interv...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Bloomgarden, Z. T. Tags: Smoking and tobacco, Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Ischaemic heart disease, Diabetes, Health education, Smoking Therapeutics Source Type: research

ACE inhibitors in African Americans with hypertension associated with worse outcomes as compared to other antihypertensives
Commentary on: Bangalore S, Ogedegbe G, Gyamfi J, et al.. Outcomes with angiotensin-converting enzyme inhibitors vs other antihypertensive agents in hypertensive blacks. Am J Med 2015;128:1195–203. Context Hypertension affects one-third of the world's population and remains a leading cause of myocardial infarction, stroke, heart failure, renal failure and death. Although hypertension control has improved,1 the prevalence is increasing due to an ageing population, rising obesity and a shift towards western lifestyles and disease patterns in low-income and middle-income countries. Hypertension is now also a major contr...
Source: Evidence-Based Medicine - January 22, 2016 Category: Internal Medicine Authors: Lund, L. H. Tags: EBM Prognosis, Epidemiologic studies, Drugs: cardiovascular system, Stroke, Hypertension, Obesity (nutrition), Ischaemic heart disease, Renal medicine, Drugs: musculoskeletal and joint diseases, Health education Source Type: research

Prevalence and Costs of Discharge Diagnoses in Inpatient General Internal Medicine: a Multi-center Cross-sectional Study
ConclusionsGIM services care for a markedly heterogeneous population but the most common conditions were similar across 7 hospitals. The diversity of conditions cared for in GIM may be challenging for healthcare delivery and quality improvement. Initiatives that cut across individual diseases to address processes of care, patient experience, and functional outcomes may be more relevant to a greater proportion of the GIM population than disease-specific efforts.
Source: Journal of General Internal Medicine - July 27, 2018 Category: Internal Medicine Source Type: research

Perioperative selective serotonin reuptake inhibitor administration is a marker of poor outcomes after surgery
Commentary on: Auerbach AD, Vittinghoff E, Maselli J, et al.. Perioperative use of selective serotonin reuptake inhibitors and risks for adverse outcomes of surgery. JAMA Intern Med 2013;173:1075–81. Context With a lifetime prevalence of 6–11%, depression is a common comorbidity in surgical patients. Owing to their high efficacy and safety, selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed antidepressants.1 Some studies suggest that SSRIs may increase surgical bleeding. However, SSRI discontinuation may exacerbate psychiatric illness or precipitate withdrawal symptoms. Therefore, ...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Holt, N. F. Tags: EBM Aetiology, Epidemiologic studies, Drugs: cardiovascular system, Drugs: CNS (not psychiatric), Heart failure, Stroke, Obesity (nutrition), Interventional cardiology, Drugs: musculoskeletal and joint diseases, Health education Source Type: research

Type 2 diabetes mellitus screening has no effect on mortality
Commentary on: Selph S, Dana T, Blazina I, et al. Screening for type 2 diabetes mellitus: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2015; 162:765–6. Context Screening for type 2 diabetes mellitus in asymptomatic persons could lead to early identification and treatment, and potentially result in improved outcomes. In 2008, the U.S. Preventive Services Task Force (USPSTF) recommended diabetes screening in asymptomatic adults with sustained blood pressure (BP) greater than 135/80 mm Hg. Unfortunately, the USPSTF found insufficient evidence to assess the balance of benefits...
Source: Evidence-Based Medicine - July 24, 2015 Category: Internal Medicine Authors: Yoon, U. Tags: Epidemiologic studies, Drugs: cardiovascular system, Heart failure, Stroke, Hypertension, Diet, Obesity (nutrition), Screening (epidemiology), Diabetes, Health education, Screening (public health) Therapeutics/Prevention Source Type: research

A Point ‐based Prediction Model for Cardiovascular Risk in Orthotopic Liver Transplantation: The CAR‐OLT Score
Conclusion: The point‐based CAR‐OLT risk score can identify patients at risk for CVD complications after OLT surgery (available at: www.carolt.us). This score may be useful for identification of candidates for further risk stratification or other management strategies to improve CVD outcomes after OLT. This article is protected by copyright. All rights reserved.
Source: Hepatology - July 1, 2017 Category: Internal Medicine Authors: Lisa B. VanWagner, Hongyan Ning, Maureen Whitsett, Josh Levitsky, Sarah Uttal, John T. Wilkins, Michael M. Abecassis, Daniela P. Ladner, Anton I. Skaro, Donald M. Lloyd ‐Jones Tags: Liver Failure, Cirrhosis and Portal Hypertension Source Type: research

Comparative Effectiveness of Glucose-Lowering Drugs for Type 2 Diabetes: A Systematic Review and Network Meta-analysis.
CONCLUSION: In diabetic patients at low cardiovascular risk, no treatment differs from placebo for vascular outcomes. In patients at increased cardiovascular risk receiving metformin-based background therapy, specific GLP-1 RAs and SGLT-2 inhibitors have a favorable effect on certain cardiovascular outcomes. PRIMARY FUNDING SOURCE: European Foundation for the Study of Diabetes, supported by an unrestricted educational grant from AstraZeneca. (PROSPERO: CRD42019122043). PMID: 32598218 [PubMed - as supplied by publisher]
Source: Annals of Internal Medicine - June 29, 2020 Category: Internal Medicine Authors: Tsapas A, Avgerinos I, Karagiannis T, Malandris K, Manolopoulos A, Andreadis P, Liakos A, Matthews DR, Bekiari E Tags: Ann Intern Med Source Type: research