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Transcatheter Aortic Valve Replacement Versus Surgical Aortic Valve Replacement: How Would You Manage This Patient With Severe Aortic Stenosis? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center
Ann Intern Med. 2021 Apr 13. doi: 10.7326/M21-0724. Online ahead of print.ABSTRACTAortic stenosis (AS) is common, especially among the elderly. Left untreated, severe symptomatic AS is typically fatal. Surgical aortic valve replacement (SAVR) was the standard of care until transcatheter aortic valve replacement (TAVR) was shown to have lower mortality rates in patients at the highest surgical risk and was recommended for this group in the 2014 American Heart Association/American College of Cardiology (AHA/ACC) guidelines. In the 2017 AHA/ACC focused update, evidence of benefit and noninferiority extended the use of TAVR to...
Source: Annals of Internal Medicine - April 12, 2021 Category: Internal Medicine Authors: Eileen E Reynolds Suzanne J Baron Tsuyoshi Kaneko Howard Libman Source Type: research

Should This Patient Be Screened for Atrial Fibrillation?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2019 Dec 03;171(11):828-836 Authors: Burns RB, Zimetbaum P, Lubitz SA, Smetana GW Abstract Atrial fibrillation (AFib) is the most common type of cardiac arrhythmia, affecting 2.7 million to 6.1 million persons in the United States. Although some persons with AFib have no symptoms, others do. For those without symptoms, AFib may be detected by 12-lead electrocardiogram (ECG), single-lead monitors (such as ambulatory blood pressure monitors and pulse oximeters), or consumer devices (such as wearable monitors and smartphones). Pulse pa...
Source: Annals of Internal Medicine - December 2, 2019 Category: Internal Medicine Authors: Burns RB, Zimetbaum P, Lubitz SA, Smetana GW Tags: Ann Intern Med Source Type: research

Should This Patient Receive Aspirin?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2017 Dec 05;167(11):786-793 Authors: Burns RB, Graham K, Sawhney MS, Reynolds EE Abstract Aspirin exerts antiplatelet effects through irreversible inhibition of cyclooxygenase-1, whereas its anticancer effects may be due to inhibition of cyclooxygenase-2 and other pathways. In 2009, the U.S. Preventive Services Task Force endorsed aspirin for primary prevention of cardiovascular disease. However, aspirin's role in cancer prevention is still emerging, and no groups currently recommend its use for this purpose. To help physicians bala...
Source: Annals of Internal Medicine - December 5, 2017 Category: Internal Medicine Authors: Burns RB, Graham K, Sawhney MS, Reynolds EE Tags: Ann Intern Med Source Type: research

Should We Screen This Patient for Carotid Artery Stenosis?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2017 Oct 03;167(7):484-492 Authors: Smetana GW, Schermerhorn M, Mukamal KJ Abstract In July 2014, the U.S. Preventive Services Task Force (USPSTF) published a clinical guideline on screening for asymptomatic carotid artery stenosis. The guideline recommended against screening in asymptomatic adults, based primarily on the results of 3 large randomized trials (grade D recommendation). The principal screening test was carotid ultrasonography, and the intervention in the 3 trials was carotid endarterectomy for patients with stenosis ex...
Source: Annals of Internal Medicine - October 3, 2017 Category: Internal Medicine Authors: Smetana GW, Schermerhorn M, Mukamal KJ Tags: Ann Intern Med Source Type: research