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Empagliflozin Reduces Cardiovascular Events and Mortality in Type 2 Diabetes.
Authors: Guthrie R Abstract Review of: Zinnam, B, Wanner C, Lachin JM, et al. Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. New England Journal of Medicine. 2015; 373: 2117-2128. Patients were required to have a history of established cardiovascular disease, along with Type 2 Diabetes but were either not on antidiabetic therapy for the preceding 12 weeks, with a glycated hemoglobin level between 7% and 9%, or were on stable antidiabetic therapy for the preceding 12 weeks, with a glycated hemoglobin between 7.0% and 10.0%. Patients were randomized in a 1:1:1 ratio to either empagliflozin ...
Source: Postgraduate Medicine - April 6, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Defining Metabolic Syndrome and Factors Associated with Metabolic Syndrome in a Poly-pharmaceutical Population.
CONCLUSION: The IDF definition for METs that makes allowance for treatment for each specific condition can lead to an overestimation in the prevalence of METs in population studies. Not including those medicated with normal results conversely underestimates the prevalence of METs. We have therefore proposed adjustments to BP and lipid measurements based on pooled mean effects from published systematic reviews to mitigate bias in future research on prevalence of METs. PMID: 27558757 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - August 27, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Cardiovascular effects of dipeptidyl peptidase-4 inhibitor in diabetic patients with and without established cardiovascular disease: A meta-analysis and systematic review.
CONCLUSION: DPP-4is may have no cardiovascular protective effects in diabetic patients with coexisting CVD, while there is a lack of definitive evidence supporting the cardiovascular benefits of DPP-4is treatment among diabetic patients free of CVD history. PMID: 27813442 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - November 6, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Transient ischemic attacks.
Authors: Chaturvedi S, Hachinski V Abstract Preview All transient ischemic attacks are not created equal. However, they are a medical emergency, and all patients should be hospitalized for urgent evaluation of their risk for stroke or myocardial infarction. For optimal management, it must be determined whether an ischemic attack affects the anterior or posterior circulation. In this article, the authors review current medical options for stroke prevention and the indications for carotid endarterectomy. PMID: 29219705 [PubMed]
Source: Postgraduate Medicine - December 10, 2017 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Practice Pearl: Liraglutide and Cardiovascular and Renal Events in Type 2 Diabetes.
Authors: Guthrie R Abstract Review of: Marso S, Daniels G, Brown-Frandsen K, et al. Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes. N Engl J Med 2016; 375: 311-322. Mann J, Orsted D, Brown-Frandsen K, et al. Liraglutide and Renal Outcomes in Type 2 Diabetes. N Engl J Med 2017; 377: 839-848. This comprehensive research project, LEADER, led to two reports, one focusing on the effect of liraglutide on cardiovascular events, and the second one reporting on the renal effects on the same study population. The study group included 9340 patients with type 2 diabetes. Patients were required to have type 2 diabet...
Source: Postgraduate Medicine - January 21, 2018 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Factors associated with renal impairment in Chinese patients with non-valvular AF and without an established renal disease: a cross-sectional study.
Conclusions: Renal dysfunction is highly prevalent in Chinese NVAF patients and is significantly associated with older age, non-paroxysmal AF, use of ACEI/ARB, congestive heart failure, LVEF <50% and prior TIA/stroke/SE. Further studies on the mechanisms by which these risk factors affect renal function in NVAF patients need to be conducted. PMID: 32174239 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - March 18, 2020 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Incidence and predictors of progression of carotid atherosclerosis in a low-income Chinese population-a prospective cohort study
CONCLUSIONS: This is the first longitudinal study to explore the incidence and predictors of CAS progression in a low-income rural population in China with a high prevalence of stroke. More detailed and precise strategies for prevention and intervention of CAS progression are necessary, especially in low-income rural areas in China.PMID:34696679 | DOI:10.1080/00325481.2021.1997483
Source: Postgraduate Medicine - October 26, 2021 Category: Internal Medicine Authors: Qiuxing Lin Jie Liu Peng Hu Teng Li Qiaoxia Yang Jun Tu Jinghua Wang Jidong Li Xianjia Ning Source Type: research

A retrospective case series of the lipid effects of switching from omega-3 fatty acid ethyl esters to icosapent ethyl in hyperlipidemic patients.
CONCLUSION: The results of this real-world retrospective analysis of 14 patients with hyperlipidemia demonstrated reductions in TG, LDL-C, TC, and non-HDL-C levels, with mixed results in HDL-C levels, after switching from OM3EE to IPE. PMID: 24977343 [PubMed - indexed for MEDLINE]
Source: Postgraduate Medicine - November 28, 2014 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Understanding the type 2 diabetes mellitus and cardiovascular disease risk paradox.
Authors: Green JB Abstract Patients with diabetes have approximately a 2-fold increase in the risk for coronary heart disease, stroke, and death from vascular causes compared with patients who do not have diabetes. Interventions targeted at modifiable risk factors, such as smoking cessation and management of hypertension and dyslipidemia, reduce the risk of cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM). Paradoxically, large randomized studies have failed to conclusively show that intensively lowering glucose reduces CVD event rates in patients with T2DM, despite pathophysiologic and ...
Source: Postgraduate Medicine - November 28, 2014 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Management of atrial fibrillation: What is new in the 2014 ACC/AHA/HRS guideline?
Authors: Rajagopalan B, Curtis AB Abstract Abstract Recently, the American College of Cardiology, the American Heart Association, and the Heart Rhythm Society published an updated guideline on the management of atrial fibrillation (AF). This document is a complete revision of the 2006 guideline. Prominent changes in the 2014 guideline include the use of the CHA2DS2-VASc score for risk stratification of stroke, recommendations on when and how to use newer oral anticoagulants for thromboprophylaxis, downgrading of the use of aspirin for thromboprophylaxis of moderate-risk patients, and the use of catheter ablation in...
Source: Postgraduate Medicine - March 11, 2015 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Long-Term Use of Ticagrelor in Patients with Prior Heart Attack: Ticagrelor Plus Aspirin Versus Aspirin Monotherapy.
Authors: Amico F, Schlesinger A, Mazzoni J Abstract Review of: Bonaca MP, Bhatt DL, Braunwald E et al. Design and rationale for the Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54) trial. Am Heart J. 167(4), 437-444.e5 (2014). This Practice Pearl reviews the recent study Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared With Placebo on a Background of Aspirin-Thrombolysis in Myocardial Infarction 54 (PEGASUS-TIMI 54). It cha...
Source: Postgraduate Medicine - December 26, 2015 Category: Internal Medicine Tags: Postgrad Med Source Type: research

Impact of bromocriptine-QR therapy on cardiovascular outcomes in type 2 diabetes mellitus subjects on metformin.
CONCLUSION: These findings suggest that in T2DM subjects on metformin, BQR therapy may represent an effective strategy for reducing CVD risk. PMID: 27687032 [PubMed - as supplied by publisher]
Source: Postgraduate Medicine - October 2, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

A review of trazodone use in psychiatric and medical conditions.
Authors: Khouzam HR Abstract Trazodone is an antidepressant that is FDA-approved for the treatment of depression. It has been used by mental health and primary care providers for the treatment of multiple psychiatric and medical conditions .This review describes trazodone mechanism of action, formulation, dosage and adverse effects and then summarizes the beneficial effects of trazodone in the treatment of various psychiatric and medical conditions such as major depression, as well non-approved FDA indications such as insomnia,anxiety disorders, posttraumatic stress disorder, obsessive compulsive disorder, feeding ...
Source: Postgraduate Medicine - October 18, 2016 Category: Internal Medicine Tags: Postgrad Med Source Type: research

The evolving role of oral hormonal therapies and review of conjugated estrogens/bazedoxifene for the management of menopausal symptoms.
Authors: Parish SJ, Gillespie JA Abstract This review describes the evolving role of oral hormone therapy (HT) for treating menopausal symptoms and preventing osteoporosis, focusing on conjugated estrogens/bazedoxifene (CE/BZA). Estrogens alleviate hot flushes and prevent bone loss associated with menopause. In nonhysterectomized women, a progestin should be added to estrogens to reduce the risk of endometrial cancer. Use of HT declined since the Women's Health Initiative (WHI) studies showed that HT does not prevent coronary heart disease (CHD) and that conjugated estrogens/medroxyprogesterone acetate increased th...
Source: Postgraduate Medicine - February 1, 2017 Category: Internal Medicine Tags: Postgrad Med Source Type: research

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