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For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI - POEMs...

Jun 1, 2020 - For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0601/p698.html

Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins - POEMs - American...

May 15, 2020 - For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0515/p630a.html

Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly ...

Apr 1, 2020 - This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0401/p434a.html

Increased Readmissions and Adverse Events with Intensification of Antihypertensive ...

Feb 15, 2020 - The intensification of antihypertensive regimens on discharge in older adults hospitalized for noncardiac conditions is associated with an increased risk of readmission (number needed to harm [NNH] = 27) and medication-related serious adverse events (NNH = 63) within 30 days.

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0215/p248a.html

One Month of Dual Antiplatelet Therapy Followed by Clopidogrel Alone is Superior to 12 ...

Dec 15, 2019 - This study found that one month of dual antiplatelet therapy (aspirin plus clopidogrel or prasugrel [Effient]) followed by clopidogrel monotherapy for up to five years is both noninferior and superior to 12 months of dual antiplatelet therapy followed by aspirin for up to five years for...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1215/od5.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ...

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ...

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Vitamin D Is Not Effective as Primary Prevention of Cardiovascular Disease or Cancer - ...

Sep 15, 2019 - Vitamin D supplementation does not prevent cardiovascular events or cancer in mostly nondiabetic adults (men 50 years and older, women 55 years and older).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374.html

Omega-3 Fatty Acids Do Not Prevent Cancer or Cardiovascular Disease Events - POEMs - ...

Sep 15, 2019 - This is the second large, well-designed study (the first one included patients with diabetes mellitus; this one included patients without diabetes) that found no benefit from a 1-g daily dosage of marine n-3 fatty acid supplementation for the primary prevention of cardiovascular disease...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0915/p374a.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

In Healthy Older Adults, Low-Dose Aspirin Increases All-Cause and Cancer-Specific ...

Jul 15, 2019 - The findings are completely unexpected. Although recent studies by this group and other groups of researchers have failed to find a cardiovascular benefit, likely because of better control of other cardiovascular risk factors, this study found increased all-cause mortality, primarily ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p118a.html

Omega-3 Oil Does Not Reduce Serious Cardiovascular Events for Patients with Diabetes ...

Jul 15, 2019 - In this study, there was no significant difference in the likelihood of a composite vascular outcome or all-cause mortality in patients given an omega-3 fatty acid supplement compared with those given an olive oil placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0715/p120.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

Statins Ineffective for Primary Prevention of Cardiovascular Disease in Patients 75 ...

Apr 1, 2019 - In this retrospective study, statin treatment in patients 75 years or older without preexisting CVD did not change the likelihood of developing CVD or reduce any-cause mortality. However, patients 75 to 84 years of age with diabetes mellitus benefitted from treatment. These results ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p461.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Statins Effective for LDL 190 mg per dL or Higher, Regardless of Risk Level - POEMs - ...

Jul 1, 2018 - These results confirm that the use of statins for men with an LDL cholesterol level of at least 190 mg per dL, regardless of calculated risk, is associated with a clinically and statistically significant reduction in cardiovascular events and probably cardiovascular and all-cause ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p54a.html

Lower Systolic BP During Antihypertensive Treatment Associated with More Deaths in ...

Jan 1, 2019 - In this small cohort study of patients older than 85 years, lower systolic blood pressure during treatment with antihypertensive medications is associated with higher death rates and greater cognitive decline.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0101/p54.html

Febuxostat Increases All-Cause and Cardiovascular Mortality Compared with Allopurinol -...

Sep 15, 2018 - For patients with gout who require treatment to lower their uric acid level, allopurinol is a safer option than febuxostat.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p385.html

PCI Equal to Sham PCI for Exercise Tolerance in Patients with Stable Angina Plus Severe...

Jul 1, 2018 - In patients with stable angina and severe coronary artery disease (CAD), PCI plus optimal medical treatment does not improve exercise tolerance or angina more than sham PCI plus optimal medical treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0701/p55.html

In Very High-Risk Patients with Vascular Disease, Evolocumab Slightly Reduces Nonfatal ...

Oct 1, 2017 - In an extremely high-risk group of patients with known vascular disease, taking evolocumab instead of placebo in addition to standard statin therapy for slightly more than two years will prevent one myocardial infarction (MI) for every 83 persons treated and prevent one stroke for every...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/1001/p470.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

More Accurate Prediction of the Pretest Probability of Cardiovascular Disease with ...

May 15, 2017 - The European approach to determining the pretest likelihood of coronary artery disease (CAD) in patients with chest pain is superior to that of the Diamond-Forrester approach recommended by U.S. guidelines, and will result in less need for immediate invasive treatment.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0515/od1.html

Niacin Does Not Decrease Mortality in Patients with Coronary Artery Disease or Low HDL ...

Jul 15, 2017 - We are now flush with data about the effects of niacin in patients with elevated cholesterol levels. Despite its ability to raise high-density lipoprotein (HDL) serum cholesterol levels, it does not add additional mortality or morbidity benefit to statin treatment. Patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0715/p129.html

Bare Arm Best for Blood Pressure Measurement - POEMs - American Family Physician

Jun 1, 2017 - To get the most accurate measure, let patients sit for a few minutes, and then measure their blood pressure on a completely bare arm. Does a difference of 4 mm systolic and 6 to 7 mm diastolic matter?

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733.html

Semaglutide Reduces CV Events in High-Risk Patients with Type 2 Diabetes Mellitus - ...

Mar 15, 2017 - Semaglutide significantly reduced the composite outcome of CV death, nonfatal myocardial infarction, and nonfatal stroke (number needed to treat [NNT] = 43 over 2.1 years). It was generally well tolerated, and it reduced body weight by approximately 6.4 to 9.5 lb (2.9 to 4.3 kg).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/p396.html

Pioglitazone After Stroke or TIA Reduces Stroke and MI, but Also Has Significant Harms ...

Aug 15, 2016 - In patients with a recent stroke or TIA and evidence of insulin resistance, pioglitazone reduces the likelihood of myocardial infarction (MI) or stroke (number needed to treat [NNT] = 36 over five years) but increases the risk of significant weight gain (number needed to treat to harm ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0815/p319.html

No Reduction in Readmissions with Telemonitoring, Coaching for Patients with Heart ...

Jul 15, 2016 - A care transition intervention that incorporates remote monitoring of weight, blood pressure, and heart rate with scheduled telephone coaching did not reduce readmission rates at 30 days or 180 days for patients with heart failure. However, patients in the study were only modestly ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0715/p168a.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Low High-Sensitivity Troponin I Level Accurate in Identifying Patients at Low Risk of ...

Apr 15, 2016 - The high-sensitivity troponin I assay used in this study was fairly accurate in identifying patients with chest pain who are at low risk of cardiac events.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0415/p704a.html

Systolic BP of 120 Instead of 140 in High-Risk Older Patients Without Diabetes Leads to...

Mar 15, 2016 - In this group of older patients (mean age = 68 years) who do not have diabetes but are at high risk of cardiovascular disease, a more aggressive systolic BP target of 120 mm Hg instead of 140 mm Hg led to benefits (lower all-cause mortality, lower cardiovascular mortality, less heart ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0315/p520a.html

CCTA and Radionuclide Stress Testing Similar for Evaluation of Chest Pain - POEMs - ...

Dec 1, 2015 - For the evaluation of chest pain in intermediate-risk patients, CCTA is comparable with myocardial perfusion imaging in its ability to select patients for invasive management. Both modalities are also similar when it comes to downstream resource use and adverse cardiovascular events. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1022.html

CT Coronary Angiography in Patients with Suspected CAD: No Short-Term Benefit, ...

Nov 15, 2015 - For patients with suspected stable CAD, adding CT coronary angiography had no short-term effect on patient symptoms or hospitalizations but increased the number of coronary angiograms. Additionally, more patients who had CT coronary angiography underwent preventive treatment and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1115/p928.html

Real-World Study Finds Lower Mortality and Stroke Risk with Dabigatran, but More GI ...

Sep 15, 2015 - In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p529.html

Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More ...

Sep 1, 2015 - This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0901/p398.html

Two-Hour Algorithm to Rule In or Rule Out Acute MI - POEMs - American Family Physician

Aug 1, 2015 - A simple rule (see synopsis) using high-sensitivity cardiac troponin levels measured on presentation and two hours later is an effective way to identify patients with or without MI. This rule was developed in one group of patients and validated in a second group. At a prevalence of 9%, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0801/p228a.html

No Benefit to Screening with CTA for Asymptomatic CAD in Adults with Diabetes - POEMs -...

Apr 15, 2015 - Using coronary CTA to screen for CAD in adults with type 1 or type 2 diabetes and no indication of existing CAD does not improve outcomes more than standard care.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0415/p566.html

Optimal Treatment of Acute Venous Thromboembolism - POEMs - American Family Physician

Apr 1, 2015 - This complex network meta-analysis of eight treatment regimens for acute venous thromboembolism found that a combination of unfractionated heparin and vitamin K antagonists is associated with the least effective strategy with the highest risk of recurrent events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p492.html

Diagnosing and Managing Acute Heart Failure Guidelines: NICE - POEMs - American Family ...

Feb 15, 2015 - There is not much new in these guidelines except some caveats on what not to do. Diagnose new acute heart failure with a natriuretic peptide measurement and, if the level is high, follow with transthoracic echocardiography. Do not routinely treat with opiates, nitrates, inotropes, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p260.html

Omega-3 Fatty Acid Supplementation Does Not Decrease CVD-Related Outcomes - POEMs - ...

Nov 1, 2014 - Omega-3 fatty acid supplementation does not decrease the risk of cardiovascular outcomes in this older population. Although the numbers are small, supplementation may prevent heart disease in patients already at low risk; that is, patients without a history of cardiovascular disease ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p662.html

No Benefit to Prolonged Dual Antiplatelet Therapy After Drug-Eluting Stent Placement - ...

Oct 1, 2014 - Prolonging dual antiplatelet therapy with aspirin plus clopidogrel (Plavix) for more than one year after the placement of a drug-eluting stent confers no clinical benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1001/p502.html

Influenza Vaccine Reduces Risk of Adverse Cardiovascular Events in High-Risk Patients -...

Feb 1, 2014 - This meta-analysis found that the influenza vaccine is associated with a significantly lower risk of major adverse cardiovascular events in adults with coronary disease. The benefit of influenza vaccination is strongest in adults with a history of recent acute coronary syndrome within ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p224a.html

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