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Overview of New ACC/AHA Lipid Guidelines - POEMs - American Family Physician

Jun 1, 2019 - These updated guidelines, made without any input from primary care physicians who manage most patients with hyperlipidemia, are more complex than the 2013 guidelines and will likely lead to even more recommendations for statins, ezetimibe (Zetia), and PSK9 inhibitors.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p716.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

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

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

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

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

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

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

High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of ...

Mar 15, 2018 - A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p410.html

No Effect on Mortality with Oxygen Therapy in Nonhypoxemic Patients with Suspected MI -...

Feb 15, 2018 - In patients with suspected MI and normal oxygen levels, giving immediate supplemental oxygen therapy does not improve mortality at one year. Although this study was underpowered because of fewer than expected deaths in the control group, the results were consistent across all subgroups,...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0215/od3.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

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

PCI Has More Benefits and Harms Than CABG for Selected Patients with Left Main Coronary...

Apr 1, 2017 - Patients undergoing PCI had fewer early myocardial infarctions, but more later deaths and later myocardial infarctions. There are other benefits to PCI, including shorter hospital stay, lower cost, and faster recovery. But patients should be informed of the tradeoffs, and it is ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0401/p455a.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

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

In Patients with Vascular Disease, Treating Sleep Apnea Does Not Reduce the Risk of ...

Jan 15, 2017 - Compared with usual care, the use of CPAP provides a modest improvement in daytime sleepiness, but does not reduce the likelihood of cardiovascular events, even in a high-risk population.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p123.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

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

More Nuanced Guidelines for Lipid Lowering to Prevent CVD - POEMs - American Family ...

Jan 1, 2016 - The authors of this guideline give a more nuanced and less aggressive approach to lipid lowering than other groups. For the primary prevention of CVD, check blood pressure and lipids (nonfasting is fine) to calculate the 10-year CVD risk. If greater than 12%, treat; if 12% or less, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0101/p59.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

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

NSAID Use Associated with Increased Risk of Serious Bleeding and CV Events After MI - ...

Jul 1, 2015 - The use of concomitant NSAIDs in adults who receive antithrombotic therapy after MI increases the risk of serious bleeding complications and recurrent adverse CV events. This study found the highest risk among users of celecoxib (Celebrex) and diclofenac, and the lowest risk among users...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p60.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

Post-Myocardial Infarction Beta Blockers Do Not Decrease Mortality - POEMs - American ...

Mar 15, 2015 - Although recommended by guidelines and used as a so-called quality indicator of hospital care, the use of beta blockers following myocardial infarction, when combined with optimal acute and chronic treatment, does not provide a further survival benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p402a.html

Low-Carbohydrate Diet Better Than Low-Fat Diet to Reduce Cardiovascular Risk Factors ...

Feb 15, 2015 - More than 40 years ago, Dr. Robert Atkins wrote his first book advocating for a low-carbohydrate diet to cause and sustain weight loss. This study (of mostly women) found that a low-carbohydrate diet—though not as severe a diet as the Atkins approach—caused an average 3.5 kg (7.7 lb) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p262.html

Increasing HDL Level Ineffective at Decreasing Cardiovascular Events - POEMs - American...

Jan 15, 2015 - Being the good cholesterol is not the same as being the useful cholesterol. Drug therapy aimed at increasing HDL cholesterol levels, when added to statin treatment, does not decrease patients' likelihood of experiencing a cardiovascular event or of dying earlier.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p133.html

Niacin Does Not Improve Clinical Outcomes in Patients with Vascular Disease - POEMs - ...

Nov 1, 2014 - This large, adequately powered trial did not find any clinically meaningful benefit to the use of niacin in patients who are already taking a statin, even with several study design features that should bias the result in favor of niacin. Niacin should not be prescribed to reduce the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p660a.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

ACE Inhibitors Decrease Cardiovascular Events in Patients with Diabetes, ARBs Do Not - ...

Sep 1, 2014 - In patients with diabetes, ACE inhibitors decrease cardiovascular events and all-cause mortality. ARBs do not. Both drug classes decrease heart failure incidence. Although both drug classes have been available for almost 15 years, there is only one study of 250 patients that directly ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p326.html

Screening Echocardiography Not Beneficial - POEMs - American Family Physician

Feb 1, 2014 - Population-based screening for heart disease or valve disease with echocardiography will identify cardiac pathology in patients but does not decrease mortality, myocardial infarction risk, or stroke risk.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p224.html

Routine Stress Testing After Negative Biomarker Testing Is Seldom Helpful - POEMs - ...

Nov 15, 2013 - Fewer than 1% of patients who undergo routine provocative cardiac testing after having two sets of negative serum troponin results following an episode of acute chest pain are identified as having potential benefit from revascularization (American Heart Association [AHA] class I or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1115/od2.html

n-3 Fatty Acids Do Not Prevent Cardiovascular Events in High-Risk Patients - POEMs - ...

Nov 1, 2013 - There is no evidence that n-3 fatty acids prevent cardiovascular events or death in older adults who have cardiovascular disease (or who are at risk of it but have not had a myocardial infarction).

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/od2.html

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