• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

2 Minute Medicine Rewind December 9 – December 15, 2013

bys25qthea
December 16, 2013
in Cardiology, Chronic Disease, Gastroenterology, Surgery, Weekly Rewinds
Reading Time: 4 mins read
0
Share on FacebookShare on Twitter

Image: PD

In this section, we will highlight the key high-impact studies, updates, and analyses published in medicine during the past week.

A Pharmacogenetic versus a Clinical Algorithm for Warfarin Dosing

A Randomized Trial of Genotype-Guided Dosing of Warfarin

Warfarin metabolism has been previously shown to be partially genetically determined with polymorphisms CYP2C9*2, CYP2C9*3, and VKORC1 (−1639G→A) conferring different pharmcokinetic rates of metabolism. This past week in NEJM, two multicenter, randomized trials compared genotype guided algorithms of warfarin induction compared to a clinical algorithm or a standard loading dose. In the first trial, 1015 patients were randomized to warfarin induction algorithms using either clinical features alone or clinical features with genotyping and compared time in therapeutic range during the first four weeks of therapy. This trial found no difference in mean time in therapeutic range (45.2% for genotype-guided group vs. 45.4% for clinically-guided group, p = 0.91) and there was no significant difference in major bleeding, thromboembolism, or other complications. The second trial randomized 455 patients to a genotype-guided algorithm vs. a set 3-day loading dose and compared time in therapeutic range during the first twelve weeks of therapy. This study found a difference in mean time in therapeutic range (67.4% for genotype-guided group vs. 60.3% for clinically-guided group, p<0.001) with fewer instances of supratherapeutic INR > 4 in the genotype-guided group. Differences in the study include different follow-up times, control groups, genotyping assays, and patient demographics. Genotyping to guide warfarin induction remains controversial.

Effect of CPAP on Blood Pressure in Patients With Obstructive Sleep Apnea and Resistant Hypertension

Significant subsets of patients with resistant hypertension have obstructive sleep apnea (OSA). In this multiple center, randomized, open-label trial, 194 patients with resistant hypertension and OSA were randomized to CPAP with standard blood pressure control medications vs. blood pressure control medications alone and blood pressure was tracked for 12 weeks. The CPAP group achieved a greater decrease in 24-hour mean blood pressure (3.1 mm Hg [95% CI, 0.6 to 5.6]; P = .02) and 24-hour DBP (3.2 mm Hg [95% CI, 1.0 to 5.4]; P = .005), but not in 24-hour SBP (3.1 mm Hg [95% CI, −0.6 to 6.7]; P = .10) compared with the control group. More frequent and longer duration of CPAP use was associated with greater change in 24-hour mean blood pressure (r = 0.29, P = .006), SBP (r = 0.25; P = .02), and DBP (r = 0.30, P = .005). There was a small but significant decrease in blood pressure with the initiation of CPAP in patients with OSA and resistant hypertension.

RELATED REPORTS

Prevalence, awareness, treatment, and control of hypertension in China

Chlorthalidone is not superior to hydrochlorothiazide in preventing hypertension-related cardiovascular events

Fecal microbiota transplantation not associated with weight loss in bariatric surgery patients

Weight Change and Health Outcomes at 3 Years After Bariatric Surgery Among Individuals With Severe Obesity

Bariatric surgery has been characterized to decrease insulin dependence and cause significant weight loss immediately after surgery however limited long term studies have been performed. In this retrospective analysis of a multicenter observational cohort, investigators identified 2458 patients undergoing first time Roux-en-Y gastric bypass (RYGB) or laparoscopic adjustable gastric banding (LAGB). At three years, median weight loss was 41kg (31.5%), with 216 (67.5%) RYGB patients and 28 (28.6%) LAGB patients experiencing partial remission of diabetes. Improvements in dyslipidemia and hypertension were also seen. The majority of weight was lost during the first year after procedure.

Effect of cangrelor on periprocedural outcomes in percutaneous coronary interventions: a pooled analysis of patient-level data

Cangrelor is a potent, rapid-acting, reversible intravenous platelet inhibitor used during percutaneous intervention for acute coronary syndrome. In this retrospective analysis of three randomized, control trials comparing cangrelor vs. clopidogrel vs. placebo, investigators assessed cangrelor’s efficacy and prespecified primary efficacy composite of death, myocardial infarction, ischaemia-driven revascularisation, or stent thrombosis at 48 h in 24,910 patients. Cangrelor reduced the odds of the primary outcome by 19% (3·8% for cangrelor vs 4·7% for control; odds ratio [OR] 0·81, 95% CI 0·71—0·91, p=0·0007), and stent thrombosis by 41% (0·5% vs 0·8%, OR 0·59, 95% CI 0·43—0·80, p=0·0008). There was no difference in the primary safety outcome (0·2% in both groups), in GUSTO moderate bleeding (0·6% vs 0·4%), or in transfusion (0·7% vs 0·6%), but cangrelor increased GUSTO mild bleeding (16·8% vs 13·0%, p<0·0001). Cangrelor seems to decrease the risk of thrombotic events but have an increased risk for bleeding events compared to clopidogrel.

By David Ouyang

© 2013 2minutemedicine.com. All rights reserved. No works may be reproduced without written consent from 2minutemedicine.com. Disclaimer: We present factual information directly from peer reviewed medical journals. No post should be construed as medical advice and is not intended as such by the authors or by 2minutemedicine.com. PLEASE SEE A HEALTHCARE PROVIDER IN YOUR AREA IF YOU SEEK MEDICAL ADVICE OF ANY SORT. Content is produced in accordance with fair use copyrights solely and strictly for the purpose of teaching, news and criticism. No benefit, monetary or otherwise, is realized by any participants or the owner of this domain.

Tags: bariatric surgerycpaphypertensionwarfarin
Previous Post

Antibiotic prophylaxis not associated with UTI prevention in children [Pediatrics Classics Series]

Next Post

Pulse oximetry may overestimate oxygen saturation in PICU patients

RelatedReports

Prevalence of hypertension among adolescents varies by race and BMI
Cardiology

Prevalence, awareness, treatment, and control of hypertension in China

January 20, 2023
Preterm birth associated with cardiovascular risk factors in adolescence
Cardiology

Chlorthalidone is not superior to hydrochlorothiazide in preventing hypertension-related cardiovascular events

January 4, 2023
Many new pediatric asthma cases attributable to obesity
Chronic Disease

Fecal microbiota transplantation not associated with weight loss in bariatric surgery patients

December 22, 2022
Prevalence of hypertension among adolescents varies by race and BMI
Cardiology

Aprocitentan is an effective and safe option for the treatment of resistant hypertension

December 14, 2022
Next Post
Hypercortisolemia in ICU patients is due to reduced cortisol metabolism, not increased production

Pulse oximetry may overestimate oxygen saturation in PICU patients

AAP policy supports consumption of only pasteurized dairy products

AAP policy supports consumption of only pasteurized dairy products

The TRITON trial: Prasugrel vs clopidogrel in ACS [Classics Series]

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Deep intronic FGF14 repeat expansion associated with late-onset cerebella ataxia
  • Plant-based diets may be associated with lower risk of aggressive prostate cancer
  • #VisualAbstract: Adagrasib provides antitumour activity against KRAS G12C mutant metastatic colorectal cancer both as monotherapy and in combination with cetuximab
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options