Despite the known role of inflammation in atherosclerosis, interventions beyond statins that address this mechanism have been either unsuccessful or plagued with extreme costs and/or intolerable side effects. As a relatively low-cost and acceptably-tolerated medication, colchicine would be a practical choice to target the inflammatory nature of atherosclerosis and has shown promise in previous studies. This blog discusses the recent publication of the Colchicine Cardiovascular Outcomes Trial (COLCOT) and the implications for colchicine to reduce ischemic events.
TRED Lightly: Should Guideline-Directed Medical Therapy be Continued Indefinitely in Everyone?
The TRED-HF trial considerably narrowed the population deemed as being low risk for heart failure relapse following the withdrawal of guideline-directed medical therapy (GDMT). However, several key subgroups were underrepresented and some patients may still wish to attempt GDMT withdrawal, especially in the setting of adverse effects or excess costs. In this post, we explore three questions that can be used to guide a shared decision-making process regarding GDMT withdrawal.
Should DOACs be Used for Treatment of Cancer-Related Thromboembolism?
Patients with active cancer are at an increased risk of arterial and venous thromboembolism (VTE) and bleeding events. Until recently, low molecular weight heparins (LMWH) were generally the preferred therapeutic class for treatment of VTE in patients with cancer. However, LMWH use is limited in the outpatient setting by parenteral administration. Recently, direct oral anticoagulants (DOACs) have demonstrated efficacy in large randomized clinical trials of patients with both VTE and atrial fibrillation and are recommended over warfarin in certain populations. Given the attractive oral dosing option and lack of laboratory montioring, DOAC use have been used for VTE treatment for patients with cancer. In this blog, we summarize the available trial data and provide clinical recommendations for VTE treatment in patients with cancer.