Cardiovascular disease is the leading cause of morbidity and mortality in patients with end stage renal disease (ESRD). A significant number of patients with ESRD undergoing dialysis have reduced left ventricular ejection fraction. Contemporary treatment of heart failure with reduced ejection fraction (HFrEF) includes multiple pharmacotherapeutic strategies such as renin-angiotensin-aldosterone system inhibitors to reduce mortality and slow disease progression. However, because of concerns about hyperkalemia, aldosterone receptor antagonists are not commonly used in patients with HFrEF and ESRD undergoing dialysis. This blog summarizes the current evidence for efficacy and safety of aldosterone receptor antagonists in patients with concomitant HFrEF and ESRD requiring dialysis.
The Four Preceptor Roles: Part II
Residency preceptors must be able to demonstrate the ability to use the four preceptor roles. Applying these roles allows for due diligence when training pharmacy students and residents. In this two part blog post, we will review these roles (instruct, model, coach and facilitate) and discuss reasons for and examples of how to apply these.
3 Clinical Pearls For Acute Management of Atrial Fibrillation in Patients with Heart Failure with Reduced Ejection Fraction
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) often occur concomitantly. Despite this, optimal treatment strategies remain unclear. Current rate and rhythm control pharmacotherapy options present challenges when used in patients with HFrEF. In this blog, we cover 3 clinical pearls to consider for acute management of AF in patients with HFrEF.
The Four Preceptor Roles: Part I
Residency preceptors must be able to demonstrate the ability to use the four preceptor roles. Applying these roles allows for due diligence when training pharmacy students and residents. In this two part blog post, we will review these roles (instruct, model, coach and facilitate) and discuss reasons for and examples of how to apply these.
Dyslipidemia in the Post-Transplant Patient
Cardiovascular disease is a leading cause of morbidity and mortality in patients who have undergone solid organ transplantation. Despite this, limited evidence exists for how to appropriately identify and mitigate cardiovascular risk in this population. In this blog, we discuss the management of dyslipidemia in transplant recipients.
Icosapent Ethyl for Prevention of Cardiovascular Disease: Worth the Hype or Fishing for a Place in Therapy?
Omega-3 fatty acids have been associated with lowering TG; however, robust data for clinical outcomes have been lacking until the recent publication of the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT).2,3 This blog will give a brief review of historical evidence, detail differences in fish oil supplements, and provide considerations for the role of Vascepa (icosapent ethyl) in high-risk patients with dyslipidemia.
Career Reflections: Learning to Say “No”
Becoming a new practitioner will be one of the most exciting times in your career, but having a lot of autonomy might also seem a bit unnerving at first. In this post, we’ll cover one of the most important skills to learn during this transition: saying “no.”
Hydralazine-nitrate combination for heart failure with a reduced ejection fraction – does formulation matter?
Teaser: Does the formulation of oral nitrate therapy matter when used for patients with heart failure with reduced ejection fraction (HFrEF)? Should fixed-dose hydralazine (HYD)/isosorbide dinitrate (ISDN) (BiDil®) be used in those with HFrEF or can the medications be prescribed separately? In clinical practice the individual components HYD and ISDN are often prescribed as a result of cost concerns with the brand name, fixed-dose combination product. Additionally, clinicians often substitute extended-release isosorbide mononitrate (ISMN) for ISDN given its less frequent administration schedule. In this post we will discuss whether these formulations can be used interchangeably in those with HFrEF.
DOAC vs. NOAC: An ATRIUM Perspective
Unsure of whether to use the term NOAC or DOAC? Here is a brief explanation of our preference.
3 Things You Should Know Before Throwing in the Towel on Triple Therapy
When it comes to triple therapy, the totality of the evidence strongly suggests “less is more”. While many practitioners have been quick to adopt dual antithrombotic therapy, it is important to consider the external validity of these trials and how we apply them to our patients. In this blog, Dr. Noel offers 3 considerations that require careful reflection before throwing in the towel on triple therapy.