There has been a wealth of information in the literature over the past few years about various strategies to prevent cardiovascular disease. Many have been highly anticipating the new primary prevention recommendations from the American College of Cardiology/American Heart Association for guidance on how to apply all of this new evidence. The guidelines have recently been released! A summary of the key takeaways from the Primary Prevention guideline are provided in this blog.
4 Mistakes You Could Be Making with Loop Diuretics
Despite being the mainstay of therapy, questions remain as to how to properly use loop diuretics in patients with acute decompensated heart failure (ADHF). In this post, we’ll cover four of the most common mistakes with using loop diuretics in this population.
AC in ESRD (Part III): Warfarin Over Apixaban for Patients with Atrial Fibrillation and End Stage Renal Disease
Part III of this three part series focuses on the role of warfarin in end stage renal disease (ESRD). Is it time to retire warfarin for anticoagulation in patients with ESRD and atrial fibrillation (AF)? Are there supporting data for warfarin in patients with ESRD? How does it compare to apixaban? Check out the blog for full details and answers to these questions.
4 Updates Every Clinician Should Know About the 2019 AF Guidelines
The highly anticipated focused update of the 2014 atrial fibrillation guideline incorporates modified recommendations based on evidence from several recent publications. This blog will detail the four most important updates from the guideline, including a brief discussion of the data influencing these changes.
AC in ESRD (Part II): Apixaban Over Warfarin for Patients with Atrial Fibrillation and End Stage Renal Disease
Part II of this three part series focuses on apixaban in end stage renal disease. Is it safe? How does it compare to warfarin? What dose should you use? Check out the blog for full details and answers to these questions.
AC in ESRD (Part 1): First, Do No Harm – No Anticoagulation in Patients with End Stage Renal Disease and Atrial Fibrillation
Selecting the best anticoagulation strategy for patients with end stage renal disease and atrial fibrillation remains controversial. In this three part series, we will explore potential strategies that seek to balance the risk of stroke with adverse effects in patients with end stage renal disease and atrial fibrillation. In Part 1 of this series, we will discuss the risks of anticoagulation and provide a compelling argument for avoiding anticoagulation. The role of direct oral anticoagulants and warfarin in this patient population will be reviewed in Parts 2 and 3, respectively.
Post-TAVR Antithrombotic Therapy: What To Do When No One Knows What To Do.
Transcatheter aortic valve replacement (TAVR) has proven to be an effective treatment option for patients with severe aortic stenosis at intermediate-high risk for complications with surgical aortic valve replacement. In spite of the growing popularity of TAVR, the optimal antithrombotic regimen remains unknown. This blog outlines current guideline recommendations for post-TAVR antithrombotic therapy and gives guidance on how to handle special populations and patient-specific factors.
Transitions Squared: Transitioning Sacubitril/Valsartan at Transitions of Care
One of the questions that remained unanswered after the PARADIGM-HF trial was whether the angiotensin receptor/neprilysin inhibitor sacubitril/valsartan could be safely initiated in patients with acute decompensated heart failure who had been previously stabilized on an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker. In this blog, Dr. Reed discusses the implications of the PIONEER-HF and TRANSITION studies, and provides a practical strategy for transitioning patients to sacubitril/valsartan.
Cutting through the Fat: Digesting the 2018 ACC/AHA Cholesterol Guidelines
The long-awaited American College of Cardiology/American Heart Association (ACC/AHA) cholesterol guidelines were recently released at AHA 2018 in Chicago. This update can be described as an amalgamation of various previous guidelines and highlights the growing complexity of lipid management. In this post, we highlight some of the most important changes in the latest update.
Propofol-Induced Myocardial Depression: Does This Really Exist?
In the intensive care setting, propofol is a commonly used medication for management of sedation in mechanically ventilated, critically ill patients. However, intensivists often select dexmedetomidine over propofol in patients with cardiovascular disease due to concern for cardiac adverse effects such as myocardial depression. In this blog, I’ll be discussing three important considerations before accepting propofol-induced myocardial depression as clinically significant.