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Chest pain syndrome in women: A diagnostic dilemma

The ability to diagnose coronary artery disease (CAD) in women may be limited by the sensitivity and specificity of symptoms as well as of noninvasive testing. The choice of which test should be performed to evaluate the presence of CAD in women remains controversial. Currently American Heart Association/American College of Cardiology guidelines recommend initial evaluation with exercise electrocardiogram (ECG) testing. In a meta-analysis of 3721 women, however, exercise ECG had a sensitivity of 61% and a specificity of 70%1 as compared to 68% sensitivity and 77% specificity in men.

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Reactivation of Hepatitis B Associated With Immunosuppressive Medications

In patients with chronic HBV, the immune system may have very low levels of the virus. When reactivation occurs due to immunosuppression, these viruses begin to replicate again. Common symptoms of this event include inflammation of the liver and elevations of liver enzyme levels in the blood. In some cases, bilirubin levels may rise in response to reactivation of infection.

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Combining warfarin and antiplatelet therapy after coronary stenting

We conducted an observational study to compare singleantiplatelet therapy with dualantiplatelet therapy among patients requiring long-term warfarin therapy after coronary stenting. Results showed that there was no difference in mortality or myocardial infarction between the 2 treatment regimens at 6 months, with no excess in-hospital bleeding; however, larger trials are needed to determine firm recommendations.

Bisphosphonates' Growing Role in Breast Cancer

Intravenous bisphosphonates, often used to treat metastases and bone pain in breast cancer patients, are now being used by clinicians for osteoporosis in these patients—pharmacists need to recommend appropriate screening and treatment.

Different means to the same end, or just different?

The study by Schuijf and Bax, which compares multislice computed tomography (CT) versus myocardial perfusion imaging, is very timely, as this new cardiac imaging modality has gained rapid acceptance by cardiologists for managing patients.

Reduction of inflammatory biomarkers through the use of hyperlipidemia drugs in patients with diabetes

Diabetes and inflammation influence the development of atherosclerosis. We performed a study that showed the inflammatory markers high-sensitivity C-reactive protein and lipoprotein-associated phospholipase A2 were lowered with the use of fenofibrate, simvastatin, and combination therapy. The anti-inflammatory effects were most pronounced among patients with elevated baseline inflammatory markers. Combination therapy significantly altered lipid concentrations and exerted a greater positive effect on low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides than monotherapy with either drug.

Cardiac resynchronization in a patient with Class IV heart failure and narrow QRS-the role of mechanical dyssynchrony

Cardiac resynchronization treatment (CRT) has moved into the mainstream of patient care after several randomized studies have demonstrated improved quality of life, reversed remodeling, and decreased heart failure hospitalizations. More recently, 2 large studies have demonstrated a mortality benefit of CRT independent of implantable cardioverter defibrillator

Prevalent atherosclerosis-Choose your biomarker

Circulating biomarkers have been used in cardiovascular medicine as predictors of incident or prevalent disease.

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Venetoclax Approved for Older Patients With AML

The drug is approved as a treatment for adult patients with newly-diagnosed acute myeloid leukemia (AML) who are 75 years or older, or who have comorbidities that preclude the use of intensive induction chemotherapy.