Authors

Management of multivessel CAD in ACS patients: Do not leave for later what you can finish today

Although multivessel coronary artery disease (CAD) is commonly encountered in patients with acute coronary syndrome (ACS), no randomized controlled trials have evaluated the effi cacy of singlevessel percutaneous coronary intervention (PCI) versus multivessel PCI.

Valproic Acid and Carbapenem Antibiotics Interaction

The effect of a carbapenem on VPA is significant and may result in reduced efficacy and increased seizure activity. Because of the mechanism of this interaction, increasing the dose of the VPA will unlikely achieve therapeutic plasma concentrations.

Avoid the Sham Master and Sham Trusts

Estate Planning Essentials for Physicians

Planning can dramatically reduce-or avoid altogether-some common tax hits, including: capital gains, state, inheritance, and estate and gift taxes. There are several options to consider when building an estate plan.

Comprehensive lifestyle modification and blood pressure control

Lifestyle recommendations for the prevention and treatment of hypertension include weight loss, reduced sodium intake, increased physical activity, limited alcohol intake, and the Dietary Approaches to Stop Hypertension (DASH) diet. The 18-month results of the Prospective Registry Evaluating Myocardial Infarction: Events and Recovery (PREMIER) randomized clinical trial showed that individuals with prehypertension and stage 1 hypertension can make and sustain many of these lifestyle changes over the long term, thereby reducing their risk of cardiovascular disease.

Multislice computed tomography coronary angiography: A study in search of a clinical niche

The study presented in this issue of Cardiology Review by Schuijf and colleagues investigated various aspects of what is rapidly becoming an accepted imaging modality for the assessment of coronary artery disease.

On Epilepsy, Insurers Should Follow Their Own Rhetoric on In-home Care

If CVS and Aetna are truly charting the future of healthcare in this country, then it’s long past-time that their actions align to their rhetoric.

Lipid-lowering therapy and atherosclerotic aortic plaques

We showed that a significant reduction in thoracic aortic plaques and low-density lipoprotein cholesterol levels occurred after 12 months of treatment with atorvastatin. In the abdominal aorta, however, the change in atherosclerotic plaques correlated with age. These results show that plaques in the thoracic and abdominal aortas may respond differently to lipid-lowering therapy, and other factors, such as aging, may be more important for plaque progression in the abdominal aorta.

Should the Hemoglobin A1C Test Be Used to Diagnose Diabetes?

The pros and cons of using the hemoglobin A1C test to diagnose prediabetes and diabetes was the subject of a lively debate at the AACE Meeting.

Insulin as a strategy to optimize glycemic control in patients with type 2 diabetes

Treatment of type 2 diabetes should achieve and maintain euglycemia, thereby preventing complications from this progressive disease. Current antidiabetic therapies should be a part of a multimodal management program that includes diet, exercise, and blood pressure and lipid control. Oral antidiabetic drugs are still first-line therapy for type 2 diabetes, but intensification of therapy, including starting insulin, should occur every 2 to 3 months as needed to achieve euglycemia. The first insulin added is typically a basal insulin, which is effective in lowering fasting plasma glucose (FPG). A persistently elevated glycated hemoglobin (HgbA1C) level despite near or complete normalization of FPG, however, indicates postprandial hyperglycemia. In these cases, the addition of bolus insulin is required to reduce postprandial glucose (PPG). Several approaches to initiate and titrate insulin can be used based on FPG, PPG, HgbA1C, and patient factors.

How Accurate are Cardiac Risk Calculators?

This prospective epidemiological study compares the capabilities of the new 2013 American Heart Association and American College of Cardiology ASCVD risk calculator against several alternative cardiovascular risk calculators and explores the potential effect of preventive therapy on risk overestimation in the AHA-ACC-ASCVD model.

Peace Greets Guests in the Northern Neck

Suffering in Silence: The Scourge of Physician Suicide

Physician suicide is a taboo topic—and despite high rates of depression and PTSD among doctors, little help exists for those at risk.