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https://www.readbyqxmd.com/read/28497379/-choosing-wisely-recommendations-in-cardiology
#1
REVIEW
K Werdan, S Baldus, N Frey, U Nixdorff, K-H Kuck, H Katus
This article describes controversially discussed Choosing wisely recommendations presented by the German Cardiac Society: anticoagulation therapy in patients with atrial fibrillation and "only" moderate stroke risk, on the one hand, and goal-directed low-density lipoprotein (LDL) cholesterol-lowering, on the other. Presuming an adequate regime, patients with atrial fibrillation and only moderate risk of stroke (CHA2DS2-VASc Score of 1 in men and of 2 in women) also benefit from anticoagulation therapy, even in elderly patients...
May 11, 2017: Der Internist
https://www.readbyqxmd.com/read/28487744/atorvastatin-diltiazem-combination-induced-rhabdomyolysis-leading-to-diagnosis-of-hypothyroidism
#2
N D B Ehelepola, S M B Y Sathkumara, H M P A G S Bandara, K L R Kalupahana
Statins and hypothyroidism, independently, can rarely cause rhabdomyolysis. The combination of them especially with concurrent intake of drugs such as diltiazem increases the risk of rhabdomyolysis. Hashimoto's encephalopathy is a rare condition associated with Hashimoto's thyroiditis and some patients with that can present with a stroke like picture. An elderly male who has been on atorvastatin for three years and on diltiazem for a week presented with sudden onset inability to walk and confusion. On examination muscle tenderness was noticed and creatine kinase levels indicated rhabdomyolysis which we attributed to atorvastatin...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#3
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28408169/prescriber-acceptance-rate-of-pharmacists-recommendations
#4
Jonathan F Doellner, Rick W Dettloff, Susan DeVuyst-Miller, Katie L Wenstrom
OBJECTIVES: To determine the prescriber acceptance rates of pharmacists' recommendations, specifically related to 2 Medicare Part D Star ratings: appropriate use of high-risk medications (HRMs) in elderly patients and use of statins for primary prevention in patients with diabetes. The secondary objective was to assess factors associated with prescriber acceptance. DESIGN: Retrospective cohort. SETTING AND PARTICIPANTS: Medicare Part D beneficiaries at a regional grocery store chain pharmacy in Michigan from January 2014 to October 2015...
April 10, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28401726/the-genomic-potential-of-the-aspirin-in-reducing-events-in-the-elderly-and-statins-in-reducing-events-in-the-elderly-studies
#5
Paul Lacaze, Robyn Woods, Sophia Zoungas, John McNeil
Human genetic studies are continuing to increase in size and scale, but the availability of well-phenotyped longitudinal cohorts remains rare. Significant infrastructure, investment and effort are required to establish and maintain high-quality cohorts with biobanking, genetic consent and repeated clinical data measurements. Australia currently has two such cohorts established by Monash University as part of community-based clinical trials in the elderly. Both studies involve capture of demographic, mood, cognitive performance, physical function, neuroimaging, audiometry and various clinical data types over an average of 5 years...
April 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28385949/primary-prevention-with-statin-therapy-in-the-elderly-new-meta-analyses-from-the-contemporary-jupiter-and-hope-3-randomized-trials
#6
LETTER
Paul M Ridker, Eva Lonn, Nina P Paynter, Robert Glynn, Salim Yusuf
No abstract text is available yet for this article.
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28370905/exposure-to-statins-is-associated-to-fracture-risk-reduction-in-elderly-people-with-cardiovascular-disease-evidence-from-the-aifa-i-grade-observational-project
#7
Federico Rea, Stefano Bonassi, Cristiana Vitale, Gianluca Trifirò, Silvia Cascini, Giuseppe Roberto, Alessandro Chinellato, Ersilia Lucenteforte, Alessandro Mugelli, Giovanni Corrao
PURPOSE: Conflicting findings were observed from clinical trials and observational studies evaluating the association between the use of statins and the risk of fracture. A case-control study nested into a cohort of elderly patients on treatment with statins for cardiovascular secondary prevention was performed on this issue. METHODS: The cohort was formed by 13 875 individuals aged ≥65 years from several Italian health units receiving statins after hospital discharge for cardiovascular outcomes...
March 31, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28326532/common-drug-side-effects-and-drug-drug-interactions-in-elderly-adults-in-primary-care
#8
Susan E Merel, Douglas S Paauw
Prescribing medications, recognizing and managing medication side effects and drug interactions, and avoiding polypharmacy are all essential skills in the care of older adults in primary care. Important side effects of medications commonly prescribed in older adults (statins, proton pump inhibitors, trimethoprim-sulfamethoxazole and fluoroquinolone antibiotics, zolpidem, nonsteroidal antiinflammatory drugs, selective serotonin reuptake inhibitors, dipeptidyl peptidase 4 inhibitors) were reviewed. Important drug interactions with four agents or classes (statins, warfarin, factor Xa inhibitors, and calcium channel blockers) are discussed...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28321243/cardiac-drug-therapy-considerations-in-the-elderly
#9
REVIEW
Mohamed Ayan, Naga Venkata Pothineni, Aisha Siraj, Jawahar L Mehta
Elderly individuals constitute a majority of patients encountered in current cardiovascular clinical practice. Management of these patients is a clinical challenge owing to a multitude of factors. Although medications such as statins have been shown to reduce cardiovascular mortality in the general population, evidence supporting the use of these drugs in patients greater than 75 years of age is sparse. Furthermore, aging associated changes in organ function and associated comorbidities influence the pharmacokinetics of multiple medications and can potentiate drug toxicity...
December 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28321237/management-and-risk-factor-control-of-coronary-artery-disease-in-elderly-versus-nonelderly-a-multicenter-registry
#10
Arintaya Phrommintikul, Rungroj Krittayaphong, Wanwarang Wongcharoen, Smonporn Boonyaratavej, Chaiyasith Wongvipaporn, Woraporn Tiyanon, Pakaphan Dinchuthai, Rapeephon Kunjara-Na-Ayudhya, Pyatat Tatsanavivat, Piyamitr Sritara
BACKGROUND: Coronary artery disease (CAD) is a leading cause of death in elderly because aging is the important non-modifiable risk factors of atherosclerosis and also a predictor of poor outcomes. Underuse of guideline directed therapy may contribute to suboptimal risk factor control and worse outcomes in the elderly. We aimed to explore the management of CAD, risk factors control as well as goal attainment in elderly compared to nonelderly CAD patients. METHODS: The CORE-Thailand is an ongoing multicenter, prospective, observational registry of patients with high atherosclerotic risk in Thailand...
December 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28279605/memory-alterations-and-white-matter-hyperintensities-in-elderly-patients-with-hypertension-the-adelahyde-2-study
#11
João Pedro Ferreira, Anna Kearney Schwartz, Ghassan Watfa, Lamiral Zohra, Jacques Felblinger, Jean-Marc Boivin, Serge Bracard, Gabriella Hossu, Antoine Verger, Laure Joly, Faiez Zannad, Patrick Rossignol, Athanase Benetos
OBJECTIVES: The longitudinal ADELAHYDE-2 study aims to identify the factors associated with cognitive impairment/decline and white matter hyperintensities burden. METHODS: Longitudinal single-center study comprising two visits separated by approximately 7 years. A total of 131 patients completed the two visits. The primary outcome was global memory composite scale, while the secondary outcome was white matter hyperintensities (WMH/Fazekas scale) load. RESULTS: Global memory at visit 2 (V2) was largely influenced by age, smoking status, glycated hemoglobin, and history of stroke already present at visit 1 (V1)...
May 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28270383/patterns-and-predictors-of-adherence-to-statin-therapy-among-older-patients-protocol-for-a-systematic-review
#12
Richard Ofori-Asenso, Ella Zomer, Andrea Curtis, Andrew Tonkin, Mark Nelson, Manoj Gambhir, Danny Liew, Sophia Zoungas
BACKGROUND: The benefits of statin therapy are significantly compromised by noncompliance. Although elderly patients may have particular challenges with medication adherence and persistence, previous reviews on statin adherence have not focused on this population. Additionally, comparisons of adherence and persistence specific to statin indication (primary or secondary prevention) have not been thoroughly explored. OBJECTIVE: We aim to assess the extent of, and factors associated with, adherence and persistence to statin therapy among older populations (aged ≥65 years)...
March 7, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28257284/pharmacogenomics-and-tailored-polypharmacy-an-80-year-old-lady-with-rosuvastatin-associated-rhabdomyolysis-and-maprotiline-related-ogilvie-s-syndrome%C3%A2
#13
Katherina B Sreter, Blazenka Barisic, Sanja Popovic-Grle
What is known and objectives: Multiple adverse drug reactions (ADRs) are expected, and thus should be prevented in the elderly comorbid patient on polypharmacy. Rosuvastatin is commonly prescribed for the treatment and prevention of atherosclerotic diseases, and in rare cases, is associated with rhabdomyolysis. Maprotiline is a tetracyclic antidepressant, infrequently used in the United States, but seemingly more broadly in European countries. Acute colonic pseudo-obstruction (Ogilvie's syndrome) caused by maprotiline has thus far, to our knowledge, not yet been described in the literature...
May 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28228632/physical-and-psychological-characteristics-of-the-community-dwelling-elderly-with-heart-disease
#14
Takeshi Kera, Hisashi Kawai, Hideyo Yoshida, Hirohiko Hirano, Motonaga Kojima, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi
Objectives Although the survival rates of patients with heart diseases, such as myocardial infarction and heart failure, have increased, the incidence of heart disease in elderly individuals has also increased. We compared characteristics of the community-dwelling elderly with heart diseases (heart disease group) and without heart diseases (non-heart disease group).Methods A total of 758 elderly individuals participated in our survey ("Otassha-kensin") in 2014. The heart disease group (47 men, 28 women) and the non-heart disease group (263 men, 420 women) were selected from among these participants...
2017: [Nihon Kōshū Eisei Zasshi] Japanese Journal of Public Health
https://www.readbyqxmd.com/read/28198684/statin-therapy-in-the-frail-elderly-a-nuanced-decision
#15
EDITORIAL
Donald Clark, Leslie S Cho
No abstract text is available yet for this article.
February 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28188508/potentially-inappropriate-prescribing-and-associated-factors-in-elderly-patients-at-hospital-discharge-in-brazil-a-cross-sectional-study
#16
Ana Luiza Pereira Moreira Mori, Renata Cunha Carvalho, Patricia Melo Aguiar, Maria Goretti Farias de Lima, Magali da Silva Pacheco Nobre Rossi, José Fernando Salvador Carrillo, Egídio Lima Dórea, Sílvia Storpirtis
Background The Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) criteria is used to identify instances of potentially inappropriate prescribing in a patient's medication regimen. Objective To determine the prevalence and predictors of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients at hospital discharge. Setting A university hospital medical clinic in Brazil. Method Discharge prescriptions were examined using the STOPP/START criteria...
February 10, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28138911/new-onset-diabetes-after-statin-exposure-in-elderly-women-the-australian-longitudinal-study-on-women-s-health
#17
Mark Jones, Susan Tett, Geeske M E E Peeters, Gita D Mishra, Annette Dobson
INTRODUCTION: Extensive clinical research has consistently shown statins lower the risk of cardiovascular events and mortality. Some studies also suggest statins increase the risk of new-onset diabetes. Research to date has rarely included elderly women, hence little is known about the risk of diabetes after statin exposure in this population. OBJECTIVES: Our objectives were to evaluate and estimate the risk of new-onset diabetes associated with statin exposure in a cohort of elderly Australian women...
March 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28102774/interactions-between-c-reactive-protein-and-traditional-risk-factors-in-predicting-mortality-of-older-adults
#18
Henrik Rudolf, Naemi Wall, Renate Klaassen-Mielke, Ulrich Thiem, Curt Diehm, Hans-Joachim Trampisch, Dietmar Krause
BACKGROUND: Elevated levels of C-reactive protein (CRP) are known to be associated with cardiovascular (CV) morbidity and mortality in older adults, however, there seems to be heterogeneity of this association across subsets of individuals. We aim to assess the effects of interactions between CRP and one of the following traditional CV risk factors regarding all-cause mortality in unselected elderly men and women: age, sex, body mass index, diabetes, and hypertension. PATIENTS AND METHODS: Three hundred and forty-four general practitioners all over Germany enrolled 6,817 unselected participants, aged 65 years or older, and performed thorough examinations, including CRP measurement at baseline (getABI study)...
March 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28095900/post-stroke-dementia-a-comprehensive-review
#19
REVIEW
Milija D Mijajlović, Aleksandra Pavlović, Michael Brainin, Wolf-Dieter Heiss, Terence J Quinn, Hege B Ihle-Hansen, Dirk M Hermann, Einor Ben Assayag, Edo Richard, Alexander Thiel, Efrat Kliper, Yong-Il Shin, Yun-Hee Kim, SeongHye Choi, San Jung, Yeong-Bae Lee, Osman Sinanović, Deborah A Levine, Ilana Schlesinger, Gillian Mead, Vuk Milošević, Didier Leys, Guri Hagberg, Marie Helene Ursin, Yvonne Teuschl, Semyon Prokopenko, Elena Mozheyko, Anna Bezdenezhnykh, Karl Matz, Vuk Aleksić, DafinFior Muresanu, Amos D Korczyn, Natan M Bornstein
Post-stroke dementia (PSD) or post-stroke cognitive impairment (PSCI) may affect up to one third of stroke survivors. Various definitions of PSCI and PSD have been described. We propose PSD as a label for any dementia following stroke in temporal relation. Various tools are available to screen and assess cognition, with few PSD-specific instruments. Choice will depend on purpose of assessment, with differing instruments needed for brief screening (e.g., Montreal Cognitive Assessment) or diagnostic formulation (e...
January 18, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28076256/statin-therapy-as-primary-prevention-in-exercising-adults-best-evidence-for-avoiding-myalgia
#20
N John Bosomworth
INTRODUCTION: This review aims to determine whether active adults who begin statins and develop myalgia reduce or stop activity to become less symptomatic. If this occurs, strategies to mitigate symptoms are explored. Should these strategies fail, the question of whether exercise is an adequate alternative to statin therapy is addressed. METHODS: PubMed, Google Scholar, and the Cochrane Database were searched with keywords designed to retrieve information on statin myopathy in exercising adults...
November 2016: Journal of the American Board of Family Medicine: JABFM
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