The Mediterranean Diet Is Heart Healthy: The PREDIMED Trial

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The PREDIMED Trial Comments Eligible participants were mostly older Caucasian women with no evidence of cardiovascular disease at enrollment, with either type II diabetes mellitus or at least three of the following major risk factors: smoking, hypertension, elevated LDL levels, low HDL levels, overweight or obesity, or a family history of premature coronary heart disease: Baseline Characteristics Female gender 60% Mean …

Five Things Physicians and Patients Should Question

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Five Things Physicians and Patients Should Question: Don’t perform stress cardiac imaging or advanced non-invasive imaging in the initial evaluation of patients without cardiac symptoms unless high-risk markers are present. Asymptomatic, low-risk patients account for up to 45 percent of unnecessary “screening.” Testing should be performed only when the following findings are present: diabetes in patients older than 40-years-old; peripheral …

Improper Cardiac Stent Implantations

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Senate Finance Committee Chairman Max Baucus (D-Mont.) and Ranking Member Chuck Grassley (R-Iowa) today released a Finance Committee report detailing the case of a doctor who reportedly implanted nearly 600 potentially medically unnecessary stents from 2007 through mid-2009 at St. Joseph Medical Center in Towson, Maryland, and his relationship with the manufacturer of the stents, Abbott Labs.  The Senators’ report …

Cost-Effectiveness of PCI with Drug Eluting Stents versus CABG

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Cost-Effectiveness of PCI with Drug Eluting Stents versus Bypass Surgery for Patients with Diabetes and Multi-vessel Coronary Artery Disease: Results from the FREEDOM Trial. Not only did patients with diabetes and multi-vessel CAD experience significantly better clinical outcomes after revascularization with CABG than PCI with a drug-eluting stent, according to results of the FREEDOM trial, based on lifetime projections, CABG was found to be more …

Stents and Stroke

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 LONDON – Stroke patients over 70 who get stents to keep their arteries open may be doubling their risk of having another stroke or dying compared to patients who get surgery instead, a new study says. European researchers examined past studies from more than 3,400 stroke patients, including 1,725 who got stents and 1,708 who had surgery, and found that …

Coronary Artery Bypass Grafting is Superior to Percutaneous Coronary Intervention in Diabetics with Coronary Artery Disease

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A dramatic increase in percutaneous coronary intervention (PCI), coupled with a similar decrease in coronary artery bypass grafting (CABG) has characterized the treatment of coronary artery disease for the 20 years. The just released FREEDOM trial results[1] have once again confirmed that diabetic patients with coronary artery disease have better outcomes with CABG than with PCI – even if contemporaneous …

The Best Cardiology Blogs

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Ask Dr T was nominated in September 2012 as one of The Best Cardiology  Blogs on Internetmedicine, “where Internet meets medicine” in the company of others that include The American College of Cardiology, Dr. Topol,  Dr. Cresman and Harvard Health Publications

Stenting for stable coronary artery disease is wrong!

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In  a January 4th, 2012 JAMA editorial, the authors describe that patients were not being helped by a variety of well-established procedures including stenting for stable coronary artery disease: “Percutaneous coronary intervention (stenting) performed for stable coronary artery disease… cost(s) billions of dollars and (has supported) the existence of (an) entire specialty for many years. Stable coronary artery disease accounted for …

Is HbA1c the gold standard for diagnosis of Diabetes?

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HbA1c is not a sure-fire tool for Diabetes diagnosis.At the European Association for the Study of Diabetes meeting on HbA1c for diagnosis, many physicians did not trust glycated hemoglobin levels alone to diagnose diabetes, despite ADA guidelines. High-risk, pre-diabetic patients could be left untreated with an HbA1c of less than 6.5%, and a fasting Glucose or a Glucose tolerance test …