Does a “One-Size-Fits-All” Aspirin Dosing Approach Still Hold WEIGHT?

December 7, 2018

Personalized medicine is at the forefront of health care today, focusing on how best to tailor the treatment approach to each person. But should we be thinking about personalizing the approach for prevention as well?  The one-dose-fits-all approach has been used in nearly all aspirin studies.  What is poorly understood is the influence of body weight.  Perhaps the reason why aspirin has resulted in only modest benefits in clinical trials might be related to under (and over) dosing based on patient weight.

Podcast Case:  Weight-based Dosing of Aspirin

Guest Author:  Marina Maes, PharmD, BCPS

Music by Good Talk 

00:0000:00

Aspirin for Primary Prevention of CV Events in Diabetes - Is the Evidence ASCENDing?

November 23, 2018

Aspirin is no doubt beneficial in patients with overt vascular disease for the secondary prevention of myocardial infarction, stroke, or cardiovascular death. However, evidence supporting use of aspirin for primary prevention in patients who have not had a cardiovascular event is far less compelling. The clinical uncertainty of aspirin use for the primary prevention of CV events in patients with diabetes is reflected in the different recommendations in current guidelines. The investigators of the ASCEND (A Study of Cardiovascular Events in Diabetes) trial set out to determine the safety and efficacy of daily aspirin use in patients with diabetes without known occlusive arterial disease.

Podcast Case:  ASA Use in DM - Evidence ASCENDing?

Guest Author:  Kirstie Perry, Pharm.D.

Music by Good Talk

00:0000:00

Top Ten Things Every Clinician Should Know About the 2018 Antithrombotic Therapy Atrial Fibrillation Guidelines

October 12, 2018

The American College of Chest Physicians (ACCP) recently updated their guideline recommendations for the use of antithrombotics for the prevention of stroke in patients with atrial fibrillation (aka the Chest Guidelines).  Find out what's new, who shouldn't receive treatment based on the CHA2DS2-VASc score, and why the guideline panel recommends calculating a patient's SAME-TTR score.

Guest Author:  Dylan Lindsay, PharmD

Music by Good Talk

00:0000:00

Where is the COMPASS Taking Us? Rivaroxaban, Aspirin, or Both for Stable CVD ?

December 8, 2017

Since the introduction of direct oral anticoagulants (DOACs) less than a decade ago, use of this class has expanded beyond the prevention and treatment of venous thromboembolism and stroke prevention in the setting of atrial fibrillation. The potential role of DOACs in the secondary prevention of coronary artery disease (CAD) has been of considerable interest. In the setting of CAD, warfarin has resulted in significant more major bleeding when given either alone or in combination with antiplatelet agents when compared to aspirin alone.  Therefore, clinicians have been reluctant to embrace the combination of an anticoagulant plus an antiplatelet agent. However, could DOACs have a role in stable CAD? The COMPASS trial aimed to find an answer.

Guest Authors:  Candyce Bryant, Pharm.D., Joy Hoffman, Pharm.D., and M. Shawn McFarland, Pharm.D.

Music by Good Talk

00:0000:00

It’s All Relative: EINSTEIN CHOICE - Rivaroxaban for Extended Secondary Prevention of VTE

June 10, 2017

For the acute treatment of venous thromboembolism, the direct oral anticoagulants (DOACs) have increasingly replaced injectable anticoagulant therapy followed by warfarin.  For patients with an unprovoked deep vein thrombosis or pulmonary embolism who may benefit from long-term extended prophylaxis for the secondary prevention of VTE, the choice is less clear. Should a DOAC be used?  If so, which one and what's the best dose?  What about low-dose aspirin? Is extended therapy needed at all?  The EINSTEIN CHOICE study adds important new insights to the growing body of literature.

Guest Author: Sarah Anderson, PharmD, BCPS

Theme music by Good Talk

00:0000:00

Peeling Back the Layers on Coated Aspirin

April 14, 2017

More than 15 million Americans have coronary heart disease and most should be taking aspirin daily.  Given aspirin’s ubiquity in cardiovascular medicine and patients’ pill boxes, it is shocking that there are still so many unanswered questions about aspirin use. Which dose and dosage forms should be prescribed?  How common is aspirin resistance?  What is the relationship between platelet inhibition and clinical outcomes?

Guest Author:  Daniela Valencia, Pharm.D.

Theme Music by Good Talk

00:0000:00

Antithrombotic Therapy Following Stent Placement in Patients with A-Fib: Should DOACs Be Preferred?

March 24, 2017

Many patients with atrial fibrillation (AF) received triple antithrombotic therapy after undergoing a percutaneous coronary intervention (PCI) and receiving cardiac stent. Triple therapy consists of warfarin plus dual antiplatelet therapy (DAPT) with a P2Y12 inhibitor and low-dose aspirin. But is triple therapy the best approach? This practice, while widely employed, is not entirely evidence-based. Moreover, the effectiveness and safety of the direct oral anticoagulants (DOACs) in this patient population is unknown.

Theme Music by Good Talk

00:0000:00

An Aspirin a Day to Prevent Colon CA

December 22, 2015

Several studies have evaluated the correlation between low-dose aspirin and NSAID use and the development of colorectal cancer. In 2007, the U.S. Preventive Services Task Force (USPSTF) recommended against the use aspirin for the prevention of colorectal cancer in most adults. However, there is mounting evidence that daily, long-term aspirin use may prevent colorectal cancer in patients aged 50-69. Could something as simple as an aspirin a day prevent colon CA?

00:0000:00

Taking a CHANCE on Clopidogrel Plus Aspirin to Prevent Stroke Recurrence

October 30, 2015

The CHANCE (Clopidogrel in High risk patients with Acute Non-disabling Cerebrovascular Events) trial investigators examine whether patients who have a TIA or mini-stroke should receive aspirin AND clopidogrel to reduce the risk of recurrent stroke.

00:0000:00

Intensive Antiplatelet Therapy - Is Extended Therapy Worth It?

June 21, 2015

Our guests - Dr. Cortney Mospan and Dr. Augustus (Rob) Hough - critically examine the results of the DAPT and PEGASUS-TIMI 54 studies and explain how the results should be applied in practice.

00:0000:00