Episodes
Friday Oct 29, 2021
What’s the Right Dose of Aspirin in Patients with Heart Disease?
Friday Oct 29, 2021
Friday Oct 29, 2021
There is no consensus regarding the preferred dosage of aspirin in patients with atherosclerotic cardiovascular disease (ASCVD) and this has led to variability in prescribing patterns. This is likely due to the lack of head-to-head trials evaluating different aspirin doses and data weighing the clinical benefits and adverse effects experienced with aspirin. Until now?
Guest Authors: Ivy Nwogu, PharmD and Megan Supple, PharmD, BCACP, CPP
Music by Good Talk
Tuesday Oct 05, 2021
Guiding Antiplatelet Therapy: Is a Personalized Approach Worth It?
Tuesday Oct 05, 2021
Tuesday Oct 05, 2021
Variability in clopidogrel pharmacokinetics among patients has been appreciated for years and this results in inconsistent effects on platelet inhibition and poor outcomes. Multiple strategies to personalize antiplatelet therapy intended to balance the risks and benefits of therapy have been tested. A recent systematic review and meta-analysis attempts to answer the question: Is a personalized approach worth it?
Guest Authors: Kiana R. Green, PharmD and Augustus (Rob) Hough, PharmD, BCPS, BCCP
Music by Good Talk
Friday Aug 28, 2020
Can VOYAGER Put PAD Patients Back on Their Feet?
Friday Aug 28, 2020
Friday Aug 28, 2020
Peripheral artery disease (PAD) impacts 8.5 million Americans age 40 years or older, often leading to acute limb ischemia, amputation, hospitalization, revascularization, major adverse cardiac events (MACE), and death. In addition to being at very high risk of MACE, more than 10% of PAD patients who had revascularization surgery are hospitalized for major adverse limb events, including acute limb ischemia leading to amputation. Could combination therapy, an antithrombotic regimen comprised of a direct oral anticoagulant and an antiplatelet agent, help prevent limb ischemia and cardiovascular (CV) events in these high-risk patients?
Guest Authors: Navya Varshney, PharmD, BCPS and Rachel Lowe, PharmD, BCPS
Music by Good Talk
Friday Dec 07, 2018
Does a “One-Size-Fits-All” Aspirin Dosing Approach Still Hold WEIGHT?
Friday Dec 07, 2018
Friday Dec 07, 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
Friday Nov 23, 2018
Friday Nov 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
Friday Oct 12, 2018
Friday Oct 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
Friday Dec 08, 2017
Friday Dec 08, 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
Saturday Jun 10, 2017
Saturday Jun 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
Friday Apr 14, 2017
Peeling Back the Layers on Coated Aspirin
Friday Apr 14, 2017
Friday Apr 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
Friday Mar 24, 2017
Friday Mar 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