December 14, 2018
Daily low-dose aspirin has long been considered a “wonder drug” for its cardioprotective effects, particularly in patients with pre-existing cardiovascular and cerebrovascular disease; however, despite decades of research, the use of aspirin to prevent a first event is less certain. In 2014, the Food and Drug Administration (FDA) responded to a citizen petition requesting the labeled indications for low dose aspirin be updated to include primary prevention. The FDA concluded that the evidence “fail[ed] to establish that aspirin reduces the risk of primary myocardial infarction (MI) in patients with a coronary heart disease (CHD) risk of 10% or more for over 10 years.” The Asprin to Reduce Risk of Initial Vascular Events (ARRIVE) study is intended to address this gap in our knowledge.
Guest Authors: Amy St. Amand, PharmD, BCPS and Christine Borowy, PharmD, BCPS
Music by Good Talk
December 15, 2017
We interview Eric MacLaughlin, Joseph Saseen, and Kristin Rieser about the ACC/AHA Guidelines for the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure in Adults released in November 2017. Dr. MacLaughin, a member of the Guideline Writing Committee, gives a insiders view of the guidelines development process and explains the rationale for lower blood pressure goals. Drs. Saseen and Rieser talk about some of the practical considerations that we all must consider as we move forward to making these recommendations a reality.
Guests: Kristin Rieser, Pharm.D., Joseph Saseen, Pharm.D, and Eric MacLaughlin, Pharm.D.
Music by Good Talk
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
March 25, 2016
For over two decades LMWHs have been routinely used to provide therapeutic coverage in patients who must temporarily stop warfarin. Current guidelines suggest using injectable anticoagulants during warfarin interruption (aka bridging) in patients with atrial fibrillation based on patients’ risk of arterial thrombosis. Using the CHADS2 score to assess risk, the guidelines recommend (grade 2C) bridge therapy if the CHADS2 score is 5 or higher and not bridging if the CHADS2 score is 2 or lower. But what about patients with a CHADS2 score of 3 or 4?
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.
September 18, 2015
Many clinicians are questioning the role pharmacists play in anticoagulation therapy management as direct oral anticoagulants (DOACs) increasingly replace warfarin for a variety of indications. A recent study examined medication adherence and therapy management practices at Veterans Health Administration (VHA) patient care sites. Although this study does not have all the answers, it does reveal the importance of patient selection and ongoing patient monitoring – potentially key roles for pharmacists.
July 24, 2015
Stroke is responsible for 1 in 19 deaths in the United States and is the leading cause of long-term disability. Could something as simple and cheap as folic acid substantially reduce the risk of stroke? The China Stroke Primary Prevention Trial examined this important question.