#7: Post-stroke DOACs, SGLT-2 inhibitors and hematocrit, post-discharge rivaroxaban for COVID-19, plus the influence of age on statin efficacy
Welcome to the latest episode of Cardiology Digest, where we dive into the pressing questions of today's medical research. Here's a glimpse of what's to come: STUDY #1: Have you ever wondered about the optimal timing for introducing DOACs (direct-acting oral anticoagulants) after strokes due to atrial fibrillation? This New England Journal of Medicine study dives into the potential advantages of early DOAC introduction. You might be surprised at the rates of symptomatic intracranial hemorrhage. But remember, patient profiles vary—for example, what works for those with mild neurologic deficits might not hold true for everyone. Fischer, U, Koga, M, Strbian, D, et al. 2023. Early versus later anticoagulation for stroke with atrial fibrillation. N Engl J Med. 26: 2411–2421. (https://doi.org/10.1056/NEJMoa2303048) STUDY #2: Next, we’ll take a look at the curious case of rising hematocrit in certain chronic kidney disease patients who have anemia and were treated with SGLT-2 inhibitors. Did they have a genuine improvement in anemia or was it merely an illusion? SGLT-2 inhibitors are the focal point, and we'll dissect their multifaceted effects that may be at play here. Koshino, A, Schechter, M, Chertow, GM, et al. 2023. Dapagliflozin and anemia in patients with chronic kidney disease. NEJM Evid. 6. (https://doi.org/10.1056/EVIDoa2300049) STUDY #3: Hospitalization due to COVID-19 has presented a conundrum regarding post-discharge thromboprophylaxis. With the pandemic making such profound impacts on global health, it's crucial to address these concerns. See how new findings align with prior observational studies, and where rivaroxaban fits into all of this. Wang, TY, Wahed, AS, Morris, A, et al. 2023. Effect of thromboprophylaxis on clinical outcomes after COVID-19 hospitalization. Ann Intern Med. 4: 515–523. (https://doi.org/10.7326/M22-3350) STUDY #4: Cholesterol management remains pivotal in cardiac care. But the question our fourth study poses is this: do age differences impact the effectiveness of statins, particularly in lowering LDL cholesterol? A dive into this study could reshape perceptions on dosage recommendations for certain patient demographics. Corn, G, Melbye, M, Hlatky, MA, et al. 2023. Association between age and low-density lipoprotein cholesterol response to statins: A Danish nationwide cohort study. Ann Intern Med. 8: 1017–1026. (https://doi.org/10.7326/M22-2643) So, arm yourself with your favorite beverage and comfy earphones, and join us in uncovering the gems these studies hold. The revelations might just change the way you see these medications and treatments! 🎧🔍📚 For show notes, visit us at https://www.medmastery.com/podcasts/cardiology-podcast.