In episode 585, Mike and James finally get back to being PREMIUM. We review the REDUCE-AMI trial which tried to answer the question – do you need to use a beta-blocker after an MI if there is preserved ejection fraction? We also review a COPD trial that shows integrating respiratory specialists in primary care improves guideline adherence. However, the interesting finding is what happens to the quality-of-life change and hospitalizations. The results of both of these trials may surprise you.

Show notes
1) REDUCE-AMI- Beta-Blockers after Myocardial Infarction and Preserved Ejection Fraction
N Engl J Med 2024;390:1372-1381

2) Cluster randomised controlled trial of specialist-led integrated COPD care (INTEGR COPD)
Thorax 2024;79:209–218

In episode 584, Mike and James invite Tina Korownyk back to the podcast to talk about the evidence for amyloid-targeting monoclonal antibodies in mild cognitive impairment or Alzheimer’s dementia. Unfortunately, the evidence shows these medications don’t seem to have a clinically important effect and do have some harms. Have a listen as we give you all the numbers so you will be able to properly discuss these medications with your patients.

Show notes

Tools for Practice
Remind me, do medications that target brain amyloid improve my dementia?

In episode 583, Mike and James continue to go over the issues associated with using CVD risk calculators. We talk about some of the limitations, how to think about the results and explain the risks and benefits to patients.

Show notes
PEER Simplified Cardiovascular Decision Aid

Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793

Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2

Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956

In episode 582, Mike and James go over the issues associated with using CVD risk calculators. We talk about where the numbers come from, what they mean, what their limitations are, how to think about them and how to use them. So have a listen as it may decrease your risk but it will definitely increase your understanding.

Show notes
1) PEER Simplified Cardiovascular Decision Aid
https://decisionaid.ca/cvd/

2) Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793

3) Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2

4) Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956

In episode 581, Mike and James invite Mike Kolber back to the podcast for the umpteenth time – this time we talk about a topic we haven’t discussed before – acute diverticulitis. Historically, if a person has diverticulitis they were given antibiotics BUT do they really do anything? We look at all the evidence and the results may surprise you.

Show notes
Tools for Practice
Antibiotics or no antibiotics for acute diverticulitis, that is the question!

In episode 580, Mike and James invite Jennifer Young to talk about the treatment of pityriasis rosea. Believe it or not there are 2 simple treatments that seem to work really quite well. Tune in to hear what works and how well they work.

Show notes
Tools for Practice
(A)dressing the Christmas Tree? Therapies for pityriasis rosea

In episode 58, the fourth in our installment of podcasts on diabetes, we briefly talk about the evidence surrounding intensive glucose lowering (ACCORD, ADVANCE, VADT and UKPDS trials) – podcasts #9 and #38 did this in more detail. At the end of the podcast, Mike identifies many of James’ flaws, but does it with compassion and kindness; at least he says he does.

Show Notes

1) Does tight glycemic control burden patients with complex treatment programs, hypoglycemia, weight gain, and costs and offers uncertain benefits in return?

Ann Int Med 2009;150:803-8

2) ACCORD and ADVANCE studies

Click here for a synopsis of the results

N Engl J Med 2008 358:2545-2559

N Engl J Med 2008 358:2560-2572

Also listen to Episode 9: News Flash: Aggressive Blood Sugar Control Not All Sweet

3) VADT trial N Engl J Med 2009;360:129-39

Also listen to Episode 38: New trials you need to know about

4) Glucose lowering meta-analysis – do the results support the conclusions?

Lancet 2009; 373:1765-72

5) UKPDS data

BMJ 2000;320:1720-3

6)UKPDS – 10 year update (recent results)

NEJM 2008;359:1577-89