Episode 312: 311. Risk of Stroke in Women Using Levonorgestrel-Releasing Intrauterine Device for Contraception

Episode 312: 311. Risk of Stroke in Women Using Levonorgestrel-Releasing Intrauterine Device for Contraception

https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.124.047438



We studied the risk of IS and ICH in women using LG-IUDs—aka mirana-- compared to women not using hormonal contraceptives.

The commonly used combined hormonal contraceptives with progestins and ethinylestradiol are associated with an increased risk of ischemic stroke (IS).

In this Danish historical cohort study (2004-2021) we followed non-pregnant women (18-49 years) registering incident IS and ICH in relation to use of LG-IUD/non-use of hormonal contraceptives utilizing Danish high-quality registries with nation-wide coverage.

A total of 1,681,611 non-pregnant women A total of 1,681,611 non-pregnant women

The numbers get huge here however--

After adjustment incidence rate ratio for IS was 0.78 (CI: 0.70; 0.88), and for ICH it was 0.94 (CI: 0.69; 1.28)

Use of LG-IUD was associated with a 22% lower incidence rate of IS without raising incidence rate of ICH. I think IUD are unutilized and now we have data that says they have lowers rates of stroke.

Jaksot(385)

Episode 375: 386. Could half dose anticoagulation be the answer?

Episode 375: 386. Could half dose anticoagulation be the answer?

Estimated 5-year incidence of recurrent VTE was similar in the reduced-dose and full-dose groups (2.2% and 1.8%). Estimated 5-year bleeding incidence was significantly lower with reduced-dose than wi...

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Episode 374: 385. PRACTICE CHANGER! Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis

Episode 374: 385. PRACTICE CHANGER! Male-Partner Treatment to Prevent Recurrence of Bacterial Vaginosis

https://www.nejm.org/doi/full/10.1056/NEJMoa2405404NNT of 4! systemic metronid and topical clinda bid for one week

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Episode 373: 384. Chronic Kidney Disease and Empagliflozin Legacy Effect

Episode 373: 384. Chronic Kidney Disease and Empagliflozin Legacy Effect

What Was Studied?The EMPA-KIDNEY trial followed 6,609 CKD patients at risk of disease progression. Participants were randomly assigned to receive empagliflozin (10 mg daily) or a placebo for a median ...

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Episode 372: 383. What is the GFR at which we stop metforin?

Episode 372: 383. What is the GFR at which we stop metforin?

Metformin while not necessarily first line therapy for diabetes depending on the patients co-morbid conditions it is certainly highly ranked on the list of medications! I know often metformin is stopp...

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Episode 371: 382. Is it safe to give the flu and covid vaccine at the same time?

Episode 371: 382. Is it safe to give the flu and covid vaccine at the same time?

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2825813Conclusions and Relevance  In this randomized clinical trial assessing simultaneous vs sequential administration of mRNA COVID-19 an...

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Episode 370: 381. Relative efficacy of prehabilitation interventions and their components

Episode 370: 381. Relative efficacy of prehabilitation interventions and their components

https://www.bmj.com/content/388/bmj-2024-081164systematic review and meta-analysis on prehabilitation before surgery, published in the BMJ in February 2025.Prehabilitation aims to prepare patients for...

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Episode 369: 380. REPOST mammo part 2

Episode 369: 380. REPOST mammo part 2

Mammograms

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Episode 368: 379. REPOST mammogram part 1

Episode 368: 379. REPOST mammogram part 1

379. REPORT mammogram part 1

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