Questioning Medicine12 Joulu 2024

Episode 352: 251. Safety of Triptans in Patients Who Have or Are at High Risk for Cardiovascular Disease

Wang Z et al. Safety of triptans in patients who have or are at high risk for cardiovascular disease: A target trial emulation. Mayo Clin Proc 2024 Nov; 99:1722. (https://doi.org/10.1016/j.mayocp.2024.03.023)

How unsafe are triptans

triptans — the mainstays of migraine therapy — are vasoactive, the U.S. FDA considers them to be contraindicated in patients with cardiovascular (CV) disease or elevated CV risk.

many patients with migraine (including those with CV disease) request triptans because they work

how bad are they??

Within 60 days of starting treatment, 52 patients who received triptans and 13 who received nontriptans experienced major adverse CV events — a significant difference (1.5% vs. 0.4%; relative risk, 4.0).

Compared with nontriptans, triptans are associated with elevated risk for major adverse CV events in patients with migraine and established CV disease or elevated CV risk; however, the absolute risk difference in this study was small (1.1%).

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Episode 432: 439. 6 articles in 2026

CME

24 Heinä 0s

Episode 431: 438. CME- What To Do AFTER PE Diagnosis

OMED lecture

21 Heinä 0s

Episode 430: edit fix 437. A Brief Review of the Medical Literature!

Xin X, et al. Optimal exercise modalities and dosages for blood pressure reduction in adults with prehypertension and established hypertension: A network meta-analysis and dose–response relationship s...

8 Heinä 32min

Episode 429: 436. postpartum burnout., asundexian, semaglutide and ETOH, neck infection, varenicline

Jafari K, et al. Risk factors for pediatric deep neck infection revisit after emergency department discharge for pharyngitis or localized neck symptoms. Ann Emerg Med 2026 May; 87:605. DOI: 10.1016/j....

15 Kesä 31min

Episode 428: 435. Evolocumab, Statin and CKD, PCN allergy, MRI vs Rotator Cuff

https://pubmed.ncbi.nlm.nih.gov/41903215/ Evolocumab to Reduce First Major Cardiovascular Events in Patients Without Known Significant Atherosclerosis and With Diabetes: Results From the VESALIUS-CV ...

8 Touko 17min

Episode 427: 434. 6 Articles From Arb to Patient Perspective to Cervical Cancer Screening

https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.70463 Angiotensin Receptor Blockers Versus Calcium Channel Blockers for First-Line Antihypertensive Therapy and Survival in Adults Aged 75Y...

4 Touko 25min

Episode 426: 433. Salt, Statins, and Stents

Donato J, et al. Things We Do For No Reason™: Low salt diets for patients with acute heart failure. J Hosp Med 2026 Feb 4; [e-pub]. DOI: 10.1002/jhm.70278.Some guidelines now recommend "normal sodium ...

21 Huhti 16min