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

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%).


Jaksot(388)

Episode 426: 433. Salt, Statins, and Stents

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

Episode 425: 432.  CME LECTURE-  Under Pressure, Blood Pressure

Episode 425: 432. CME LECTURE- Under Pressure, Blood Pressure

432.  CME LECTURE-  Under Pressure, Blood Pressure

18 Huhti 34min

Episode 424: 431. Gout should we treat to a number? Is Co-testing needed?

Episode 424: 431. Gout should we treat to a number? Is Co-testing needed?

https://www.sciencedirect.com/science/article/abs/pii/S2665991326000342?via%3Dihublancet rheumatology A treat-to-target strategy versus symptom-driven management of gout in the Netherlands (GO TEST Ov...

14 Huhti 18min

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Episode 423: 430. Hormone Replacement Therapy and the Black Box Warning

Let’s rewind to the early 2000s. Flip phones were cool, low-rise jeans were a crime, and the Women’s Health Initiative—WHI—dropped what became the medical equivalent of a headline: “Hormone Therapy In...

24 Maalis 12min

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

Episode 422: 429. Rivaroxaban vs Apixaban = The Battle of the Blood Thinners!

— rivaroxaban versus apixaban.Yes, folks, this is The Battle of the Blood Thinners!And spoiler alert — one of them came out looking like the overachiever in a safety class... while the other probably ...

20 Maalis 9min

Episode 421: 428. Asthma and Stroke --- A breathless combination

Episode 421: 428. Asthma and Stroke --- A breathless combination

Minocycline in Acute Ischemic Stroke (EMPHASIS trial)A multicenter, double-blind RCT in China studied 1,724 patients with acute ischemic stroke treated within 72 hours of onset. Patients received eith...

13 Maalis 16min

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Episode 420: 427. Kawasaki disease-no, not the motorcycle company

Today, we're talking about Kawasaki disease-no, not the motorcycle company, though sometimes treating it does feel like trying to ride one at full speed through uncertainty.For decades, high-dose aspi...

11 Maalis 7min

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Episode 419: 426. Go Big or Go Partial? The Knee Replacement Showdown

Setting the stagePicture this: your knee is like a three-room apartment. You've got a medial room, a lateral room, and a patellofemoral room. In isolated anteromedial osteoarthritis, just one room is ...

10 Maalis 11min

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