Episode 376: 387. Methods Monday and an Example of Subgroup Analysis

Episode 376: 387. Methods Monday and an Example of Subgroup Analysis

https://www.nejm.org/doi/full/10.1056/NEJMoa2405923?query=clinical-medicine

Mineralocorticoid receptor antagonists have been shown to reduce mortality in patients after myocardial infarction with congestive heart failure. Whether routine use of spironolactone is beneficial after myocardial infarction is uncertain.

Recent attempts to improve outcomes with intensified renin–angiotensin–aldosterone inhibition have not shown improvements in outcomes.7,8 A trial of routine aldosterone antagonism with spironolactone in addition to standard therapy among 1603 patients after myocardial infarction without heart failure showed no improvement in outcomes.9

https://pubmed.ncbi.nlm.nih.gov/27102506/ “ In a non-pre-specified exploratory analysis, the odds of death were reduced in the treatment group (3 [0.5%] vs. 15 [2.4%]; HR: 0.20; 95% CI: 0.06 to 0.70) in the subgroup of ST-segment elevation MI (n = 1,229), but not in non-ST-segment elevation MI (p for interaction = 0.01).”’

However, there was a significant reduction in mortality in the subgroup of 1229 patients with ST-segment elevation myocardial infarction (STEMI), a finding that highlights the need for a large trial.

We conducted the CLEAR trial to evaluate whether routine use of spironolactone is beneficial in patients after myocardial infarction.

Episoder(386)

Episode 400: 408. CME Obesity and MASH

Episode 400: 408. CME Obesity and MASH

GLP1 drugs work but they likely need lifestyle modificationsNo convincing evidence GLP1 cause thyroid cancer in humans BUT contraindication if family history existStopping therapy usually results in w...

27 Sep 20251h 2min

Episode 399: 407. OMED COPD CME

Episode 399: 407. OMED COPD CME

OMED COPD CME

22 Sep 202539min

Episode 398: 406. Update of Medical Articles

Episode 398: 406. Update of Medical Articles

All of these articles have been talked about on questioning medicine social media on tik tok and instagram but here is an update of my recent reading

27 Aug 202529min

Episode 397: 405. 4 New Medical Articles That Are Deceiving

Episode 397: 405. 4 New Medical Articles That Are Deceiving

Buelt, Andrew | 2:13 PM (1 hour ago) |  | to mehttps://jamanetwork.com/journals/jama/fullarticle/2833338 Conclusions and Relevance  These results support use of metformin for treatment of symptomatic ...

1 Aug 202519min

Episode 396: 404. albuterol/budesonide, DOAC in 4 Days, Statins for AAA

Episode 396: 404. albuterol/budesonide, DOAC in 4 Days, Statins for AAA

https://www.nejm.org/doi/10.1056/NEJMoa2504544  During follow-up ranging from 12 to 52 weeks, fewer patients had severe exacerbations in the albuterol/budesonide group than in the albuterol group (5% ...

24 Jul 202512min

Episode 395: 403. COVID Maternal Booster And Cervical Self Swabs

Episode 395: 403. COVID Maternal Booster And Cervical Self Swabs

https://publications.aap.org/pediatrics/article/156/1/e2024070175/202234/Infant-Antibodies-After-Maternal-COVID-19?autologincheck=redirected  Objective:The study aimed to evaluate the kinetics and du...

22 Jul 202510min

Episode 394: 402. Cardiovascular Risk Factors, Zilebesiran, Shared Decision Making

Episode 394: 402. Cardiovascular Risk Factors, Zilebesiran, Shared Decision Making

https://www.nejm.org/doi/10.1056/NEJMoa2415879?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Key Findings: Classic Risk Factors: The five risk factors examined were hype...

18 Jul 202515min

Episode 393: 404. 3 quick articles you might want to know about (oral semaglutide, tiktok, and GLP1 thyroid cancer)

Episode 393: 404. 3 quick articles you might want to know about (oral semaglutide, tiktok, and GLP1 thyroid cancer)

GLP1 might cause thyroid cancer in mice but the evidence is drastically lacking in humansOral semaglutide is expensive for an NNT of 50 at 4 yrsTiktok videos of skin care are a scam

25 Jun 202512min

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