Aspirin vs. Plavix after upper GI bleeding

What a frustrating paper. In last week’s NEJM is a study from the Prince of Wales Hospital in Hong Kong looking at clopidogrel versus aspirin and esomeprazole to prevent recurrent ulcer bleeding. More precisely, the authors studied patients who had been on 325 mg aspirin or less, who presented with upper GI bleeding and who […]

More on CRP

The two NEJM articles on C-Reactive Protein which I commented on yesterday have raised quite a stir. Gina Kolata’s headline in the NY Times that I saw in my print paper yesterday blared: “Two Studies Suggest a Protein Has a Big Role in Heart Disease“. Today, I went to the Times website to find the […]

CRP and statins

Today’s NEJM has two articles on statin therapy and achieved LDL and CRP levels in relation to coronary disease. The first article, from Harvard, is a substudy of the Pravastatin or Atorvastatin Evaluation and Infection Therapy – Thrombolysis in Myocardial Infarction 22 study (I challenge you to reread the name of this study once and […]

Coronary revascularization before vascular surgery

Patients undergoing vascular surgery are at higher risk for cardiovascular events. Despite published guidelines, the exact approach to pre-operative cardiac evaluation for these patients varies significantly. The report of a VA cooperative study in last week’s NEJM looked at the value of prophylactic coronary-artery revascularization before elective major vascular surgery. Patients undergoing elective AAA repair […]