In this retrospective cohort of over 8000 patients with ACS in over 120 VA hospitals, researchers examined the rate of death or ACS re-hospitalization in clopidogrel patients, comparing those with or without PPI therapy. Over 28 months, patients on PPI’s met the primary outcome 30% of the time, compared to 21% in those not on PPI’s. Given that almost 2/3 of these patients were discharged on clopidogrel, this is a substantial number of patients potentially affected. We should closely examine the risks and benefits of PPI’s at the time of discharge in post-ACS patients on clopidogrel (abstract), bearing in mind the recent guidelines endorsing PPI’s for patients with dual anti-platelet therapy (guideline summary).
Fill in the Blanks: Q: “The diagnosis of type 2 MI is associated with a _____ prognosis. ___% of patients will live five years after their diagnosis.” The answer is a) POOR and b) a staggering 40%. I did not know that. However, what I am aware of is the ambiguity around Type 2 MIs and […]
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]