Does the controversy over statin drugs herald a new era of doctoring?

In July, I wrote a short blog post expressing doubt about the value of statin drugs. Medscape republished it on their website and it went viral–in a medical sort of way. The post has 631 comments. It was Tweeted extensively, page views have been off the charts (for me), and I even received an invitation […]

To deprescribe…Adding a new verb to the language of doctoring

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What follows is my most recent editorial in the Journal of the Kentucky Medical Association. It is reposted with permission. **** One day every month, my wife Staci, a hospice and palliative care physician, goes to see an elderly woman in the nursing home. The routine has gone on for years, which is surprising because […]

Review of the 2014 ESC Sessions in Barcelona

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Hey Everyone, It’s been a few days since I returned home from Spain. The jet leg has resolved and normal sleep patterns have returned. I’ve had time to review the entire ESC program book. What follows is a review of my work and some notes on the past week in Barcelona. The first thing to […]

On the eve of ESC 2014 — Barcelona Spain

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The 2014 European Society of Cardiology Congress begins tomorrow in Barcelona, Spain. I’m here with my colleagues from the theheart.org Medscape | Cardiology to cover the action. ESC is special because it is such a large meeting, with over 30,000 registered attendees and more than 500 journalists. This year’s addition has an added flair–as the […]

Is this the most important cardiology study of the last decade?

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In recent years, progress in the field of cardiology has been painfully incremental. We have enjoyed small gains–a better ablation catheter and mapping system, a couple of new anti-platelet drugs, maybe better stents, and even the highly touted anticoagulant drugs are within 99% in efficacy and safety of warfarin. Major breakthroughs, though, are non-existent. (And […]

Five lessons from the Niacin failure

This week the New England Journal of Medicine published two studies on the role of niacin in preventing future cardiac events. The short story is that niacin was ineffective and associated with significant harm. A number of excellent summary pieces have been written, and I will reference them at the end. The purpose of writing […]

Growing doubt on statin drugs — the problem of drug-lifestyle interaction

My mind is changing about statins. I’m growing increasingly worried about the irrational exuberance over these drugs, especially when used for prevention of heart disease that is yet to happen. An elderly patient called my office last week to tell me thank you…not for a successful procedure or surgery, but rather, for helping with a […]

New post on Medscape/Cardiology: My take of the 2014 Atrial Fibrillation treatment guidelines

Atrial fibrillation affects millions of patients, and its incidence and prevalence are on the rise. It’s a peculiar disease in that it affects people so differently. When populations are studied, AF associates with higher rates of stroke, heart failure and death. But patients aren’t populations. In recent years, the treatment options for this pesky disease […]

A follow-up on the LifeVest…and decision quality

One of the most controversial posts I have ever written concerned Zoll corporation’s wearable cardiac defibrillator, which they have smartly branded the LifeVest. Here is the link to the 2013 post: LifeVest: A Precarious and Unproven Bridge . . . to Somewhere The less-than-glowing assessment brought me a great deal of criticism, both publicly and […]

Dronedarone (Multaq), clinical guidelines and patient safety

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(What follows is a brief introduction for a post I wrote over at Medscape/Cardiology. The link is at the bottom of the page.)  It is appropriate to worry about medical errors and patient safety. Here the low-hanging fruit is plentiful: antibiotic stewardship, automated notification of drug interactions and attention to hand washing all join a […]

NSAIDs — Yet another dubious “health” product at CVS

Now that the ‘healthiness’ of products sold at CVS stores is a matter of public discourse, it seems a perfect time to mention the common pain relievers known as Non-Steroidal Anti-inflammatory Drugs (NSAIDs). It just so happens that two FDA advisory committees are meeting today and tomorrow to discuss the cardiovascular risks of NSAIDs. The […]