Patient Care Endocrinology & Cardiology - December 2007 - (Page 28)

ClinicalClips JOHN J. RUSSELL, MD, Contributing Editor Associate Director, Family Medicine Residency, Abington Memorial Hospital, Abington, Pa. Dr Russell and colleagues abstract current reports and studies from evidence-based medical literature and provide commentary relevant to primary care. I Benefit of sleep apnea treatment on serum cardiovascular markers Steiropoulos P, Tsara V, Nena E, et al. Effect of continuous positive airway pressure treatment on serum cardiovascular risk factors in patients with obstructive sleep apneahypopnea syndrome. Chest. 2007;132(3):843-851. connection between elevated markers and OSAHS remains unclear, because patients with OSAHS are at greater risk for cardiovascular disease and CPAP decreases surrogate markers, compliance should be aggressively stressed in the primary care setting. Matthew Mintz, MD George Washington University Medical Center Washington, DC To examine the effect of continuous positive airway pressure (CPAP) therapy on serum markers associated with cardiovascular morbidity in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS), the investigators performed a prospective observational study in 53 patients with OSAHS. Patients were newly diagnosed, nonsmokers, without comorbidities or medication use. At baseline and 6 months after CPAP was started, serum markers were measured. Patients were classified into 3 groups according to CPAP use: Group 1, good compliance; group 2, poor compliance; and group 3, refused CPAP treatment. Impact for clinicians The researchers observed significant decreases in the levels of hs-CRP homo, cysteine, total cholesterol, and total cholesterol/ HDL cholesterol and ApoB/ApoA-I ratios in group 1. The patients in group 2 showed a decrease in homocysteine levels only, while no significant changes were observed in the patients in group 3. They concluded that good compliance with CPAP treatment lowers the serum levels of markers for cardiovascular morbidity, indicating a beneficial effect on the overall cardiovascular risk. Although the Clinical Clips is adapted from Clinical Update, which is formatted for Palm OS devices and delivered electronically. Contact the publisher at http://www.redi-reference.com/ beweek.htm for information on how to subscribe. I Does aspirin help prevent embolism? Glynn RJ, Ridker PM, Goldhaber SZ, et al. Effect of low-dose aspirin on the occurrence of venous thromboembolism: a randomized trial. Ann Intern Med. 2007;147(8):525-533. A secondary analysis of the Women’s Health Study, this study evaluated whether long-term use of lowdose aspirin helps prevent venous thromboembolism (VTE) in healthy women. In the trial, 39,876 women were randomly assigned to aspirin, 100 mg, or placebo, taken every other day for 10 years. Documented VTE—deep venous thrombosis or pulmonary embolism—and unprovoked VTE—no recent surgery, trauma, or malignancy—were prospectively evaluated as secondary end points. Impact for clinicians VTE occurred in 482 participants, with incidences of 1.18 and 1.25 per 1000 person-years in the aspirin and placebo groups, respectively. For unprovoked VTE, the relative hazard was 0.90—not statistically significant. Women in the aspirin group were more likely to experience bleeding complications. The findings indicate that long-term, low-dose aspirin does not reduce the risk of VTE in healthy women. Jonathan D. Beck, MD New Milford Hospital, New Milford, Conn. Clinical Clips Panel Jonathan D. Beck, MD Christopher V. Chambers, MD Jeff Kirchner, DO Matthew Mintz, MD David Nicklin, MD S. Scott Paist, MD Charles A. Pohl, MD 28 PATIENT CARE ENDOCRINOLOGY & CARDIOLOGY www.patientcareonline.com http://www.redi-reference.com/beweek.htm http://www.redi-reference.com/beweek.htm http://www.patientcareonline.com

Table of Contents Feed for the Digital Edition of Patient Care Endocrinology & Cardiology - December 2007

Patient Care Endocrinology & Cardiology - December 2007 Research Digest Contents Medicine in the News Options for Managing Diabetes: Three Types of Basal Insulin Therapy Using the New AHA Guidelines for Preventing Coronary Heart Disease in Women Cardiovascular and Metabolic Implications of Polycystic Ovary Syndrome Case & Comment Classified Advertising Clinical Clips

Patient Care Endocrinology & Cardiology - December 2007

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.