Questioning Medicine Questioning Medicine
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- Health & Fitness
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Join Andrew on a medical rollercoaster as we ask a medical question and answer it based on recent published papers.
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QM on Spring Break
QM on Spring Break-- but do you like the new format? Andrewbuelt@gmail.com
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260. SGLT2 Summary Recap
Diabetic patient- Empagliflozin prevents death from cardiovascular causes: NNT 46 per 3.1 yrs ($600 a month, 1 million dollars per life saved)-HFpEF- SGLT2 inhibitors do not prevent death and cost roughly $364,000 to prevent one hospitalization-HFrEF -Using Cox models, only Dapagliflozin has mortality benefit (NNT 53) and comes at a cost of $229,914 prevent one cardiovascular death. (117,126$$$ dap for hospitalization)
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259. EMPULSE Trial- Empagliflozin and Win Ratios
These findings indicate that initiation of empagliflozin in patients hospitalized for acute heart failure is well tolerated and results in significant clinical benefit in the 90 days after starting treatment.They combined HFpEF and HFrEFThey used win ratiosIndividual trials didn’t show mortality benefit but now there is?https://pubmed.ncbi.nlm.nih.gov/35228754/
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258. SOLOIST-WHF -- Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure
Primary Outcome: Composite of deaths from cardiovascular causes or hospitalizations and urgent visits for heart failureDeath was not improved!NNT of 5 for hospitalizations and urgent visits -- However, results are not reported separately for hospitalizations and urgent visits, which are not equal events https://www.nejm.org/doi/full/10.1056/NEJMoa2030183
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256. EMPEROR-Reduced- Cardiovascular Outcomes with Empagliflozin in Heart Failure
NNT of 20 to prevent 1 hospitalization at 16 months of follow upThey composite outcome was driven by decrease hospitalizations NOT deathhttps://www.nejm.org/doi/full/10.1056/NEJMoa2022190
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256. DAPA-HF- Dapagliflozin and Heart Failure with Reduced Ejection Fraction - DAPA-HF
NNT of 21 over 18 months to prevent a composite of worsening heart failure or cardiovascular deathNNT for hospitalization = 27NNT for Cardiovascular Death = 53N Engl J Med 2019; 381:1995-2008
Customer Reviews
Really good and concise
Relevant too. Recovering long time Pharma rep I still love to hear latest and greatest. Don’t agree w everything as that is the nature of opinions
Always relevant material for primary care!
Excellent resource for relevant information.
Very helpful
This podcast is extremely palatable, always covers relevant material ( typically new guidelines / recommendations ), and engaging. He breaks down peer reviewed literature to the “meat and potatoes” and also identifies any potential issues with the case studies and the significance of the results. Very useful tool for providers to stay up to date with guidelines as he consistently references reputable sources.