Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease — NEJM

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Conclusions: Treatment with rosuvastatin at a dose of 10 mg per day resulted in a significantly lower risk of cardiovascular events than placebo in an intermediate-risk, ethnically diverse population without cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; HOPE-3 ClinicalTrials.gov number, NCT00468923.)

Source: Cholesterol Lowering in Intermediate-Risk Persons without Cardiovascular Disease — NEJM

Source: Blood-Pressure Lowering in Intermediate-Risk Persons without Cardiovascular Disease — NEJM

Source: Blood-Pressure and Cholesterol Lowering in Persons without Cardiovascular Disease — NEJM

Failure To Get Into Private College To Be Most Financially Responsible Act Of 17-Year-Old’s Life

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COLORADO SPRINGS, CO—Saying the turn of events will greatly benefit the 17-year-old’s economic security, sources confirmed Friday that local high school senior Emily Harrison’s failure to get into the University of Southern California, a private academic institution, will be the single most financially responsible act of her entire life.  According to reports, Harrison’s rejected application, which she spent weeks preparing in hopes of spending four years at her “dream school,” will save the young student a total of nearly $370,000.

Source: Failure To Get Into Private College To Be Most Financially Responsible Act Of 17-Year-Old’s Life – The Onion – America’s Finest News Source

A system that piles debt on students in exchange for a marginal or even zero-return on their investment is morally and financially bankrupt.

Charles Hugh Smith

 

JAMA Cardiology – Effect of the Presence and Type of Angina on Cardiovascular Events in Patients Without Known Coronary Artery Disease Referred for Elective Coronary Angiography

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This study describes the characteristics of patients referred for typical, atypical, or no angina and examines the associations between angina type, pre–cardiac catheterization stress test results, and burden of coronary atherosclerosis identified on coronary angiography.

Source: JAMA Network | JAMA Cardiology | Effect of the Presence and Type of Angina on Cardiovascular Events in Patients Without Known Coronary Artery Disease Referred for Elective Coronary Angiography

In this short research letter we find further lack of utility for stress tests in the manner for which we are currently using them for risk stratification. The authors categorized patients referred for catheterization without known CAD to groups based on chest pain symptoms of: typical, atypical, or absent. They then looked at their stress test results, categorized as positive or negative, and found that a negative stress test did not help predict those without obstructive CAD on catheterization. Specifically, patients with typical angina symptoms and a negative stress test were the MOST likely to have obstructive CAD (74%). Clearly limited by the nature of the data presented, and the limited information given regarding the methodology in this research letter, it does further raise doubts regarding the utility of stress testing to risk stratify patients for CAD.

HT to Jeremy Fried for the observation quoted above. Source: Research and Reviews R&R in the FastLane | LITFL: Life in the Fast Lane Medical Blog