CRP as Risk Factor for CHD

C-Reactive Protein as a Risk Factor for Coronary Heart Disease: A Systematic Review and Meta-analyses for the U.S. Preventive Services Task Force — Ann Intern Med

Conclusion: Strong evidence indicates that CRP is associated with CHD events. Moderate, consistent evidence suggests that adding CRP to risk prediction models among initially intermediate-risk persons improves risk stratification. However, sufficient evidence that reducing CRP levels prevents CHD events is lacking.

 

J-point Elevation

Medical News: AHA: EKG Pattern Linked to Cardiac Death in General Population – in Meeting Coverage, AHA from MedPage Today

During a mean follow-up of 30 years, 56.5% of the participants died. About a third of the deaths (32.1%) were attributed to cardiac causes. Of those, 40.4% were from sudden arrhythmia.

 

As in individuals with a J-point elevation of at least 0.1 mV, those with an elevation of greater than 0.2 mV in the inferior leads had an increased risk of death from cardiac causes (RR 2.98, 95% CI 1.85 to 4.92) and from sudden arrhythmia (RR 2.92, 95% CI 1.45 to 5.89).

Nearly half of those with an elevation of more than 0.2 mV (47.2%) died from cardiac causes, compared with 17.2% among those who did not have the early repolarization pattern (P<0.001).

Ziprasidone (Geodon) – Think Bipolar

Medical News: Ziprasidone Okayed for Bipolar Disorder – in Psychiatry, Bipolar Disorder from MedPage Today

Ziprasidone comes with a long list of precautions and contraindications:

 

* It should not be used in patients with a known history of QT prolongation, recent acute myocardial infarction, or uncompensated heart failure, and should not be used with other QT-prolonging drugs.
* It should also be avoided in elderly patients with dementia-related psychosis, as studies have shown that ziprasidone increases the risk of death in such patients.
* Discontinuation should be considered in patients showing signs of tardive dyskinesia.
* Treatment should be stopped immediately in patients with symptoms of neuroleptic malignant syndrome, which include hyperpyrexia, muscle rigidity, diaphoresis, tachycardia, irregular pulse or blood pressure, cardiac dysrhythmia, and altered mental status.
* Patients and clinicians should be alert for hyperglycemia, rash, seizures, and orthostatic hypotension with ziprasidone.