Internal Medicine Alert – April 15, 2016

April 15, 2016

• Is Anticoagulant Bridging Needed in Patients with Atrial Fibrillation Going to Surgery?

  In patients with atrial fibrillation who had warfarin treatment interrupted for an elective operation or other elective invasive procedure, forgoing bridging anticoagulation was not inferior to perioperative bridging with low molecular weight heparin for the prevention of arterial thromboembolism and decreased the risk of major bleeding.

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• Selecting Patients for Statin Primary Prevention

  The new vascular disease risk calculator discriminates who will experience a vascular event in the near future better than using a trial entry criteria approach or a hybrid approach.

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• ICH May Clinically Mimic TIA

  In a large retrospective review of 2137 patients with intracerebral hemorrhage, 34 presented with transient symptoms that could have been misclassified as “transient ischemic attack” if brain imaging had not been performed.

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• Tenofovir Alafenamide vs Tenofovir Disoproxil Fumarate

  Tenofovir alafenamide has replaced the tenofovir disoproxil fumarate component of two commonly used drug combinations for HIV-1 infection.

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• Clinical Briefs

  In this section: the insulin misadministration problem; comparing smoking cessation pharmacotherapies; more support for ambulatory BP monitoring.

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• Chest Pain and Giant T Wave Inversion

  Chest pain (rather than shortness of breath) and ST elevation (rather than T wave inversion) in leads V1 and V2 make massive pulmonary embolism unlikely.

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