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Paper Chase #4 | CV Disease Risk Management

Andrew Buelt, DO and Joe Weatherly, DO
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06:01
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No me gusta!

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ADA guidelines for management of cardiovascular disease in diabetics have several grade A recommendations that we will cover in this paperchase.

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Chris -

Andrew or Joe made a brief reference to this near the end, but I think the question of how a PCSK9 inhibitor got mentioned in a Grade A recommendation is significant and shouldn't be glossed over. Is there actually evidence for their use in this context that would make it reasonable for it to be included in a Grade A recommendation? Were there any relevant conflicts of interest from the group making these recommendations?

Neda F., MD -

Thanks, Chris. We're waiting to hear back from Andrew and Joe and will keep you posted when we do!

Neda F., MD -

Here's Andrew's response: "Yes, there is some evidence that it improves cardiovascular outcomes and all cause mortality in patients with acute coronary syndrome... As far as conflicts of interest, no memory of them declaring anything but usually in looking for conflicts of interest I do google searches [and] CMS open payment searches."

Chris -

Thanks for following up! I've done a bit more reading and apparently I needed to remind myself of the FOURIER trial.

Dr. Brett -

I have returned to this episode after listening to some of the more recent podcasts, and I'm curious if the weight-based dosing of aspirin (Paper Chase #2 from November) would change these recommendations? I assume more information and studies are needed.

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Retrieve Those Filters Full episode audio for MD edition 170:36 min - 80 MB - M4APrimary Care RAP September 2018 Written Summary-V2 590 KB - PDF

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