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14 Cards in this Set
- Front
- Back
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what is the leading killer of Americans:
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cardiovascular disease
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what is the number 1 cause of cardiovascular death:
what is the number 2 cause of cardiovascular death: |
coronary heart disease
stroke |
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what accounts for the decline in cardiovascular death in 2004:
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advances in cardiovascular medicine
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what are the types of cardiovascular disease that we treat with drug therapy: (x6)
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dyslipidemia
ischemic heart disease acute coronary syndromes aearrrhythmias heart failure hypertension |
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what professional societies are involved in the development of guidelines for drug therapies of cardiovascular disease:
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American Heart Association
American College of Cardiology |
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in the CAST trial, what was the assumption of PVCs:
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they are mostly asymptomatic
they are triggers for sustain ventricular fibrillation |
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what was the hypothesis of the CAST study:
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suppression of PVCs post MI would reduce risk of sudden death and total mortality
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what were the drugs used in the CAST trial:
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encainide
flecainide moricizine |
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what happened in the trial:
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mortality rate higher than placebo was associated with enc/flec → trial stopped early
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what were the broad implications of the CAST trial: (x4)
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1. development of new class 1 drugs stopped
2. spurred interest in class 3 drugs 3. device therapy 4. cardiology trials (evidence required for drug approval, use of surrogate markers) |
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what are surrogate markers:
(in general) |
lab measurement or physical sign is used to substitute for a clinical endpoint.
the effect on the marker predicts outcome |
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what are examples of surrogate markers in cardiology clinical trials: (x3)
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blood pressure
cholesterol blood sugar |
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what are the major advances in treatment of cardiovascular disease that arose from evidence-based medicine: (x7)
(drugs and devices) |
1. thrombolytic drugs and PCI (percutaneous coronary intervention - angioplasty) for ST-elevation MI
2. aspirin for primary and secondary prevention 3. beta-blockers post MI 4. ACE inhibitors 5. statins 6. warfarin in atrial fibrillation 7. ICD (implantable cardioverter defibrillators) |
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what are the limitations to evidence based medicine and guideline focused approach to treating cardiovascular disease: (x5)
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1. rigidly defined patient populations
2. close follow-up and monitoring 3. predicts how population will respond to treatment but not an individual patient 4. new drugs/devices developed more rapidly than can be evaluated 5. only 25-50% of patients are treated with c/w guidelines |
