Cardiovascular Rapid Fire: MRI-Guided Thrombolysis, Recurrent Stroke Prevention, and E-Cigs & Smoking Cessation


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This week on The Rounds Table Kieran Quinn and Mike Fralick are back with another rapid fire episode: just the salient points from four articles instead of two, this time examining important cardiovascular studies.

The risk of subsequent stroke after minor stroke or TIA is as high as 15% within 90 days. Mike covers the POINT trial which examined whether the combination of clopidogrel and aspirin reduces the rate of recurrent stroke.

Next, Mike shares the results of the WAKE-UP trial. This RCT examined whether patients with an unknown time of onset of stroke and features suggestive of recent infarct on MRI benefitted from thrombolysis with tPA.

Kieran then takes the lead and covers an RCT which investigated the efficacy and safety of empirically giving rivaroxaban compared to aspirin for the prevention of recurrent stroke in patients with embolic strokes of unknown source (ESUS).

Kieran then takes listeners through a study which examined whether e-cigarette use after hospital discharge was associated with subsequent tobacco abstinence among smokers who planned to quit and were advised to use evidence-based treatment.

Finally, the Good Stuff segment. Kieran covers insurance companies and their contribution to rising healthcare costs. Mike covers a massive fentanyl bust in Nebraska.

If you like what you hear, rate us on iTunes! Chat with us on Twitter @roundstable and tweet at Kieran @kieranlquinn, and Mike @FralickMike. Let us know how we’re doing here:

The Papers

1. POINT: https://www.nejm.org/doi/full/10.1056/NEJMoa1800410

2. WAKE-UP: https://www.nejm.org/doi/full/10.1056/NEJMoa1804355

3. Rivaroxaban for Stroke Prevention: https://www.nejm.org/doi/full/10.1056/NEJMoa1802686

4. E-Cigs & Smoking Cessation: http://annals.org/aim/article-abstract/2676738/association-e-cigarette-use-smoking-cessation-among-smokers-who-plan

Good Stuff

1. Insurance & Costs: https://www.npr.org/sections/health-shots/2018/05/25/613685732/why-your-health-insurer-doesnt-care-about-your-big-bills

2. Fentanyl Bust: http://www.techtimes.com/articles/228700/20180527/fentanyl-bust-in-nebraska-seizes-118-pounds-of-opioids-enough-to-kill-26-million-people.htm

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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