Big Data: Dabigatran vs. Rivaroxaban for Atrial Fibrillation and Association of Frailty with Post-Operative Mortality


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It’s big data week on The Rounds Table! When initiating pharmacotherapy for atrial fibrillation, which drug is best? How does frailty influence surgical outcomes? Kieran and Michael Fralick, General Internist at St. Michael’s Hospital, take listeners through two noteworthy studies:

When a new medication is developed it is generally compared against standard of care or placebo in clinical trials. Rarely do drug manufacturers compare their medication to a competitor’s since it is not required from a regulatory standpoint. However, Mike guides listeners through a unique observational study that compared two competitor drugs for treatment of atrial fibrillation. Which is safer and more effective: dabigatran or rivaroxaban? Listen to find out!

Frailty is increasingly recognized as an important clinical phenotype that reflects an accumulation of deficits that impact function, mobility, or cognition. A frail patient is at increased risk of disability and death from even minor external stressors. Kieran takes listeners through a retrospective cohort study examining the effect of frailty on surgical outcomes.

Last, but definitely not least, the Good Stuff segment! Mike brings listeners up to date with the JUNO oncology story. Then, are football-related injuries more common at any particular time of year? Tune in to find out!

Like what you hear? Rate us on iTunes! Follow us on Twitter @roundstable and tweet at this week’s hosts directly @kieranlquinn and @fralickmike

The Papers

1. Dabigatran vs. Rivaroxaban: http://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2560376

2. Frailty & Surgery: http://jamanetwork.com/journals/jamasurgery/article-abstract/2482671

Good Stuff

1. Did JUNO?: https://www.statnews.com/2016/11/24/deaths-juno-trial-transparency-fda/, https://www.bloomberg.com/news/articles/2016-11-23/1juno-s-cancer-trial-on-hold-after-patient-death-brain-swelling

2. Football is Life: http://www.npr.org/2016/11/24/503279166/emergency-rooms-experience-spike-in-football-injuries-on-thanksgiving?utm_medium=RSS&utm_campaign=health  

Music Credits (Creative Commons)

In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart

Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music

Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music

All tracks have been modified for the purposes of this podcast.

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