Old Questions, New Options: Spironolactone for Resistant Hypertension and Polymer-Free Stents
This week, we debut our new “Two Truths, One Lie” segment! Join us and put your knowledge to the test.
As always, Amol, general internal medicine resident at the University of Toronto, and Reena, staff physician at St. Michael’s hospital, discuss 2 recent papers:
A multi-centred cross over trial conducted in the UK tried to answer the question: for patients with resistant hypertension despite being on triple therapy, what should be added as a fourth agent? The study found that spironolactone is superior to bisoprolol, doxazosin, or placebo. Reena and Amol are both believers in this trial and plan to change their practice – will you?
A new stent option for patients with atherosclerotic disease and high bleeding risk? A double blinded randomized control trial found that a new generation of polymer-free, drug-coated coronary stents is superior to bare metal stents in safety and efficacy. Amol asks, how do these new polymer-free stents compare to drug eluting stents that have a polymer coating? Is such a study in the works? If you know the answer, let us know on Twitter @roundstable!
1. Resistant hypertension: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)00257-3/abstract
2. New stent: http://www.nejm.org/doi/full/10.1056/NEJMoa1503943
1. Measuring doctors & teachers: http://www.nytimes.com/2016/01/17/opinion/sunday/how-measurement-fails-doctors-and-teachers.html?_r=0
2. Andexanet as anticoagulant reversal agent: http://www.nejm.org/doi/full/10.1056/NEJMoa1510991
Two Truths, One Lie
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.