Clinical Conversations

August 2nd, 2019

Podcast 227: Chronic kidney disease and anticoagulants

Chronic kidney disease, being a “prothrombic state,” would seem to warrant use of anticoagulants, yet they aren’t often used — why? The problem seems to be a lack of data with which to evaluate their effectiveness and possible harms. Big drug trials seem to avoid recruiting these patients, especially those in the later stages of […]

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July 11th, 2015

Podcast 179: Pradaxa (dabigatran) reversal near?

Running time: 20 minutes The anticoagulant dabigatran, marketed in the U.S. as Pradaxa, has always had the problem that, although it’s more convenient to use, there’s no sure way to stop its effect if the patient has a major bleed. Now, a monoclonal antibody fragment called idarucizumab (pronounced i-DARE-you-scis-ooh-mab) shows promise as a reversal agent. In an […]

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May 2nd, 2012

Podcast 154: Treating heart failure’s hypercoagulable state — warfarin or aspirin?

Heart failure brings problems associated with hypercoagulation, such as stroke and sudden death. An international study followed some 2300 patients with heart failure (ejection fractions of 35% or less) and in stable sinus rhythm for a mean of 3.5 years, randomizing them to treatment with either warfarin or aspirin. The two treatment groups showed about the same […]

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March 10th, 2011

Podcast 115: Talking about the real-world use of dabigatran with Drs. Elaine Hylek and Samuel Goldhaber

Clinical Conversations, in a collaboration with CardioExchange, has interviewed two expert working clinicians on how best to use dabigatran — a drug poised to supplant warfarin in the prevention of stroke and systemic embolism in patients with atrial fibrillation. The wide ranging discussion with Drs. Elaine Hylek and Samuel Goldhaber  includes sections on who should be […]

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February 20th, 2009

Podcast 31: Making your clinical life easier — with genetics. Dr. Julie Johnson talks about using a patient’s genetic profile to help set their initial warfarin dose more accurately. You got a problem with that?

Starting a patient on warfarin is nobody’s idea of a good time, but pharmacogenetic research can help. A study in this week’s NEJM shows the advantage of using genetic information (plus some clinical data) over the old “start at 5 mg a day and pray for success” approach. We talk with Julie Johnson of the […]

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