geoffrey modest medical blogs

  A very recent study, the VESALIUS-CV (Effect of Evolocumab in Patients at High Cardiovascular Risk without Prior Myocardial Infarction or Stroke) trial found that adding the PCSK9 inhibitor evolocumab to patients with diabetes with no prior history of ASCVD (atherosclerotic cardiovascular disease) prevented the first major cardiovascular event (see   diabetes primary ASCVD prevention with PCSK9 JAMA2026  in dropbox, or doi:10.1001/jama.2026.3277)   Details : -- VESALIUS-CV was a randomized, double-blind, placebo-controlled trial of evolocumab conducted across 774 sites in 33 countries, enrolling 12,257 patients with diabetes but no prior myocardial infarction or stroke, LDL-C level 90mg/dL or greater, and qualifying atherosclerosis or high-risk diabetes. This current study was a prespecified subgroup analysis to examine outcomes in patients without known significant atherosclerosis     --none of the patients had prior arterial revascularization, arte...

  another study highlighting benefit of caffeinated coffee, this time finding a decrease in recurrent atrial fibrillation after ablation (see   afib caffeine dec afib recurrence JAMA2026  in dropbox, or doi:10.1001/jama.2025.21056), in the DECAF study (Does Eliminating Coffee Avoid Fibrillation) Details : --  200 current or previous (within past 5 years) coffee-drinking adults with persistent atrial fibrillation (AF), or atrial flutter with a history of AF, planned for electrical cardioversion from 5 hospitals in the US, Canada, and Australia between November 2021 and December 2024 in this  prospective, open-label, randomized clinical trial. The date of final follow-up was June 5, 2025. -- all patients had planned upcoming direct current electrical cardioversion -- patients who had sustained successful cardioversion were randomized to 2 groups: one group had regular caffeinated coffee consumption, and the other group to abstain from coffee and caf...