geoffrey modest medical blogs

  A recent article found that adults with a provoked venous thromboembolism (VTE) and enduring risk factors are still at risk for a recurrent VTE event and do benefit from long-term anticoagulation, in the company-funded HI-PRO study  (see  dvt provoked prolonged anticoag NEJM2025  in dropbox, or DOI: 10.1056/NEJMoa2509426)   Details : -- 600 adults who had had an objectively-confirmed symptomatic venous thromboembolism (VTE) after a transient provoking risk factor (eg, autoimmune disorders, chronic lung disease, obesity) and had completed the at least 3-month course of anticoagulation were randomized to apixaban 2.5mg twice a day vs placebo for 12 months, in this single-center, double-blind trial done at the Brigham and Women's Hospital in Boston from November 2020 through November 2023 --mean age 59.5, 57% female, 81% white/12% Black/ 9% Latino -- BMI 31, current smokers 5%  -- coexisting conditions: VTE prior to this trial in 21%; diabetes...

  A study from the recent Am Heart Assn meeting confirmed that tirzepatide leads to fewer cardiovascular events in patients having heart failure with preserved ejection fraction (HFpEF) and obesity, in the SUMMIT trial, a drug company supported trial (see   heart failure preserved tirzep NEJM2024  in dropbox, or  DOI: 10.1056/NEJMoa2410027)   Details : -- 731 participants who  were at least 40yo with heart failure, a left ventricular ejection fraction (LVEF) of at least 50% and a BMI of at least 30 in an international, double-blind RCT were recruited between April 2021 and June 2023     -- all participants had to have a 6-minute walk distance of 100-425 meters; a Kansas City Cardiomyopathy Questionnaire clinic summary score of 80 or less (scores range from 0-100, the higher scores reflecting a better quality of life); and at least one of an elevated N-terminal pro-B type natriuretic peptide (NT-proBNP) level (defined as >200 pg/m...