geoffrey modest medical blogs

  A secondary analysis of the CONNECT trial, that stands for (a bit of a stretch...)  “A Randomized Comparison of Long-Term Vascular Healing Between Biodegradable Polymer vs Durable Polymer Everolimus Eluting Stents in Acute ST-Elevation Myocardial Infarction” found that a lower target LDL level was associated with decreased neoatherosclerosis, which is associated with subsequent stent failure (see   LDL goal after stent JAMAcardiol2025  in dropbox, or doi:10.1001/jamacardio.2025.4723)   Details : -- the CONNECT trial was a prospective, multicenter, open-label, assessor-blind, randomized clinical trial to investigate the association between achieving guideline-endorsed target LDL levels with long-term neoatherosclerosis formation after current-generation drug-eluting stent implantation. This trial was conducted in 7 centers in 2 countries (Switzerland and Japan)     -- patients at least 18 years old were eligible if they presented with a...

  An important article (i think) just came out that evaluated the robustness of surrogate markers as accurate  substitutes for  clinical outcomes, finding many  concerns  (see  surrogate markers concerns JAMA2024  in dropbox, or doi:10.1001/jama.2024.4175)   Details : -- researchers accessed the FDA Adult Surrogate Endpoint Table (with >100 entries) and MEDLINE from  the  inception of th is  FDA table in 2018 to March 2023, evaluating the correlation between the surrogate markers and clinical endpoints found in the relevant meta-analyses (though they excluded oncologic treatments) -- 37 surrogate markers were identified for 32 unique nononcologic chronic diseases    Results  (my comments are embedded in the review of many of the individual surrogate markers below) : --  for 22 (59%) of the surrogate markers in 21 chronic diseases, no eligible meta-analysis was identified     -- 17 (77%...