Speaker at ACP reviews top internal medical articles of 2015

WASHINGTON — A panel of speakers affiliated with the Annals of Internal Medicine discussed some of their most popular content from 2015 here at the annual American College of Physicians Internal Medicine Meeting.

Michael A. LaCombe, MD, MACP, FACC, associate editor of the journal, presented the most downloaded items from the past year, some of which have been covered by Healio.com.

ACP: Risk stratification should guide imaging, testing for suspected PE

The ACP has released a policy paper that outlines the best practice advice for physicians evaluating patients with a suspected acute pulmonary embolism.

The paper suggests that physicians should stratify patients into groups for whom different diagnostic strategies are appropriate. Read more.

Meta-analysis: PCSK9 inhibitors reduce mortality, MI

According to a systematic review and meta-analysis of trials of PCSK9 inhibitors, the novel cholesterol-lowering agents are associated with reductions in mortality and MI.

Researchers analyzed 24 phase 2 and phase 3 trials of the PCSK9 inhibitors alirocumab (Sanofi-Regeneron) and evolocumab (Amgen), both fully human monoclonal antibodies, covering 10,159 participants. Read more.

ACP advises against CHD screening in low-risk patients

High-Value Care Advice issued by the ACP recommends against screening for cardiac disease among asymptomatic, low-risk adults.

The paper, written by Roger Chou, MD, on behalf of the ACP High Value Care Task Force, utilized data from a systematic review and recommendations from the U.S. Preventive Services Task Force (USPSTF) on screening with ECG, along with guidelines and standards developed by the American College of Cardiology (ACC) in conjunction with other medical societies, and articles on cardiac screening. Read more.

Other popular articles

Other popular downloads included a discussion from the Beth Israel Deaconess Medical Center on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease and a clinical practice guideline from the AABB, formerly known as the American Association of Blood Banks, on platelet transfusion, LaCombe shared.

The discussion on the treatment of blood cholesterol occurred following the release of a clinical practice guideline from the American Heart Association and the ACC.

"The bottom line is that this is a method what will serve well until something better comes along," LaCombe said.

An internist and a cardiologist from Beth Israel shared their suggestions for treating patients with atherosclerotic cardiovascular disease in light of the new guidelines.

Based on a systematic review of randomized, clinical trials as well as observational outcomes, AABB developed six clinical recommendations on platelet transfusions for adults. Included in the recommendations were guidelines for transfusing platelets prophylactically in order to reduce risk for spontaneous bleeding, as well as a recommendation against routine prophylactic platelet transfusion for patients who have cardiac surgery with cardiopulmonary bypass and are nonthrombocytopenic. In addition, the AABB stated that it could not recommend for or against platelet transfusion for patients who have intracranial hemorrhage and are receiving antiplatelet therapy due to very low quality advice.

LaCombe noted that the platelet paper was the most downloaded paper from the Annals of Internal Medicine in all of 2015, likely because it agrees and overlaps with many other specialties, he said.

Reference:

LaCombe M, et al. Annals Articles That Can Change Practice 2015-2016. Presented at: ACP Internal Medicine Meeting; May 5-7, 2016; Washington, D.C.

Additional resources:

Chou R. Ann Intern Med. 2015;doi:10.7326/M14-1225.

Kaufman RM, et al. Ann Intern Med. 2015;doi:10.7326/M14-1589.

Mittleman MA, et al. Ann Intern Med. 2015;doi:doi:10.7326/M15-1125.

Navarese EP, et al. Ann Intern Med. 2015;doi:10.7326/M14-2957.

Raja AS, et al. Ann Intern Med. 2015;doi:10.7326/M14-1772.

Disclosures: LaCombe reported no relevant financial disclosures.