Freely Filtered 018: ISCHEMIA-CKD, Courage, and Céline Dion

We have a full house plus a couple of guests to discuss the Ischemia CKD trial and more COVID-19

The Filtrate:

Joel Topf

Swapnil Hiremath

Samira Farouk

Jennie Lin

Matt Sparks

And special guests:

David J. Cohen: Professor of Medicine at the University of Missouri-Kansas City and Director of Cardiovascular Research at Saint Luke’s Mid America Heart Institute. In addition, he is Medical Director of the Medical Economics and Technology Assessment Group at Mid America Heart Institute. He was previously Associate Director of Interventional Cardiology at Beth Israel Deaconess Medical Center where he was also Associate Professor of Medicine at Harvard Medical School and Director of Economics and Quality of Life Research at the Harvard Clinical Research Institute. He is on Twitter at @djc795

Keith Bellovich: Chief Medical Officer Ascension St John. He is also on the board of directors of the renal physician association where he currently the treasurer/secretary.

Show Notes:

Ischemia CKD trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1915925

The most famous figure in nephrology: https://jasn.asnjournals.org/content/10/7/1606

(This figure was originally published in AJKD, but is now behind a paywall, hence the JASN link https://www.ajkd.org/article/S0272-6386(98)00339-4/pdf)

Should Statins Be Banned from Dialysis? https://jasn.asnjournals.org/content/28/6/1675

Ischemia trial (not CKD) https://www.nejm.org/doi/full/10.1056/NEJMoa1915922

Courage trial from 2007: https://www.nejm.org/doi/full/10.1056/NEJMoa070829

Drug eluting stents approved in 2003: https://en.wikipedia.org/wiki/Drug-eluting_stent

Céline Dion, Courage:  https://www.youtube.com/watch?v=WN-ZHOHmvcw

Dr. Farouk hanging with her close personal friend Ms. Dion: https://twitter.com/ssfarouk/status/1246448332039471107

https://twitter.com/ssfarouk/status/1235935956152311808

A lot of the enrollment of CKD-Ischemia was from Asia, 25%

Methods: 19:40

Avoiding the Oculostenotic Reflex: https://www.acc.org/membership/sections-and-councils/fellows-in-training-section/section-updates/2016/02/12/16/29/avoiding-the-oculostenotic-reflex

Beta blockers in dialysis patients: https://www.ncbi.nlm.nih.gov/pubmed/10201019

Mehran Score: https://www.mdcalc.com/mehran-score-post-pci-contrast-nephropathy

Ultra-low contrast coronary angiography and zero-contrast percutaneous coronary intervention for prevention of contrast-induced nephropathy: step-by-step approach and review: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727230/ 

Capsulology 32:30

Antiplatelet treatment of STEMI with P2Y12 inhibitors https://en.wikipedia.org/wiki/P2Y12#Antiplatelet_treatment_of_STEMI 

Impact of concomitant use of proton pump inhibitors and clopidogrel or ticagrelor on clinical outcomes in patients with acute coronary syndrome https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4826890/

Jennie is an intermediate metabolizer so she will be sluggish to activate P2Y12 inhibitor pro-drugs (which is just about all of them) https://www.mdmag.com/conference-coverage/acc-2018/realtime-genetic-data-impacts-physician-prescribing-behavior-following-stent-procedures 

St John's Wort Supplements Endanger the Success of Organ Transplantation: https://jamanetwork.com/journals/jamasurgery/fullarticle/212243

Results 37:10

Frank Harrell https://twitter.com/f2harrell

His blog: https://www.fharrell.com 

Discussion 46:56

Samira does not work at NYU. 

The Argument for Abolishing Cardiac Screening of Asymptomatic Kidney Transplant Candidates https://pubmed.ncbi.nlm.nih.gov/31492488/

Coronary-Artery Revascularization before Elective Major Vascular Surgery https://www.nejm.org/doi/full/10.1056/NEJMoa041905

A Single Ventilator for Multiple Simulated Patients to Meet Disaster Surge https://onlinelibrary.wiley.com/doi/pdf/10.1197/j.aem.2006.05.009 

Joel’s enthusiasm for Remdesivir: The COVID Diaries 3: Ladies and Gentleman, I think this tweet is going to get me in trouble… http://pbfluids.com/2020/05/the-covid-diaries-3-the-tweet-heard-round-the-world/

Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31022-9/fulltext

NIH Clinical Trial Shows Remdesivir Accelerates Recovery from Advanced COVID-19 https://www.niaid.nih.gov/news-events/nih-clinical-trial-shows-remdesivir-accelerates-recovery-advanced-covid-19