Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, Yesterday
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.

Better long-term outcomes in carotid endarterectomy than in stenting

24 Jul 2017
Huge unethical mark-ups were charged at each stage in the supply chain of coronary stents.

Carotid endarterectomy yields better short- and long-term outcomes than stenting for carotid artery stenosis, according to a new meta-analysis. However, endarterectomy is also associated with higher risks of periprocedural myocardial infarction.

Pooled data from eight trials (n=7,005) showed significantly lower risks of periprocedural myocardial infarction in patients who underwent stenting (odds ratio [OR], 0.52; 95 percent CI, 0.33 to 0.81; p=0.004).

On the other hand, the incidence of the composite outcome of death or stroke was significantly higher in stenting than in endarterectomy (OR, 1.76; 1.38 to 2.25; p<0.0001). Minor stroke (OR, 2.19; 1.59 to 3.01; p<0.0001) accounted for majority of this association; incidence major strokes (OR, 1.41; 0.95 to 2.09; p=0.09) and deaths (OR, 1.68; 0.82 to 3.44; p=0.16) were not significantly elevated.

Pooled data from seven trials (n=6,799) showed that long-term stroke was significantly more common in stenting than in endarterectomy (OR, 1.45; 1.22 to 1.73; p<0.0001). The long-term risk of the composite outcome of death, ipsilateral stroke and periprocedural stroke was significantly higher in stenting (OR, 1.25; 1.05 to 1.48; p=0.01).

On the other hand, there were no significant differences between the two groups in terms of ipsilateral stroke (OR, 1.04; 0.79 to 1.37; p=0.80) and long-term all-cause mortality (OR, 1.09; 0.95 to 1.26; p=0.21). All but one of the trials showed low risk of bias.

The meta-analysis included randomized controlled trials that compared the efficacy and safety of endarterectomy with stenting. Exclusion criteria included retrospective and observational study designs, and a follow-up period <4 years.

The databases of Embase, PubMed and the Cochrane Library Central Register of Controlled Trials were accessed. Risk of bias was determined using the Cochrane Collaboration guidelines.

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Most Read Articles
Elvira Manzano, 4 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.
Tristan Manalac, Yesterday
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.