DynaMed Weekly Update
January 2, 2007 Volume 2 Issue 1  
DynaMed Systematic Literature Surveillance
During the weeks ending December 22 and December 29, 2007


Approximately 1286 articles were considered for inclusion in DynaMed and 408 met criteria for inclusion.  

Based on the criteria of selecting 'topics most likely to change clinical practice', two articles of significant interest are included in this weekly update.

Adverse Effects Associated with Statin Monotherapy


Statin monotherapy does not increase the risk of myalgias or rhabdomyolysis compared to placebo (level 1 [likely reliable] evidence), based on a systematic review of 35 English-language randomized double-blind placebo-controlled trials of monotherapy with statins other than cerivastatin, at least 100 adults with hyperlipidemia, and which reported adverse effects.  Myalgias were defined as any musculoskeletal pain or symptoms without documented CK elevations; rhabdomyolysis was defined as CK elevations at least 10 times the upper limit or normal. Statins were associated with a small increase in the risk of elevated liver transaminases (NNH 333) (Circulation 2006 Dec 19;114(25):2788).
Cardiovascular Risk Scores in Primary Prevention


The use of cardiovascular risk scores in primary prevention has NOT been shown to improve health outcomes, based on a systematic review of 4 published randomized trials of use of cardiovascular risk score to aid primary prevention.

 

In the same report, Framingham risk estimates may be inaccurate based on a systematic review of 27 studies of prediction of coronary or cardiovascular disease risk with Framingham risk scores (Anderson or Wilson methods) in 71,727 participants (Heart 2006 Dec;92(12):1752).

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DynaMed Weekly Update is a compilation of 1 to 5 articles that are of significant interest to clinicians.  Articles are selected from DynaMed's Systematic Literature Surveillance as topics most likely to change clinical practice. Updates are prepared by the DynaMed Editorial Team which includes 28 clinicians from multiple disciplines. Send comments to DynaMedEditor@epnet.com. To learn more about DynaMed, go to www.dynamicmedical.com.

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Copyright © 2007 EBSCO Publishing. All rights reserved.
 DynaMed® is a registered trademark of and published by DynaMed LLC. Original date of on-line publication December 15, 1995 with continuous daily updating. ISSN: 1554-1177. Subscriptions and queries can be addressed to DynaMed LLC, EBSCO Publishing, 10 Estes St., Ipswich, Massachusetts, USA 01938-0602, telephone (978) 356-6500, facsimile (978) 356-6565, e-mail Editor@DynamicMedical.com. The opinions expressed herein are solely those of the authors and editors and may or may not represent the official position of cooperating or endorsing Medical Societies. Development of DynaMed was supported in part by the National Science Foundation through a Small Business Innovative Research grant. (All other support comes from subscriptions. No advertisements are accepted.)