DynaMed Weekly Update

April 14, 2009

Volume 4 Issue 15

DynaMed Systematic Literature Surveillance

For the week ending April 10, 2009

This week, 716 articles were considered for inclusion in DynaMed and 273 met criteria for inclusion.

Based on the criteria of selecting “articles most likely to change clinical practice,” one article of significant interest is included in this weekly update.

CABG May Reduce Mortality Compared to PCI in Patients with Diabetes and Patients ≥ 65 Years Old

The relative benefits of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) continue to be actively debated and analyzed. A recent meta-analysis of individual data from 7,812 patients in 10 randomized trials suggests that CABG may be associated with lower mortality in certain populations (level 2 [mid-level] evidence). There was no difference in overall mortality comparing CABG vs. PCI (15% vs. 16%), but mortality was significantly lower for CABG among 1,233 patients with diabetes (23% vs. 29%, p < 0.05, NNT 17) and among 2,688 patients ≥ 65 years old (20% vs. 24%, p < 0.05, NNT 25). There were no differences in mortality among younger patient populations. CABG was also associated with lower rates of angina at 1 year and repeat revascularization (Lancet 2009 Apr 4;373(9670):1190). All trials used either balloon angioplasty or bare-metal stents for PCI. For more information, see the Percutaneous coronary intervention vs. coronary artery bypass grafting topic in DynaMed.

DynaMed Topic Activity

New summaries added to DynaMed this week:

· Electroconvulsive therapy (ECT) for depression

· Hypertension treatment in black patients

· Opioids for chronic cancer pain

· Peripheral neuropathy

· Streptococcal pharyngitis testing strategies

· Weight loss medications for obesity in adolescents

· Weight loss medications for obesity in adults

DynaMed Peer Review

We are currently seeking reviewers for:

· Electroconvulsive therapy (ECT) for depression

· Hypertension treatment in black patients

· Opioids for chronic cancer pain

For more information, see Editorial Policies for Authors & Reviewers and DynaMed Peer Review.

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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 articles 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 © 2009 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.)