Sub study of REVIVED in Circ last week, looking for differences in all cause death and “aborted SCD” (resuscitated cardiac arrest or appropriate device discharge) also found no benefit with PCI (HR 1.03) Vs OMT. Not sure what could’ve been made of a subgroup of an overall negative trial to begin with. But the effect is impressively null...all day long.
I imagine nobody can answer this question. I took so much junk believing the doctors had an idea of what they were doing, and then the pandemic arrived and it got clear they do not. "Stay Home"..."Do nothing untill you get so bad you need a ventilator" seemed no sensical, independent of having any kind of scientific training. Common sense is a lost currency
What about the fact that the body is capable of forming collaterals that bypass blocked arteries? You want to help heart patients keep their arteries open? Try high potency cayenne tincture (180K heat units). I know it's against the standard cardiac religion, but for $15 a bottle that lasts 3-6 months, it's well worth experimenting with. It does not hurt anything. Cayenne is a miracle herb. Statins and stents are not.
Once again, the REVIVED-BCIS trial will be ignored. It cuts too deep into the operate-at-all-costs-for-profit model that pervades most of "modern" medicine. Doctors are far too arrogant to ever change. That is why I try everything I can to doctor myself. It is amazing what you can find doing a little research that goes back to the olden days...3-6 decades ago.
it is so hard to question side effects....I was talking to my doctor the other day and I dispaired. He is so worried to do the best for me that he doesnt question anything, and refuses to argue...I think he believes he needs to show h is sure of himself
This is a perfect example of the way our medical system ignores powerful evidence to protect highly profitable procedures that don't work. It is all about the money. Congestive heart failure rates are increasing in this country because of our aging population and increases in obesity and diabetes. A Milliman paper says that congestive heart failure generates a third of Medicare spending and is the leading cause of readmissions. Best practice medical treatment for type 2 diabetes lowers hospitalizations for heart failure by 70% over 21 years, yet everyone gets a damn stent and almost no one gets best practice treatment for diabetes.
What relevance could there be to quality-of-life complaint differentials among the <35% EF cohort?
Given likely comorbidity among a patient cohort weighted toward such vulnerability, how does the flipping of results at the decade-survival point affect the results?
The study results suggest that dual anti-platelet therapy and lipid control seem to become a form of palliative care, given the daily reality of life at an EF of 35%. Perhaps that's the point.
I have enjoyed this series tremendously. My dad had open heart for a blockage at 42. He is now 76. He has had stents over the years. I sometimes worry if they just stent him...because they do...and it does make me concerned that he may go for a follow up...and be told have a stent...because that's what they do
and of course they argue that your Dad would have been dead decades ago if they hadn't done the surgery and stents. Your Dad is proof to them that what they are doing is effective.
Kind of like claiming almost supernatural powers for vaccines. Oh all these years you've been free of fill-in-the-blank because of the vaccines you took. Yet it's bad manners to suggest all these years you've had a chronic autoimmune problem because of the vaccines you took. Things always seem to cut in favor of interventions, meds or procedures.
question: Large RCT's are the "gold standard" for approval of new drugs and new "vaccines", right? But are large RCT's required for the latest hack job dreamed up by surgeons? Were RCT's required for open heart surgery that began decades ago? Were they required for other surgical procedures like stents? If not, why not? Why do surgeons get a pass on this?
Sub study of REVIVED in Circ last week, looking for differences in all cause death and “aborted SCD” (resuscitated cardiac arrest or appropriate device discharge) also found no benefit with PCI (HR 1.03) Vs OMT. Not sure what could’ve been made of a subgroup of an overall negative trial to begin with. But the effect is impressively null...all day long.
And yet this important piece of evidence did not change the recommendations for revascularisation in the latest ACC/AHA guidelines for CCS...
My best friend’s husband just had this done a month ago! New onset CHF. No blockages.
Would love to hear your analysis of the SELECT trial with Wegovy
I imagine nobody can answer this question. I took so much junk believing the doctors had an idea of what they were doing, and then the pandemic arrived and it got clear they do not. "Stay Home"..."Do nothing untill you get so bad you need a ventilator" seemed no sensical, independent of having any kind of scientific training. Common sense is a lost currency
Please DO speculate as to why!
WE do have evidence however that CABG in these cases is better dont we?
What about the fact that the body is capable of forming collaterals that bypass blocked arteries? You want to help heart patients keep their arteries open? Try high potency cayenne tincture (180K heat units). I know it's against the standard cardiac religion, but for $15 a bottle that lasts 3-6 months, it's well worth experimenting with. It does not hurt anything. Cayenne is a miracle herb. Statins and stents are not.
Once again, the REVIVED-BCIS trial will be ignored. It cuts too deep into the operate-at-all-costs-for-profit model that pervades most of "modern" medicine. Doctors are far too arrogant to ever change. That is why I try everything I can to doctor myself. It is amazing what you can find doing a little research that goes back to the olden days...3-6 decades ago.
.
Pick A Doctor. Any Doctor.
Pick 'Em All.
Their Minds Have Been Manufactured
To Operate Like Appliances.
- Don't worry. One of these doctors will be right about something one of these days.
- We will just have to wait until the wonders of life can be administered as a multiple choice test.
.
So sad to be so right.
it is so hard to question side effects....I was talking to my doctor the other day and I dispaired. He is so worried to do the best for me that he doesnt question anything, and refuses to argue...I think he believes he needs to show h is sure of himself
It’s so hard to believe that “fixing blockages” often has no benefit. Damn hard. People are gonna go nuts over this one. Bring popcorn.
This is a perfect example of the way our medical system ignores powerful evidence to protect highly profitable procedures that don't work. It is all about the money. Congestive heart failure rates are increasing in this country because of our aging population and increases in obesity and diabetes. A Milliman paper says that congestive heart failure generates a third of Medicare spending and is the leading cause of readmissions. Best practice medical treatment for type 2 diabetes lowers hospitalizations for heart failure by 70% over 21 years, yet everyone gets a damn stent and almost no one gets best practice treatment for diabetes.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6061176/
What relevance could there be to quality-of-life complaint differentials among the <35% EF cohort?
Given likely comorbidity among a patient cohort weighted toward such vulnerability, how does the flipping of results at the decade-survival point affect the results?
The study results suggest that dual anti-platelet therapy and lipid control seem to become a form of palliative care, given the daily reality of life at an EF of 35%. Perhaps that's the point.
I'll read the study again.
I have enjoyed this series tremendously. My dad had open heart for a blockage at 42. He is now 76. He has had stents over the years. I sometimes worry if they just stent him...because they do...and it does make me concerned that he may go for a follow up...and be told have a stent...because that's what they do
and of course they argue that your Dad would have been dead decades ago if they hadn't done the surgery and stents. Your Dad is proof to them that what they are doing is effective.
Kind of like claiming almost supernatural powers for vaccines. Oh all these years you've been free of fill-in-the-blank because of the vaccines you took. Yet it's bad manners to suggest all these years you've had a chronic autoimmune problem because of the vaccines you took. Things always seem to cut in favor of interventions, meds or procedures.
Thank you for this series. It's been fascinating.
Brilliant job John! I have written about the lack of efficacy of anti-depressants and how that research will not change prescribing patterns. Sad.
question: Large RCT's are the "gold standard" for approval of new drugs and new "vaccines", right? But are large RCT's required for the latest hack job dreamed up by surgeons? Were RCT's required for open heart surgery that began decades ago? Were they required for other surgical procedures like stents? If not, why not? Why do surgeons get a pass on this?