Annals of Internal Medicine




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Subclinical Coronary Atherosclerosis and Risk for Myocardial Infarction in a Danish Cohort

Andreas Fuchs, MD, PhD; Jørgen Tobias Kühl, MD, PhD, DMSc; Per Ejlstrup Sigvardsen, MD, PhD; Shoaib Afzal, MD, PhD; Andreas Dehlbæk Knudsen, MD, PhD; Mathias Bech Møller, MD, PhD; Martina Chantal de Knegt, MD, PhD; Mathias Holm Sørgaard, MD, PhD; Børge Grønne Nordestgaard, MD, DMSc; Lars Valeur Køber, MD, DMSc; and Klaus Fuglsang Kofoed, MD, PhD, DMSc

doi : 10.7326/M22-3027

April 2023Volume 176, Issue 4

Coronary atherosclerosis may develop at an early age and remain latent for many years.

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Assessment of the Risk Evaluation and Mitigation Strategy (REMS) for Phentermine–Topiramate to Prevent Exposure During Pregnancy

Amir Sarayani, PharmD, MPH, PhD; William Troy Donahoo, MD; Christian Hampp, PhD; Joshua D. Brown, PharmD, PhD; and Almut G. Winterstein, PhD

doi : 10.7326/M22-1743

The U.S. Food and Drug Administration approved phentermine–topiramate for obesity in 2012 and required a Risk Evaluation and Mitigation Strategy (REMS) to prevent prenatal exposure. No such requirement was introduced for topiramate.

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Comparison of Over-the-Scope Clips to Standard Endoscopic Treatment as the Initial Treatment in Patients With Bleeding From a Nonvariceal Upper Gastrointestinal Cause

James Y.W. Lau, MD*; Rui Li, MD*; Chen-huan Tan, MMed; Xiu-jing Sun, MD; Hao-jun Song, MSc; Lan Li, MD; Feng Ji, MD; Bu-jiang Wang, MMed; Dong-tao Shi, MD; Wai K. Leung, MD; Imogen Hartley, MBBS BSc (Hons); Alan Moss, MD; Karina Y.Y. Yu, PhD; Bing Y. Suen, BHSc; Peng Li, MD; and Francis K.L. Chan, MD

doi : 10.7326/M22-1783

Current endoscopic methods in the control of acute nonvariceal bleeding have a small but clinically significant failure rate. The role of over-the-scope clips (OTSCs) as the first treatment has not been defined.

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Incremental Health Care Costs of Self-Reported Functional Impairments and Phenotypic Frailty in Community-Dwelling Older Adults

Kristine E. Ensrud, MD, MPH; John T. Schousboe, MD, PhD; Allyson M. Kats, MS; Brent C. Taylor, PhD, MPH; Cynthia M. Boyd, MD, MPH; and Lisa Langsetmo, PhD

doi : 10.7326/M22-2626

Health care systems need better strategies to identify older adults at risk for costly care to select target populations for interventions to reduce health care burden.

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Cardiac Arrest During Delivery Hospitalization

Nicole D. Ford, PhD, MPH; Carla L. DeSisto, PhD, MPH; Romeo R. Galang, MD, MPH; Elena V. Kuklina, MD, PhD; Laurence S. Sperling, MD; and Jean Y. Ko, PhD

doi : 10.7326/M22-2750

Estimates of cardiac arrest occurring during delivery guide evidence-based strategies to reduce pregnancy-related death.

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Effect of Medicare Advantage on Hospital Readmission and Mortality Rankings

Andrew S. Oseran, MD, MBA; Rishi K. Wadhera, MD, MPP, MPhil; E. John Orav, PhD; and Jose F. Figueroa, MD, MPH

doi : 10.7326/M22-3165

Medicare links hospital performance on readmissions and mortality to payment solely on the basis of outcomes among fee-for-service (FFS) beneficiaries. Whether including Medicare Advantage (MA) beneficiaries, who account for nearly half of all Medicare beneficiaries, in the evaluation of hospital performance affects rankings is unknown.

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Worsening Spread of Candida auris in the United States, 2019 to 2021

Meghan Lyman, MD; Kaitlin Forsberg, MPH; D. Joseph Sexton, PhD; Nancy A. Chow, PhD, MS; Shawn R. Lockhart, PhD; Brendan R. Jackson, MD, MPH; and Tom Chiller, MD, MPHTM

doi : 10.7326/M22-3469

Candida auris is an emerging fungal threat that has been spreading in the United States since it was first reported in 2016.

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Evolving Real-World Effectiveness of Monoclonal Antibodies for Treatment of COVID-19

Kevin E. Kip, PhD; Erin K. McCreary, PharmD; Kevin Collins, MBA; Tami E. Minnier, MS; Graham M. Snyder, MD, MS; William Garrard, PhD; Jeffrey C. McKibben, MS; Donald M. Yealy, MD; Christopher W. Seymour, MD, MSc; David T. Huang, MD, MPH; J. Ryan Bariola, MD; Mark Schmidhofer, MD; Richard J. Wadas, MD; Derek C. Angus, MD, MPH; Paula L. Kip, PhD; and Oscar C. Marroquin, MD

doi : 10.7326/M22-1286

Treatment guidelines and U.S. Food and Drug Administration emergency use authorizations (EUAs) of monoclonal antibodies (mAbs) for treatment of high-risk outpatients with mild to moderate COVID-19 changed frequently as different SARS-CoV-2 variants emerged.

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Effectiveness of Molnupiravir and Nirmatrelvir–Ritonavir in Hospitalized Patients With COVID-19

Eric Yuk Fai Wan, PhD*; Vincent Ka Chun Yan, BPharm*; Anna Hoi Ying Mok, MClinPharm*; Boyuan Wang, MPH; Wanchun Xu, MPhil; Franco Wing Tak Cheng, MClinPharm; Francisco Tsz Tsun Lai, PhD; Celine Sze Ling Chui, PhD; Xue Li, PhD; Carlos King Ho Wong, PhD; Philip Hei Li, MBBS; Benjamin John Cowling, PhD; Ivan Fan Ngai Hung, MD; Chak Sing Lau, MD; Ian Chi Kei Wong, PhD; and Esther Wai Yin Chan, PhD

doi : 10.7326/M22-3057

Whether hospitalized patients benefit from COVID-19 oral antivirals is uncertain.

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Effect of Thromboprophylaxis on Clinical Outcomes After COVID-19 Hospitalization

Patients hospitalized with COVID-19 have an increased incidence of thromboembolism. The role of extended thromboprophylaxis after hospital discharge is unclear.

doi : 10.7326/M22-3350

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Effect of Yoga on Frailty in Older Adults

Julia Loewenthal, MD; Kim E. Innes, MSPH, PhD; Margalit Mitzner, BS; Carol Mita, MLIS; and Ariela R. Orkaby, MD, MPH

doi : 10.7326/M22-2553

Yoga, a multicomponent mind–body practice, improves several domains of physical and psychological health and may affect frailty in older adults.

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Assessing Heterogeneity of Treatment Effect in Real-World Data

Jodi B. Segal, MD, MPH*; Ravi Varadhan, PhD, PhD*; Rolf H.H. Groenwold, MD, PhD; Nicholas C. Henderson, PhD; Xiaojuan Li, PhD; Kaori Nomura, MPH, PhD; Sigal Kaplan, PhD; Shirin Ardeshirrouhanifard, PharmD, PhD; James Heyward, MHS; Fredrik Nyberg, PhD; and Mehmet Burcu, PhD

doi : 10.7326/M22-1510

Increasing availability of real-world data (RWD) generated from patient care enables the generation of evidence to inform clinical decisions for subpopulations of patients and perhaps even individuals.

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How Would You Manage This Patient With Benign Prostatic Hyperplasia?

Gerald W. Smetana, MD; C. Christopher Smith, MD; Ajay Singla, MD; and Howard Libman, MD

doi : 10.7326/M23-0113

Lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) are common in older patients assigned male sex at birth, regardless of gender identity, and treatment of these symptoms is therefore common in primary care practice.

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Drug Repurposing and Observational Studies: The Case of Antivirals for the Treatment of COVID-19

Miguel A. Hernán, MD; and Julia del Amo, MD

doi : 10.7326/M22-3582

Remdesivir and molnupiravir were the only 2 repurposed antivirals that were approved for emergency use during the COVID-19 pandemic. Both drugs received their emergency use authorization on the basis of a single industry-funded phase 3 trial, which was launched after evidence of in vitro activity against SARS-CoV-2.

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Cases in Precision Medicine: Is There an Obligation to Return Reinterpreted Genetic Results to Former Patients?

Paul S. Appelbaum, MD; Wylie Burke, MD, PhD; Erik Parens, PhD; Jessica Roberts, JD; Sara M. Berger, MS, CGC; and Wendy K. Chung, MD, PhD

doi : 10.7326/M22-3682

Interpretation of many genetic test results can change over time as new data accumulate. Hence, physicians who order genetic tests may subsequently receive revised reports with important implications for patients' medical treatment—even for patients who are no longer in their care.

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Seeing the Positive in Negative Studies

Eliseo Guallar, MD, DrPH; Steven N. Goodman, MD, PhD; A. Russell Localio, PhD; Alisa J. Stephens-Shields, PhD; and Christine Laine, MD, MPH

doi : 10.7326/M23-0576

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Self-Rated Health and Ability to Climb Stairs: A Pragmatic Health Assessment Before Lung Cancer Screening

Alison S. Rustagi, MD, PhD; Christopher G. Slatore, MD, MS; and Salomeh Keyhani, MD, MPH

doi : 10.7326/M22-3598

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Written by Humans or Artificial Intelligence? That Is the Question

Michiel Schinkel, MD; Ketan Paranjape, MSc, PhD; and Prabath Nanayakkara, MD, PhD

doi : 10.7326/M23-0154

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Contemporary Natural History of Coronary Artery Disease

Michael McDermott, MBChB David E. Newby, DM, PhD

doi : 10.7326/M23-0533

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What Is the Current Role of an Over-the-Scope Clip Used as First-Line Endoscopic Hemostasis in Patients With Nonvariceal Upper Gastrointestinal Bleeding?

Alan N. Barkun, MD, MScAli A. Alali, MBBCh, BAO, MSc

doi : 10.7326/M23-0449

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Function and Frailty: Value Added in Medicare

Julie P.W. Bynum, MD, MPH

doi : 10.7326/M23-0563

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Missed Directives

Glenn S. Ross, MD

doi : 10.7326/M22-3199

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Recommended and Prevalent Use of Glucagon-like Peptide-1 Receptor Agonists and Sodium–Glucose Cotransporter-2 Inhibitors in a National Population-Based Sample

doi : 10.7326/M22-3051

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First-Line Therapy for Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Sol Carriazo, MD , Alberto Ortiz, MD, PhD , Beatriz Fernandez-Fernandez, MD, PhD

doi : 10.7326/L23-0005

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First-Line Therapy for Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Caroline Hanna, MD , Kenneth Pettersen, MD, MPH , Nathaniel Pedley, MD, MBA

doi : 10.7326/L23-0006

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First-Line Therapy for Type 2 Diabetes With Sodium–Glucose Cotransporter-2 Inhibitors and Glucagon-Like Peptide-1 Receptor Agonists

Neda Laiteerapong, MD, MS , Jason Alexander, MD , Louis Philipson, MD, PhD , Aaron N. Winn, PhD , Elbert S. Huang, MD, MPH

doi : 10.7326/L23-0007

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Correction: Previously Undisclosed Potential Conflict of Interest by an Author of American College of Physicians Clinical Guidelines

Timothy J. Wilt, MD , Carolyn J. Crandall, MD, MS , Amir Qaseem, MD, PhD, MHA

doi : 10.7326/L23-0043

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Periprocedural Anticoagulation

Anna L. Parks, MD , Margaret C. Fang, MD, MPH

doi : 10.7326/AITC202304180

Management of patients taking anticoagulants around the time of a procedure is a common and complex clinical scenario. Providing evidence-based care requires estimation of risk for thrombosis and bleeding, knowledge of commonly used medications, multidisciplinary communication and collaboration, and patient engagement and education.

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After PCI and 6 to 18 mo of DAPT, clopidogrel reduced a composite of clinical events vs. aspirin at 6 y

Ellis W. Lader, MD

doi : 10.7326/J23-0019

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In older adults with hypertension, chlorthalidone vs. hydrochlorothiazide did not reduce major CV events or deaths at 2.4 y

Chirag Bavishi, MD, MPH

doi : 10.7326/J23-0018

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In HF with iron deficiency, IV ferric derisomaltose was associated with lower rates of HF hospitalization or CV death

Joseph B. Lerman, MD , L. Kristin Newby, MD, MHS

doi : 10.7326/J23-0012

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In critically ill patients with COVID-19, IL-6 receptor antagonists reduced mortality vs. control at 180 d

Charlotte Fuller, MD , Zain Chagla, MD

doi : 10.7326/J23-0020

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In symptomatic isolated DVT, 12 wk vs. 6 wk of rivaroxaban reduced recurrent VTE at 24 mo

Thomas G. DeLoughery, MD

doi : 10.7326/J23-0014

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In thrombotic antiphospholipid syndrome, DOACs vs. VKAs increase arterial thrombotic events but not major bleeding

Efstratios Koutroumpakis, MD , Anita Deswal, MD, MPH

doi : 10.7326/J23-0016

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After PSA screening, MRI-targeted vs. systematic biopsy detected fewer clinically insignificant prostate cancers

Richard M. Hoffman, MD, MPH

doi : 10.7326/J23-0017

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In older patients receiving aspirin, H pylori eradication reduced hospitalization or death due to peptic ulcer bleeding at 2.5 y

Abhilash Perisetti, MD , Prateek Sharma, MD

doi : 10.7326/J23-0011

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In pituitary adenoma surgery, no vs. perioperative hydrocortisone was noninferior for new-onset adrenal insufficiency

Gunjan Y. Gandhi, MD, MSc

doi : 10.7326/J23-0013

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In BPPV, canalith repositioning maneuver increased symptom resolution vs. vestibular suppressants

KoKo Aung, MD, MPH , Thwe Htay, MD

doi : 10.7326/J23-0015

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Annals Graphic Medicine - Advocating for Diastole

Ankit Mehta, MD and Tseganesh Selameab, MD

doi : 10.7326/G22-0035

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Annals Graphic Medicine - Break the Chain, Stop the Cycle

Zainab Haji, BDS and Hina Inam, FCPS

doi : 10.7326/G22-0041

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Annals for Educators - April 2023

Christine Laine, MD, MPH

doi : 10.7326/AWED202304180

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Annals for Hospitalists Inpatient Notes - Sodium–Glucose Cotransporter-2 Inhibitors for Heart Failure With Preserved Ejection Fraction�What Hospitalists Need to Know

Sarah K. Adie, PharmD , and Matthew C. Konerman, MD

doi : 10.7326/M23-0588

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