Stroke Subtypes; Statin Flop for Cancer; A Better Aneurysm Coil


By medpagetoday.com

Head-to-head evaluation of three stroke classification systems showed that all did fairly well, with the major stroke subtypes distinct irrespective of the system used, researchers reported in a study appearing in JAMA Neurology.

The Causative Classification of Stroke (CCS), Trial of Org 10172 in Acute Stroke Treatment (TOAST), and ASCO (A for atherosclerosis, S for small-vessel disease, C for cardiac source, and O for other cause) classification systems had area under the receiver operating characteristic curves for 90-day recurrence of 0.71, 0.61, and 0.66, respectively.

While all had similar discrimination for 90-day mortality, CCS "generates discrete etiologic categories with more diverse clinical, imaging, and prognostic characteristics than either TOAST or ASCO," the researchers noted.

Nevertheless, this validation study says the scales perform "fairly well" overall, so it's reasonable to stick with any of the three, commented Philip Gorelick, MD, MPH, of Michigan State University in Grand Rapids.

Statins Flop As Cancer Tx

Statins' pleiotropic benefits don't extend to cancer, according to the phase III LUNGSTAR trial showing that adding pravastatin to standard chemotherapy didn't improve survival or secondary outcomes in small cell lung cancer.

Despite promising preclinical and observational findings, this is the fifth placebo-controlled trial of statin use in patients with cancer to show no benefit.

"Given the findings from our trial and the other published, double-blind, randomized controlled trials, independent monitoring committees of studies that are still recruiting or in follow-up should examine interim analyses of clinical endpoints and stop early if there is sufficient evidence for futility, thus saving resources," the authors concluded in their paper online in the Journal of Clinical Oncology.

See MedPage Today's coverage here.

A Better Aneurysm Coil

Novel next-generation endovascular coils for treating medium-sized intracranial aneurysms reduced adverse outcomes among patients, according to the randomized GREAT trial reported at the International Stroke Conference.

MicroVention's HydroSoft or HydroFrame coils, filled with a hydrogel that expands upon contact with liquid to increase packing density, reduced the composite rate of major aneurysm recurrence at 18 months, retreatment for major recurrences within 18 months, morbidity that prevented angiographic follow-up, or death by an absolute 8.4% compared with standard platinum coils.

"In the U.S., most patients get the classic coil or the clip," commented Mark Alberts, MD, of Hartford Healthcare in Connecticut. "But this could potentially be an advance."

See the full MedPage Today story here.

Arthritic Heart Woes

Heart attack and rheumatoid arthritis are well known partners in crime, but other types of arthritis are culprits as well, a 25-study meta-analysis reported in the Annals of the Rheumatic Diseases.

MI risk was elevated most with rheumatoid arthritis but also significant for gout (HR 1.47), psoriatic arthritis (HR 1.41), and osteoarthritis (HR 1.31), with a trend seen for ankylosing spondylitis (HR 1.24, 95% CI 0.93-1.65) as well.

"The study findings support more integrated cardiovascular prevention strategies for arthritis populations that target both reducing inflammation and enhancing management of traditional cardiovascular risk factors," the researchers concluded, suggesting that gout and osteoarthritis patients should be monitored and risk factors targeted as is already recommended in the other types of arthritis.

Source: http://www.medpagetoday.com/cardiology/prevention/63560

Saturday, May 16, 2026

Trental For Venous Insufficiency: Benefits, Dosage, And Safety

When a person is diagnosed with venous insufficiency or seeks relief from it, selecting the most appropriate medication requires weighing multiple factors: the severity of symptoms, the patient's age and health history, and whether other medications are already being taken. A thoughtful treatment choice improves outcomes and reduces unnecessary side effects. The spectrum of allergic disease is broad. Seasonal allergic rhinitis, often called hay fever, flares in response to outdoor allergens such as tree pollen in spring and ragweed in fall. Perennial allergies occur year-round and are typically triggered by indoor allergens like dust mites and pet dander. Chronic urticaria manifests as persistent hives and can last months or years without a clearly identifiable cause. All of these conditions share a common inflammatory pathway driven by the immune system's release of chemical mediators. Among the medications available for blood flow, Trental provides a well-studied option that many patients discuss with their doctors. The clinical evidence supporting trental for venous insufficiency shows that it can be effective for managing this condition when used appropriately under medical supervision. Trental contains the active ingredient pentoxifylline, which works by acting on the biological pathways responsible for producing the symptoms associated with venous insufficiency. Understanding the mechanism helps patients appreciate why consistent use is often more effective than taking it only when symptoms become severe, as maintaining steady levels allows for more stable control. Patients managing venous insufficiency long-term should keep regular follow-up appointments to assess whether their treatment plan is still the best fit for their situation. As conditions change and new evidence emerges, treatment adjustments may be worthwhile. The blood flow resource section provides a helpful reference for staying current on medication options in this area.

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