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ABOUT DR. BREWER
Dr. Brewer started as an Emergency Doctor. After seeing too many preventable heart attacks, he went to Johns Hopkins to learn Preventive Medicine. While there, he went on the run the post-graduate training program (residency) in Preventive Medicine. From there, he made a career of practicing and managing preventive medicine and primary care clinics. His later role in this area was Chief Medical Officer for Premise, which has close to 1,000 primary care/prevention clinics. He was also the Chief Medical Officer for MDLIVE, the second largest telemedicine company. More recently, he founded PrevMed, a heart attack, and stroke prevention clinic.
At PrevMed, we focus on heart attack, stroke, and cognitive decline. We serve patients who have already experienced an event as well as those who have not developed a diagnosis or event. Dr. Brewer provides services via telemedicine or in person if you're in the Lexington, KY area. We find a lot of undiagnosed Pre-Diabetes or Insulin Resistance. Treating unrecognized risk factors like Pre-Diabetes allows reduction of risk and prevention of disease.
If you are interested in becoming a patient, please visit our website: https://prevmedheartrisk.com/
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ford brewer md mph Info@PrevMedHeartRisk.com
The COMPASS study was halted early and published in Aug 2017 in the New England Journal of Medicine. It compared 3 anti-platelet regimens among patients with coronary and peripheral arterial disease. Comparisons were between 3 therapeutic regimens:
1. aspirin 100 mg daily;
2. rivaroxaban 5 mg twice daily; and
3. aspirin 100 mg daily plus rivaroxaban 2.5 twice daily.
The dual therapy with low-dose rivaroxaban was the clear winner. But it came at the cost of increased serious bleeds.
There were significantly fewer cardiovascular and PVD (peripheral vascular) events. Differences in MI rates were insignificant. Stroke was by far the major difference.
This will probably change the standards for anti-platelet therapy. Which parts? Not the decision on whether to initiate anti-platelet therapy, but the dosage and dual- vs mono- therapy decision.
Will there be an impact on anti-platelet therapy for Atrial Fibrillation? I'm predicting it will. Again, CHAD2Vasc2 will still be the standard for decided when to initiate therapy. But I'm predicting the therapeutic regimen will probably go to this DAPT (DUAL ANTIPLATELET THERAPY) using low-dose Rivaroxaban. It's still to early to tell.
XARELTO (RIVAROXABAN) and COMPASS: Trial halted early due to "overwhelming evidence" of efficacy saliva de gato | |
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| Science & Technology | Upload TimePublished on 26 Nov 2017 |
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