put ice on it. I N N O VAT I O N • C O M PA S S I O N • E X C E L L E N C E
“nothing can substitute for the unique face-to-face relationship between you and your doctor.” — Dr. Asad Qamar
// INSTITUTE OF CARDIOVASCULAR EXCELLENCE //
Face to face I am one of those individuals who believe the power of the Internet is a blessing and a curse, particularly as it relates to the ones that give diagnoses. And while these sites can be educational and informative, the truth is, nothing can substitute for the unique face-to-face relationship between you and your doctor. Many websites allow individuals to input symptoms they are experiencing and after a few clicks, receive an output of a diagnosis that was generated by key words, right from the comfort of their home computers. Most of these sites include disclaimers—as they should—but what concerns me about these sites is there are so many variables that need to be considered before a proper and accurate diagnosis. This is because we each bring valuable and critical information to the table. First, a patient who is open about their feelings, what stresses they are under, their family history and what aches and pains they experience gives me a picture of their unique self. And, in turn, as the physician, I have the responsibility to foster a close relationship with the patient and to channel my inner-scientist. Take for example the results of the three studies related to acute coronary syndromes (ACS) mentioned in this issue of Impulse. We consider the latest research in medical and scientific journals, combine that with what our patients tell us about their health and map out a plan that can help us properly diagnose, prescribe, monitor and treat our patients. All these variables are best understood and interpreted by a professional, proving the necessity of the very personal patient-doctor relationship—a relationship that I continuously learn from and personally enjoy.
Yours,
A close look at antiplatelet drugs Finding the best medication to fit a patients’ needs means that physicians need to know not only what is going on at the ‘bedside’, but also what scientists are learning in their labs. Take treatments for acute coronary syndromes (ACS), for example. First, ACS is a broad term for any condition that prevents the blood from flowing properly to the heart. Heart attack are examples of ACS, which occur as a result of blockage in the coronary arteries. The blockage is formed by platelets, or remnants of cells. While blood clots are important as they stop bleeding from a cut, they are very dangerous when formed in the arteries. As a result, individuals who are at risk are prescribed an antiplatelet medication to prevent and even reverse blockage. One popular antiplatelet
Asad U. Qamar, MD FACC, FCCP, FSGC, FACP, FSCAI Cardiologist
A D VE RT ISE M E NT E NT
medication has come under scrutiny in recent years. Dual antiplatelet therapy (DAPT), which usually consists of Plavix (clopidogrel) and acetylsalicylic acid (aspirin), seems to be related to a growing number of major cardiac events including heart attack and stroke. Researchers say that the reason is because the clopidogrel does not provide the body with enough of the ADP-mediated platelet inhibition activity it needs to be successful in preventing or reversing arterial blockage. The reasons, they say, are typically related to either interactions with other medications or a person’s genetics. A look at three different studies can shed some light on how researchers work to find new options for treating and preventing ACS. In one study, scientists looked