This trial tested whether intensive blood-pressure control retards the progression of chronic kidney disease in black patients with hypertension. Although there was an apparent benefit among patients with baseline proteinuria, those with a normal protein-to-creatinine ratio had no benefit.
Patients presenting with an acute coronary syndrome and referred for an invasive strategy were randomly assigned to clopidogrel at either a double or a standard loading dose and to aspirin at either a higher or a lower dose. At 30 days, there was no difference for either the clopidogrel or the aspirin dose comparison with respect to the primary outcome of cardiovascular death, myocardial infarction, or stroke.
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Some adverse events such as a failure to disinfect medical equipment have the potential to harm many patients. The authors argue that medical institutions should develop policies for addressing large-scale adverse events and should routinely disclose these events to patients, even when the risk of harm is very low.
DOI: 10.1056/NEJMp1009423
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On September 7, Consumer Union published the results of coronary-artery bypass grafting (CABG) procedures at 221 U.S. cardiac surgery programs. The voluntary reporting of risk-adjusted outcomes in approximately 20% of U.S. cardiac surgery programs is a watershed event in health care accountability.
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Published Online July 21, 2010
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Published Online July 21, 2010
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DOI: 10.1056/NEJMp1009423
DOI: 10.1056/NEJMoa0907847
DOI: 10.1056/NEJMe1008496
