Most Paroxysmal AF Patients Report Triggers Like Alcohol, Caffeine In

Three-fourths of patients with symptomatic paroxysmal atrial fibrillation identified that at least one acute experience was triggered by alcohol, caffeine intake, a bout of exercise or a lack of sleep. Among the nearly 1300 survey respondents, women and those with a family history of AF were the likeliest to report that they had such triggers and that they had multiple triggers. Those with heart failure in addition to symptomatic paroxysmal AF were among the least likely to report that their atrial arrhythmia had triggers.

The analysis was published February 14 in Heart Rhythm, with lead author Christopher A. Groh, MD, University of California, San Francisco. An occasion of drinking alcohol in 35% Consuming caffeine in 28% A bout of exercise in 23% A lack of sleep in 21%

US FDA Approves Expanded Uses for Type 2 Diabetes Drugs

Sodium-glucose cotransporter type 2 (SGLT2) inhibitor dapagliflozin

1.      Dapagliflozin + metformin extended release 

New Indication: Type 2 diabetes and moderate renal impairment, defined as chronic kidney disease with an estimated glomerular filtration rate [eGFR] of > 45 mL/min/1.73 m2. The previous label had restricted use of the medication to patients with eGFR > 60 mL/min/1.73m2. This approval is based on results of the 24-week DERIVE study of 321 patients with inadequately controlled type 2 diabetes and eGFR > 45. Dapagliflozin alone or combined with metformin is still not recommended when eGFR is < 45 and remains contraindicated in patients with severe renal impairment (eGFR <30) or end-stage renal disease, or on dialysis.

Both doses of empagliflozin are recommended for use in patients with eGFR ≥45, as is the 100-mg dose of canagliflozin. Ertugliflozin, however, is not recommended in patients with eGFR below 60 mL/min/1.73m2. 

Noninvasive Stool Test Effective for Colon Cancer Screening

 Fecal immunochemical tests (FITs), used annually, are effective for screening for colorectal cancer in average-risk, asymptomatic adults, according to a new meta-analysis published online February 25 in the Annals of Internal Medicine. The US Preventive Services Task Force currently recommends screening for CRC for persons aged 50 to 75 years using any of several options: fecal occult blood testing (a category that includes FIT), sigmoidoscopy, colonoscopy, and other tests. It does not recommend one screening modality over another.

Colonoscopy is considered to be the "gold standard" for CRC screening. Most countries, especially those in which healthcare finances are limited, use annual or biennial stool blood tests or a combination of stool testing and lower endoscopy for screening.