Tuttle KR. Charting new territory by simulated modeling of a clinical trial. Clin J Am Soc Nephrol 5:750-752,2010

Cardiovascular disease (CVD) remains one of the most common comorbidities and causes of death among patients who are treated for ESRD by hemodialysis (1). On the basis of an extensive body of clinical trial evidence, across a spectrum of high CVD risk states from prevalent disease to primary prevention, statin therapy for LDL cholesterol lowering has emerged as one of the most important strategies to reduce risk in populations without ESRD (2-5). By logical extension, two clinical trials to date (Die Deutsche Diabetes Dialyze Studie [4D Study] and A Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events [AURORA]) evaluated whether statin therapy was effective for CVD risk reduction in patients with hemodialysis-treated ESRD (6,7). Neither study found a statistically significant benefit on the primary outcomes, whereas some indication of harm related to statin therapy emerged.

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Saha SA and Tuttle KR. Influence of glycemic control on the development of diabetic cardiovascular and kidney disease. Cardiol Clin 28:497-516,2010.

 Diabetes mellitus leads to the development of a host of micro- and macrovascular complications, which collectively lead to substantial morbidity and mortality. Among the microvascular complications of diabetes, diabetic kidney disease is the most common. Macrovascular complications from diabetes lead to a 2- to 4-fold increase in the incidence of cardiovascular disease and up to twice the mortality from cardiovascular causes as compared with nondiabetic individuals. This article discusses the various drug classes used to treat diabetes mellitus, and reviews the current clinical evidence linking glycemic control using these drug classes on diabetic kidney and cardiovascular disease.

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Raabe RD, Burr RB, Short R.  One-year cognitive outcomes associated with carotid artery stent placement.  J Vasc Interv Radiol 21:983-988;2010.

Purpose
To assess relatively long-term (ie, 1 year) neurocognitive outcomes of patients undergoing carotid artery stent (CAS) placement with cerebral protection.

Materials and Methods
Sixty-two patients (19 symptomatic; mean age, 73 years) with significant carotid stenosis (≥ 70% for symptomatic patients, ≥ 80% for asymptomatic patients) underwent CAS placement with embolic protection. Cognitive function was assessed prospectively with use of a battery of standardized tests administered at baseline (1-5 days before CAS endovascular therapy) and at 3, 6, and 12 months after CAS placement. Diffusion-weighted imaging (DWI) was performed before the procedure and within 24 hours after CAS placement.

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