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Participants critically examine the trial’s results, with some emphasizing the tragic consequences of relying on surrogate outcomes in drug approval, while others explore causality and the broader implications for patient safety; their tone and focus suggest a collective acknowledgment of how pivotal the CAST study was in reshaping cardiac treatment approaches.
All discussions emphasize the harmful effects of anti-arrhythmic drugs, especially flecainide, aligning with the study's findings that such medications increase mortality, reflecting strong agreement.
The detailed references to specific trials, mortality outcomes, and the controversy surrounding drug safety suggest a high level of curiosity and concern among participants.
Many users actively analyze causality, discuss implications, and reference related studies, indicating deep engagement and thoughtful consideration.
The discussions highlight the profound influence of the CAST findings on cardiology practice, drug regulation, and clinical guidelines, illustrating significant impact.
@epfellow @SergioPinski Beta-blocker therapy in the Cardiac Arrhythmia Suppression Trial. CAST Investigators. Kennedy HL1, Brooks MM, Barker AH, Bergstrand R, Huther ML, Beanlands DS, Bigger JT, Goldstein S. Am J Cardiol. 1994 Oct 1;74(7):674-80. https://t.co/vogi4hpoZA https://t.co/unIHKuwzHq
@simplify_drugs CAST Trial Findings: The Cardiac Arrhythmia Suppression Trial (CAST) showed that the use of Flecainide and other Class IC antiarrhythmics in patients with a history of myocardial infarction increased mortality due to the proarrhythmic effects.
RX The Cardiac Arrhythmia Suppression Trial or CAST was cardiology’s humbling moment. https://t.co/Tc6uKrM7o7 https://t.co/EqAlgyiUvN
@nicknorwitz Causality is not overrated is the first and most important step to discuss an interventional study. What the putative effect of this intervention could be, is another debate. The Cardiac Arrhythmia Suppression Trial (CAST) found that flecainide significantly increased mortality
@RWJE_BA @Stefan11005620 @f2harrell @dylanarmbruste3 @yudapearl @matloff @mzloteanu @doc_BLocke We also have a classic case to consider where RCT used for FDA approval of Class Ic antiarrhythmics using the wrong surrogate outcome Y (reduction in PVCs) led to massive deaths. Later a second RCT the Cardiac Arrhythmia Suppression Trial (CAST) using a mortality endpoint
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@RWJE_BA @Stefan11005620 @f2harrell @dylanarmbruste3 @yudapearl @matloff @mzloteanu @doc_BLocke We also have a classic case to consider where RCT used for FDA approval of Class Ic antiarrhythmics using the wrong surrogate outcome Y (reduction in PVCs) led to massive deaths. Later a second RCT the Cardiac Arrhythmia Suppression Trial (CAST) using a mortality endpoint
@nicknorwitz Causality is not overrated is the first and most important step to discuss an interventional study. What the putative effect of this intervention could be, is another debate. The Cardiac Arrhythmia Suppression Trial (CAST) found that flecainide significantly increased mortality
@simplify_drugs CAST Trial Findings: The Cardiac Arrhythmia Suppression Trial (CAST) showed that the use of Flecainide and other Class IC antiarrhythmics in patients with a history of myocardial infarction increased mortality due to the proarrhythmic effects.
RX The Cardiac Arrhythmia Suppression Trial or CAST was cardiology’s humbling moment. https://t.co/Tc6uKrM7o7 https://t.co/EqAlgyiUvN
Mas também aumentaram a ocorrência de PARADA CARDÍACA e MORTE!!!! (pra quem quiser ler: N Engl J Med. 1989 Aug 10;321(6):386-8. doi: 10.1056/NEJM198908103210608.)
@epfellow @SergioPinski Beta-blocker therapy in the Cardiac Arrhythmia Suppression Trial. CAST Investigators. Kennedy HL1, Brooks MM, Barker AH, Bergstrand R, Huther ML, Beanlands DS, Bigger JT, Goldstein S. Am J Cardiol. 1994 Oct 1;74(7):674-80. https://t.co/vogi4hpoZA https://t.co/unIHKuwzHq
doi:10.1056/NEJM198908103210608. 801. van Oort RJ, McCauley MD, Dixit SS, Pereira L, Yang Y, Respress 787. Singh BN. Controlling cardiac arrhythmias: to ...
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