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Top Internal Medicine Research Papers
1.
8.3
Bleeding Risk with Apixaban vs. Rivaroxaban in Acute Venous Thromboembolism.
Overall: This large randomized head-to-head trial found a clinically meaningful reduction in bleeding with apixaban using an intervention that is immediately applicable to outpatient VTE treatment, although recurrent thrombotic outcomes were not presented.
2.
8.1
Effectiveness of Nirmatrelvir/Ritonavir for Outpatients in the Era of Omicron, Vaccination, and Previous Infection: A Meta-analysis.
Overall: This large contemporary meta-analysis supports meaningful reductions in hospitalization and death with nirmatrelvir-ritonavir among higher-risk outpatients, although reliance on observational studies and absent harm data limit certainty.
3.
7.8
A meta-analysis of the long-term effects of antihypertensive therapy on the risk of major cardiovascular disease across 51 randomized trials.
Overall: A large and precise randomized-trial meta-analysis demonstrates early, modest reductions in major cardiovascular events from blood-pressure lowering, with high primary-care relevance but limited novelty and no reported harms.
4.
7.2
Pharmacotherapy for mild hypertension.
Overall: Pharmacotherapy for mild hypertension addresses a highly relevant primary care decision using patient-important outcomes, but low-certainty evidence shows no clear overall cardiovascular or mortality benefit and suggests increased treatment withdrawal.
5.
7.2
The Risk for Bleeding in Patients With Atrial Fibrillation From Concomitant Use of Apixaban or Rivaroxaban With Diltiazem Compared With Metoprolol.
Overall: This large, directly applicable US cohort identifies a practical drug-interaction concern involving serious bleeding, although residual confounding and a small absolute risk increase temper its impact.
6.
7.1
Oral Nirmatrelvir-Ritonavir for Covid-19 in Higher-Risk Outpatients.
Overall: These directly relevant randomized outpatient trials found no reduction in hospitalization or death from nirmatrelvir-ritonavir among vaccinated higher-risk adults despite lowering viral load.
7.
6.8
Recurrent venous thromboembolism and bleeding during anticoagulation in patients with deep-vein thrombosis treated with vitamin K antagonists or direct oral anticoagulants: insights from the RIETE registry.
Overall: A large real-world registry supports clinically important benefits and a tradeoff with more non-major bleeding, but residual confounding, missing absolute effects, and confirmation of established practice limit its impact.
8.
6.3
Lipoprotein(a) and Atherosclerotic Cardiovascular Disease Among Adults Aged 20 to 100 Years.
Overall: A large, precise prospective cohort demonstrates that lipoprotein(a) remains associated with clinically important ASCVD risk into advanced age, but it does not establish that testing or treatment improves patient outcomes.
9.
6.3
Early Sodium-Glucose Cotransporter-2 Inhibitor Use After Acute Kidney Injury in Type 2 Diabetes.
Overall: This well-structured observational study suggests a modest kidney benefit from earlier SGLT-2 inhibitor initiation without detected short-term safety concerns, but residual confounding and the lack of mortality or cardiovascular benefit limit immediate practice-changing certainty.
10.
6.3
Stopping or continuing chronic antihypertensive therapy during hospitalization.
Overall: This large, precise cohort reports important associations with kidney injury and mortality, but residual confounding and reverse causation substantially limit causal interpretation and immediate practice-changing value.
Score Guide:
9-10 Exceptional
7-8 Strong
5-6 Moderate
3-4 Weak
1-2 Poor
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