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https://www.readbyqxmd.com/read/28545082/clinical-endoscopic-management-and-outcome-of-post-endoscopic-sphincterotomy-bleeding
#1
Wei-Chen Lin, Hsaing-Hung Lin, Chien-Yuan Hung, Shou-Chuan Shih, Cheng-Hsin Chu
Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28544782/rationale-and-design-of-amphilimus-sirolimus-eluting-stents-versus-zotarolimus-eluting-stents-in-all-comers-requiring-percutaneous-coronary-intervention-recre8-a-multicenter-randomized-clinical-trial
#2
Rik Rozemeijer, Mèra Stein, Peter Frambach, Michiel Voskuil, Adriaan O Kraaijeveld, Ramón Rodríguez-Olivares, Leo Timmers, Bruno Pereira, Saskia Z Rittersma, Pierfrancesco Agostoni, Pieter A Doevendans, Pieter R Stella
BACKGROUND: Amphilimus sirolimus-eluting stents (A-SES) represent a novel elution technology in the current era of drug-eluting stents with promising results in patients with diabetes mellitus. At present no large trial has been designed to evaluate clinical outcomes of A-SES as compared to new-generation drug-eluting stents in unselected patients. Accordingly, we designed this trial to evaluate clinical noninferiority of A-SES as compared with zotarolimus-eluting stents (ZES) in a real-world, all-comers setting...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28544618/a-method-for-maintaining-vascular-access-when-impella-exchange-is-required
#3
B Scott Cook, Cleve Wilson, Brooke Kaiser, Raj Baljepally
A 45-year old male with no prior cardiac history, presented with cardiogenic shock in the setting of an anterolateral ST elevation myocardial infarction. We first placed a 2.5 Impella for hemodynamic support, and proceeded with emergent percutaneous coronary intervention to the proximal LAD. Several hours following percutaneous coronary intervention (PCI), the patient became acutely hypotensive and an echocardiogram revealed the Impella catheter was kinked within the left ventricle. The patient was taken back to the cath lab for Impella adjustment; however, damage to the distal catheter required the Impella be exchanged...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28544274/antithrombotic-therapy-in-end-stage-renal-disease
#4
REVIEW
Svetha Chunduri, Jon E Folstad, Tushar J Vachharajani
The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidney disease...
May 23, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28543543/cardiac-implantable-electronic-device-haematomas-risk-factors-and-effect-of-prophylactic-pressure-bandaging
#5
Youlin Koh, Nicholas E Bingham, Natalie Law, Dustin Le, Justin A Mariani
BACKGROUND: Cardiac implantable electronic device (CIED) haematomas are associated with many adverse outcomes. We examined the incidence and risk factors associated with haematoma formation post CIED implantation, and explored the preventative effect of prophylactic pressure bandaging (PPB) in a large tertiary centre. METHODS: 1091 devices were implanted during October 2011 to December 2014. Clinically significant haematomas (CSH) were those that necessitated prolonged admission, including those due to reoperation, and clinically suspicious haematomas were swellings noted by medical/nursing staff...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28543216/bridging-with-tirofiban-during-oral-antiplatelet-interruption-a-single-center-case-series-analysis-including-patients-on-hemodialysis
#6
Elizabeth A Walker, William E Dager
INTRODUCTION: Surgical patients requiring an interruption in dual-antiplatelet therapy (DAPT) within 6 months of cardiac stenting are at risk for thrombotic events. Bridging with short-acting intravenous antiplatelet agents has been proposed to minimize the risk of thrombotic and hemorrhagic complications. METHODS: This was a retrospective analysis of a tirofiban bridging strategy that did not use an initial bolus loading dose. Tirofiban infusions were initiated 24to 48 hours after the last oral antiplatelet dose at a rate of 0...
May 23, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28542316/antithrombotic-therapy-of-patients-with-atrial-fibrillation-discharged-after-major-non-cardiac-surgery-1-year-follow-up-sub-analysis-of-prague-14-study
#7
Martina Ondrakova, Zuzana Motovska, Petr Waldauf, Jiri Knot, Lukas Havluj, Lukas Bittner, Radek Bartoska, Robert Gűrlich, Martin Krbec, Valer Dzupa, Robert Grill, Petr Widimsky
BACKGROUND: The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes. METHODS: A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year. RESULTS: Antithrombotics (interrupted due to surgery) were resumed until discharge in 51...
2017: PloS One
https://www.readbyqxmd.com/read/28541859/emergency-cholecystectomy-for-patients-on-antiplatelet-therapy
#8
Keiichi Akahoshi, Takanori Ochiai, Ayumi Takaoka, Takuya Kitamura, Daisuke Ban, Atsushi Kudo, Shinji Tanaka, Minoru Tanabe
The use of antiplatelet therapy (APT) and/or anticoagulant therapy (ACT) continues to increase due to the aging population. Because the management of patients with acute cholecystitis receiving APT/ACT is still unclear, surgeons are sometimes faced with the difficult decision to delay surgery. We aimed to analyze characteristics and surgical risks of patients who underwent emergency cholecystectomy for acute cholecystitis without discontinuing APT. We conducted a retrospective review of 113 patients between 2006 and 2014...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541850/repeat-head-ct-not-necessary-for-patients-with-a-negative-initial-head-ct-on-anticoagulation-or-antiplatelet-therapy-suffering-low-altitude-falls
#9
Zachary M Bauman, John M Ruggero, Sunny Squindo, Chris McEachin, Michelle Jaskot, Will Ngo, Scott Barnes, Peter P Lopez
Anticoagulation and antiplatelet (ACAP) medications are increasingly prescribed to patients at high risk for falls. Many trauma centers have developed protocols for obtaining repeat head CT (HCT) for patients with low-altitude falls on ACAP therapy. We assess the need for routine scheduled repeat HCT in this population. Prospective, observational analysis of all low-altitude fall (<6 feet) patients on ACAP therapy evaluated at a Level II trauma center. All low-altitude fall patients with visible or suspected head trauma received an initial HCT...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28540976/antithrombotic-treatment-after-stroke-due-to-intracerebral-haemorrhage
#10
REVIEW
Luke A Perry, Eivind Berge, Joshua Bowditch, Elisabeth Forfang, Ole Morten Rønning, Graeme J Hankey, Elmer Villanueva, Rustam Al-Shahi Salman
BACKGROUND: Survivors of stroke due to intracerebral haemorrhage (ICH) are at risk of thromboembolism. Antithrombotic (antiplatelet or anticoagulant) treatments may lower the risk of thromboembolism after ICH, but they may increase the risks of bleeding. OBJECTIVES: To determine the overall effectiveness and safety of antithrombotic drugs for people with ICH. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (24 March 2017)...
May 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28540887/evaluation-of-medication-use-in-malaysian-predialysis-patients
#11
Muhammad Salman, Amer Hayat Khan, Azreen Syazril Adnan, Syed Azhar Syed Sulaiman, Naureen Shehzadi, Nauman Asif, Khalid Hussain, Fahad Saleem, Muhammed Hussnain Raza, Muhammad Shahid Farooq
Chronic kidney disease (CKD) patients suffer from multiple comorbidities and complications as a cause or consequence of kidney disease. Information regarding medication- prescribing patterns in predialysis patients is sparse. We conducted a retrospective study to evaluate the medication prescription patterns among predialysis patients. Medical records (both paper based and computerized) of patients at CKD Resource Centre, Hospital Universiti Sains Malaysia, were reviewed. A total of 615 eligible cases were included in the study...
May 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28540489/endoscopy-in-patients-on-antiplatelet-agents-and-anticoagulants
#12
REVIEW
Andrew M Veitch
Management of patients on anticoagulant or antiplatelet therapy undergoing endoscopy presents a balance of risks between haemorrhage due to the procedure, and thrombosis due to discontinuation of antithrombotic therapy. Haemorrhage is usually controllable endoscopically, but thrombosis could, on occasion, result in myocardial infarction or stroke, with permanent disability or death. For elective procedures, there is adequate time to plan best management of antithrombotic therapy. International guidelines have been published, but recommendations are based on limited evidence and consultation with appropriate medical specialists, and the patient is important...
May 25, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/28540395/management-of-atherosclerosis-risk-factors-for-patients-at-high-cardiovascular-risk-in-the-real-world-practice-a-multicentre-study
#13
Arintaya Phrommintikul, Rungroj Krittayaphong, Wanwarang Wongcharoen, Sukit Yamwong, Smonporn Boonyaratavej, Rapeephon Kunjara-Na-Ayudhya, Pyatat Tatsanavivat, Piyamitr Sritara
INTRODUCTION: Atherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions regarding the risk factors and clinical manifestations of atherosclerotic diseases as well as their management patterns. METHODS: We collected data from 25 centres in Thailand. Patients with documented coronary artery disease or cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014...
May 25, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28540312/rivaroxaban-as-an-antithrombotic-agent-in-a-patient-with-st-segment-elevation-myocardial-infarction-and-left-ventricular-thrombus-a-case-report
#14
Rajeev Seecheran, Valmiki Seecheran, Sangeeta Persad, Naveen Anand Seecheran
The incidence of left ventricular (LV) thrombi in the setting of an anterior myocardial infarction has declined significantly since the advent of primary percutaneous coronary intervention coupled with contemporary antithrombotic strategies in ST-segment elevation myocardial infarctions (STE-ACS). Despite oral anticoagulation with the currently accepted, standard-of-care vitamin K antagonist, warfarin, major bleeding complications still arise. Rivaroxaban is a novel, direct oral factor X anticoagulant that has several advantageous properties, which can attenuate bleeding risk...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28539540/antiplatelet-drug-regimen-in-patients-with-stent-thrombosis%C3%A3-insights-from-the-pesto-french-optical-coherence-tomography-registry
#15
Nicolas Amabile, Guillaume Cayla, Pascal Motreff, Charlotte Trouillet, Grégoire Range, Olivier Dubreuil, Estelle Vautrin, François Derimay, Lionel Mangin, Nicolas Meneveau, Christophe Caussin, Géraud Souteyrand
BACKGROUND: Stent thrombosis (ST) may be triggered by different phenomena, including underlying device abnormalities and modification of the antiplatelet therapy (APT) regimen. This work investigated the characteristics of APT regimens and their relationships with ST mechanisms among a large cohort of patients evaluated by optical coherence tomography (OCT).Methods and Results:A prospective multicenter registry was screened for patients with confirmed ST. OCT was performed after the initial intervention to the culprit lesion...
May 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28537000/advances-in-clinical-cardiology-2016-a-summary-of-the-key-clinical-trials
#16
REVIEW
Alastair Gray, Conor McQuillan, Ian B A Menown
INTRODUCTION: The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA)...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28533077/medical-management-of-claudication
#17
REVIEW
Elizabeth V Ratchford
Peripheral artery disease (PAD) is common and associated with significant morbidity and mortality. Optimal medical management of PAD is required for each patient, irrespective of the decision regarding lower extremity revascularization. The goals include reducing cardiovascular morbidity and mortality and improving quality of life. The approach should consist of aggressive and individualized risk factor modification including smoking cessation, antiplatelet therapy, a statin, and an angiotensin-converting enzyme inhibitor...
May 19, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28532894/-spanish-adaptation-of-the-2016-european-guidelines-on-cardiovascular-disease-prevention-in-clinical-practice
#18
Miguel Ángel Royo-Bordonada, Pedro Armario, José María Lobos Bejarano, Juan Pedro-Botet, Fernando Villar Álvarez, Roberto Elosua, Carlos Brotons Cuixart, Olga Cortés, Benilde Serrano, Miguel Camafort Babkowski, Antonio Gil Núñez, Antonio Pérez, Antonio Maiques, Ana de Santiago Nocito, Almudena de Castro, Eduardo Alegría, Ciro Baeza, María Herranz, Susana Sans, Pilar Campos
The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk...
May 19, 2017: Semergen
https://www.readbyqxmd.com/read/28531882/%C3%AE-thromboglobulin-and-incident-cardiovascular-disease-risk-the-atherosclerosis-risk-in-communities-study
#19
Yasuhiko Kubota, Alvaro Alonso, Aaron R Folsom
INTRODUCTION: Although it has been suggested that increased concentrations of activated platelet biomarkers are associated with increased risk of incident cardiovascular disease (CVD) in the general population, evidence for this association is still controversial. Thus, we tested the hypothesis that activated platelets, measured by higher concentrations of β-thromboglobulin, are associated with increased risk of incident CVD (coronary heart disease, heart failure ischemic stroke, and atrial fibrillation)...
May 17, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28530518/antiplatelet-therapy-and-clinical-outcomes-following-myocardial-infarction-among-patients-in-a-u-s-employer-based-insurance-database
#20
Mehul D Patel, David Wu, Monica Reed Chase, Panagiotis Mavros, Kim Heithoff, Mary E Hanson, Ross J Simpson
BACKGROUND: Estimates of residual cardiovascular risks among patients who have experienced a recent acute myocardial infarction (MI) are predominantly derived from secondary prevention trial populations, patient registries, and population-based cohorts. OBJECTIVE: To generate real-world evidence of antiplatelet treatment and recurrent events following MI in patients on antiplatelet treatment among commercial, employer-based insured patients in a large administrative database...
June 2017: Journal of Managed Care & Specialty Pharmacy
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