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https://www.readbyqxmd.com/read/29161389/innovations-in-management-of-cardiac-disease-drugs-treatment-strategies-and-technology
#1
P Foëx
Within the last generation, the management of patients with heart disease has been transformed by advances in drug treatments, interventions and diagnostic technologies. The management of arterial hypertension saw beta-blockers demoted from first- to third-line treatment. Recent studies suggest that the goal of treatment may have to change to lower systolic blood pressures to prevent long-term organ damage. Today less than 15% of coronary revascularizations are surgical and more than 85% are done by interventional cardiologists inserting coronary stents...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29160765/antithrombotic-treatment-in-peripheral-artery-disease
#2
Dan-Mircea Olinic, Dan Alexandru Tataru, Calin Homorodean, Mihail Spinu, Maria Olinic
This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke...
November 21, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29158964/ginsenoside-rk1-bioactivity-a-systematic-review
#3
Abdelrahman Elshafay, Ngo Xuan Tinh, Samar Salman, Yara Saber Shaheen, Eman Bashir Othman, Mohamed Tamer Elhady, Aswin Ratna Kansakar, Linh Tran, Le Van, Kenji Hirayama, Nguyen Tien Huy
Ginsenoside Rk1 (G-Rk1) is a unique component created by processing the ginseng plant (mainly Sung Ginseng (SG)) at high temperatures. The aim of our study was to systematically review the pharmacological effects of G-Rk1. We utilized and manually searched eight databases to select in vivo and in vitro original studies that provided information about biological, pharmaceutical effects of G-Rk1 and were published up to July 2017 with no restriction on language or study design. Out of the 156 papers identified, we retrieved 28 eligible papers in the first skimming phase of research...
2017: PeerJ
https://www.readbyqxmd.com/read/29157949/non-pci-cabg-therapies-for-refractory-angina
#4
REVIEW
Ki E Park, C Richard Conti
Angina persists for many patients despite modern medical therapy and/or revascularization, and this is referred to as refractory angina. All patients with refractory angina must be treated with aggressive risk factor modification plus optimized medical management. β-Blockers and nitrates are usually first-line agents; however most patients require multiple medications for refractory symptom control. Novel agents, such as ranolazine and ivabradine, as well as non-pharmacologic therapies, such as enhanced external counterpulsation and cardiac rehabilitation, may provide relief or reduction of angina...
October 20, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29157195/management-of-transient-ischemic-attacks-diagnosed-by-early-career-general-practitioners-a-cross-sectional-study
#5
Andrew R Davey, Daniel S Lasserson, Christopher R Levi, Amanda Tapley, Simon Morgan, Kim Henderson, Elizabeth G Holliday, Jean Ball, Mieke L van Driel, Lawrie McArthur, Neil A Spike, Parker J Magin
Background Transient ischemic attack incurs a risk of recurrent stroke that can be dramatically reduced by urgent guideline-recommended management at the point of first medical contact. Aims This study describes the prevalence and associations of new transient ischemic attack presentations to general practice registrars and the management undertaken. Methods A cross-sectional analysis of the Registrar Clinical Encounters in Training cohort study. General practice registrars from five Australian states (urban to very remote practices) collected data on 60 consecutive patient encounters during each of their three six-month training terms...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29156999/risk-factors-for-intracranial-lesions-and-mortality-in-older-patients-with-mild-traumatic-brain-injuries
#6
Ma Angustias Ibañez Pérez De La Blanca, Enrique Fernández Mondéjar, Francisco Javier Gómez Jimènez, Jóse María Alonso Morales, Ma Dolores Quijano Lombardo, Juan Luis Viso Rodriguez
PRIMARY OBJECTIVE: To identify risk factors for intracerebral lesion (ICL) in older adults with mild traumatic brain injury (MTBI) and evaluate the influence of comorbidities on outcomes. RESEARCH DESIGN: Prospective cohort study. METHODS AND PROCEDURES: Information was gathered on clinical history/examination, cranial computed tomography, admission Glasgow Coma Scale (GCS) score, analytical and coagulation findings, and mortality at 1 week post-discharge...
November 20, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29156506/lower-gastrointestinal-bleeding-in-patients-with-coronary-artery-disease-on-antithrombotics-and-subsequent-mortality-risk
#7
Parita Patel, Neha Nigam, Neil Sengupta
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common complication for patients with coronary artery disease (CAD) due to use of antithrombotic medications. Limited data exists describing which patients are at increased risk for mortality. AIM: To 1) determine whether patients on dual antiplatelet (DAPT) therapy or triple therapy are at higher risk of 90-day and 6-month mortality compared to patients on aspirin (ASA) alone and 2) evaluate risk factors for mortality in patients with CAD on antithrombotics hospitalized with LGIB...
November 20, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29153510/resumption-of-antiplatelet-therapy-in-patients-with-primary-intracranial-hemorrhage-benefits-and-risks-a-meta-analysis-of-cohort-studies
#8
REVIEW
Xueying Ding, Xi Liu, Changhong Tan, Maojia Yin, Teng Wang, Ying Liu, Lijuan Mo, Xin Wei, Xinjie Tan, Fen Deng, Lifen Chen
BACKGROUND: Clinical disagreement over antiplatelet (AP) resumption in patients with primary intracranial hemorrhage (ICH) has long existed. This meta-analysis aimed to evaluate the benefits of AP resumption on preventing ischemic or thromboembolic events against its risks of promoting ICH recurrence or hematoma expansion. METHODS: All relevant articles published in Pubmed, EMBASE, the Cochrane Library, and Science Direct from January 1950 to March 2017 were sourced, and the combined relative risk (RR) was calculated...
November 10, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29153343/prevalence-of-anemia-in-hospitalized-internal-medicine-patients-correlations-with-comorbidities-and-length-of-hospital-stay
#9
Carlo Zaninetti, Catherine Klersy, Concetta Scavariello, Raffaella Bastia, Carlo L Balduini, Rosangela Invernizzi
BACKGROUND: Several studies have documented a linear growth of the prevalence of anemia with aging. Especially in hospitalized elderly patients, anemia can aggravate the course of chronic disorders, and ultimately get worse the clinical outcomes. METHODS: To evaluate the distribution, the main causes, and the possible correlations of anemia with comorbidities and length of hospitalization in a population of internal medicine inpatients, we carried out an observational study on a cohort of 923 consecutive admissions relative to 856 subjects...
November 16, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29152293/allogeneic-hematopoietic-cell-transplantation-in-an-adult-patient-with-glanzmann-thrombasthenia
#10
Ana R Cid, Pau Montesinos, Isabel Sánchez-Guiu, Saturnino Haya, Jose I Lorenzo, Jaime Sanz, Federico Moscardo, Nieves Puig, Dolores Planelles, Santiago Bonanad, Guillermo F Sanz, Vicente Vicente, Consuelo González-Manchón, María L Lozano, José Rivera, Miguel A Sanz
Glanzmann thrombasthenia is a rare bleeding disorder that can present life-threatening bleeding. Our patients develop antiplatelet antibodies that become refractory to any pharmacological treatment. Allogeneic hematopoietic stem-cell transplantation is the only currently curative procedure, but has major risks mainly in adult; indeed, our patient died.
November 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/29151439/clopidogrel-or-ticagrelor-in-acute-coronary-syndrome-patients-treated-with-newer-generation-drug-eluting-stents-change-dapt
#11
Paolo Zocca, Liefke C van der Heijden, Marlies M Kok, Marije M Löwik, Marc Hartmann, Martin G Stoel, J W Louwerenburg, Frits H A F de Man, Gerard C M Linssen, Iris L Knottnerus, Carine J M Doggen, K Gert van Houwelingen, Clemens von Birgelen
AIMS: Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). METHODS AND RESULTS: CHANGE DAPT (clinicaltrials.gov: NCT03197298) assessed 2,062 consecutive real-world ACS patients, treated by percutaneous coronary intervention (PCI), the primary composite endpoint being net adverse clinical and cerebral events (NACCE: all-cause death, any myocardial infarction, stroke or major bleeding)...
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29151434/dual-antiplatelet-therapy-after-acute-coronary-syndromes-no-time-for-a-change
#12
Davide Capodanno
No abstract text is available yet for this article.
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29150850/comparison-of-pharmacodynamic-effects-of-ticagrelor-vs-prasugrel-in-type-2-diabetes-mellitus-patients-with-coronary-heart-disease
#13
L-L Shang, D-D Guo, H-Y Zhao, A-J Quan, P-G Cao
WHAT IS KNOWN AND OBJECTIVE: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of thrombotic complications. Studies have indicated that patients with T2DM have impaired clopidogrel-induced antiplatelet effect. Ticagrelor and prasugrel are two latest generation P2Y12 inhibitors with advantageous platelet inhibitory profiles. However, the pharmacodynamic differences between the two drugs in patients with T2DM remain poorly explored. METHODS: This study, involving 140 patients with T2DM following percutaneous coronary intervention (PCI), evaluated the efficacy of aspirin upon concomitant use of prasugrel (10 mg/d) or ticagrelor (90 mg/d)...
November 17, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29150806/ticagrelor-a-review-in-long-term-secondary-prevention-of-cardiovascular-events
#14
Zaina T Al-Salama, Gillian M Keating, Susan J Keam
Ticagrelor (Brilique(®)) is an orally administered P2Y12 inhibitor. A long-term (maintenance) regimen of ticagrelor 60 mg twice daily is indicated in the EU for coadministration with low-dose aspirin 75-150 mg/day for the secondary prevention of atherothrombotic events in high-risk patients with a history of myocardial infarction (MI) of at least 1 year. Approval is based on the results of the PEGASUS-TIMI 54 trial that compared ticagrelor with placebo (in conjunction with low-dose aspirin) in stable patients who had had a spontaneous MI 1-3 years prior to enrolment and were at high risk of atherothrombotic events...
November 18, 2017: Drugs
https://www.readbyqxmd.com/read/29147971/-antiplatelet-or-anticoagulative-strategies-after-surgical-interventional-valve-treatment
#15
A Jobs, T Stiermaier, S Klotz, I Eitel
At the end of August 2017 the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) published new joint guidelines for the treatment of valvular heart disease. These guidelines incorporate the scientific progress since the last version of the guidelines published in 2012. This article reviews current guideline recommendations for antiplatelet and anticoagulative therapy after surgical/interventional treatment of the aortic and mitral valves and discusses the underlying scientific evidence...
November 16, 2017: Herz
https://www.readbyqxmd.com/read/29147130/mobile-mass-in-the-aortic-arch-a-case-report
#16
Fatemeh Ghani-Dehkordi, Rostam Esfandiyari-Bakhtiyari, Firoozeh Alirezaee-Shahraki
BACKGROUND: The finding of a floating mass in the aortic arch is rare and the management remains controversial. CASE REPORT: We describe a 42-year-old woman with an embolic infarction in whom transesophageal echocardiography revealed a mobile mass in the aortic arch that was characterized as atherothrombi with an evidence of embolic infarction in the territory of the middle cerebral artery. Treatment with antiplatelet and anticoagulants failed to resolve the mass and is surgically resected...
July 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29146610/association-between-stroke-risk-and-metformin-use-in-hemodialysis-patients-with-diabetes-mellitus-a-nested-case-control-study
#17
Li-Nien Chien, Chu-Lin Chou, His-Hsien Chen, Chih-Chin Kao, Yen-Chung Lin, Yueh-Lin Wu, Jin-Shuen Chen, Li-Ying Chen, Te-Chao Fang
BACKGROUND: Metformin use reduces the incidence and severity of stroke in patients with type 2 diabetes mellitus (DM). The benefits of metformin for stroke have not been examined in hemodialysis patients with DM. METHODS AND RESULTS: Using the National Health Insurance Research Database, we identified 17 760 patients with DM and new-onset hemodialysis between 2001 and 2013. Of these, 1898 patients hospitalized for either ischemic or hemorrhagic stroke were matched to 7592 control patients according to sex, age, and year of initial hemodialysis therapy by using incidence sampling...
November 16, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29146276/perioperative-management-of-oral-anticoagulation-in-patients-undergoing-implantation-of-subcutaneous-implantatble-defibrillator
#18
Muhammad R Afzal, Divyesh Mehta, Christopher Evenson, Daniel Pinkhas, Auroa Badin, Dilesh Patel, Michael K Essandoh, Hemant Godara, Jaret Tyler, Mahmoud Houmsse, Zhenguo Liu, Steven J Kalbfleisch, John D Hummel, Ralph Augostini, Raul Weiss, Emile G Daoud, Toshimasa Okabe
BACKGROUND: The perioperative anticoagulation management for subcutaneous implantable cardioverter defibrillator (S-ICD) is still evolving. OBJECTIVE: To assess whether it is safe to perform S-ICD implantation with uninterrupted warfarin. METHODS: This is a single-center retrospective review of patients undergoing S-ICD implantation during 10/2012 to 6/2017. The most common indication for the implantation was primary prevention of sudden cardiac death...
November 13, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29146096/ten-year-review-of-isolated-spontaneous-mesenteric-arterial-dissections
#19
Courtney E Morgan, Neel A Mansukhani, Mark K Eskandari, Heron E Rodriguez
OBJECTIVE: Isolated spontaneous dissection of the superior mesenteric artery (SMA) and celiac artery (CA) remains a rare condition; however, it has been increasingly noted incidentally on diagnostic imaging. The purpose of this study was to examine the natural history and outcomes of patients presenting with isolated spontaneous mesenteric artery dissection (SMAD). We hypothesized that most SMADs can be treated nonoperatively. METHODS: This was a single-center retrospective review of patients presenting with the diagnosis of SMAD between 2006 and 2016...
November 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29145340/open-repair-of-intraoperative-popliteal-artery-injury-during-total-knee-arthroplasty-in-a-patient-with-severe-hemophilia-a-a-case-report-and-literature-review
#20
Bin Feng, Ke Xiao, Jiang Shao, Yu Fan, Xisheng Weng
RATIONALE: Arterial injuries during total knee arthroplasty (TKA) though rare may occur. Hemophilia may further challenge the management of such injury. PATIENT CONCERNS: A 48-year-old male patient with severe hemophilia type A and stiff knee arthropathy underwent bilateral TKAs. Left popliteal artery injury was detected at the end of the left TKA. DIAGNOSES: Urgent angiography confirmed the diagnosis of the left popliteal artery transection...
November 2017: Medicine (Baltimore)
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