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By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
https://www.readbyqxmd.com/read/27846735/perioperative-management-of-dual-anti-platelet-therapy
#1
Tyler D Webster, Prashant Vaishnava, Kim A Eagle
Dual anti-platelet therapy denotes a regimen of aspirin plus a P2Y12 receptor inhibitor, clopidogrel, prasugrel, or ticagrelor. Such therapy is a cornerstone of medical management following acute coronary syndromes and is imperative following percutaneous coronary interventions. While there is uncertainty about the optimal duration of dual antiplatelet therapy following percutaneous coronary intervention, the new 2016 American College of Cardiology/American Heart Association Guidelines suggest that for patients with stable ischemic heart disease at least six months of such therapy following a drug eluting stent and one month following a bare metal stent should be implemented...
November 16, 2016: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/27720420/perioperative-thromboprophylaxis-in-severely-obese-patients-undergoing-bariatric-surgery-insights-from-a-french-national-survey
#2
Pierre-Antoine Moulin, Anne Dutour, Patricia Ancel, Pierre-Emmanuel Morange, Thierry Bege, Olivier Ziegler, Stéphane Berdah, Corinne Frère, Bénédicte Gaborit
BACKGROUND: Venous thromboembolism (VTE) is a leading cause of death in obese patients undergoing bariatric surgery (BS), but there is neither consensus nor high-level guidelines yet on VTE prophylaxis in this specific population. OBJECTIVE: We aimed to evaluate patterns of BS perioperative thromboprophylaxis practices. SETTING: French obesity specialized care centers (CSO), which are tertiary care referral hospitals for the most severe cases of obesity METHODS: A detailed questionnaire survey (11 opened, 15 closed questions) investigating their prophylactic schemes of anticoagulation (molecule, dose, weight-adjustment, duration, associated measures, follow-up) was sent to the 37 CSO...
September 1, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27551034/association-between-resting-heart-rate-and-coronary-artery-disease-stroke-sudden-death-and-noncardiovascular-diseases-a-meta-analysis
#3
Dongfeng Zhang, Weijing Wang, Fang Li
BACKGROUND: Resting heart rate is linked to risk of coronary artery disease, stroke, sudden death and noncardiovascular diseases. We conducted a meta-analysis to assess these associations in general populations and in populations of patients with hypertension or diabetes mellitus. METHODS: We searched PubMed, Embase and MEDLINE from inception to Mar. 5, 2016. We used a random-effects model to combine study-specific relative risks (RRs). We used restricted cubic splines to assess the dose-response relation...
October 18, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/26620144/peri-operative-cardiac-protection-for-non-cardiac-surgery
#4
REVIEW
S S C Wong, M G Irwin
Cardiovascular complications are an important cause of morbidity and mortality after non-cardiac surgery. Pre-operative identification of high-risk individuals and appropriate peri-operative management can reduce cardiovascular risk. It is important to continue chronic beta-blocker and statin therapy. Statins are relatively safe and peri-operative initiation may be beneficial in high-risk patients and those scheduled for vascular surgery. The pre-operative introduction of beta-blockers reduces myocardial injury but increases rates of stroke and mortality, possibly due to hypotension...
January 2016: Anaesthesia
https://www.readbyqxmd.com/read/26685134/cardiac-surgery-during-the-acute-phase-of-infective-endocarditis-discrepancies-between-european-society-of-cardiology-guidelines-and-practices
#5
Bernard Iung, Thanh Doco-Lecompte, Sidney Chocron, Christophe Strady, François Delahaye, Vincent Le Moing, Claire Poyart, François Alla, Emmanuelle Cambau, Pierre Tattevin, Catherine Chirouze, Jean-François Obadia, Xavier Duval, Bruno Hoen
AIMS: Indications for surgery in acute infective endocarditis (IE) are detailed in guidelines, but their application is not well known. We analysed the agreement between the patient's attending physicians and European Society of Cardiology guidelines regarding indications for surgery. We also assessed whether surgery was performed in patients who had an indication. METHODS AND RESULTS: From the 2008 prospective population-based French survey on IE, 303 patients with definite left-sided native IE were identified...
March 7, 2016: European Heart Journal
https://www.readbyqxmd.com/read/26126130/epidemiology-of-the-high-risk-population-perioperative-risk-and-mortality-after-surgery
#6
REVIEW
O Boehm, G Baumgarten, A Hoeft
PURPOSE OF REVIEW: This review will provide an overview of actual data concerning perioperative risk. Furthermore, strategies to prevent, detect and treat perioperative complications will be discussed. RECENT FINDINGS: Perioperative in-hospital mortality rate of 0.4-4% has not improved over the last years possibly resulting in one to several million deaths during or immediately after surgery each year worldwide. Perioperative complications and mortality are determined not only by the type of surgery but also by preexisting comorbidities of the patient...
August 2015: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/25620436/the-effort-trial-preoperative-enoxaparin-versus-postoperative-fondaparinux-for-thromboprophylaxis-in-bariatric-surgical-patients-a-randomized-double-blind-pilot-trial
#7
RANDOMIZED CONTROLLED TRIAL
Kimberley E Steele, Joseph Canner, Gregory Prokopowicz, Franco Verde, Aleksandra Beselman, Ransom Wyse, Junnan Chen, Michael Streiff, Thomas Magnuson, Anne Lidor, Michael Schweitzer
BACKGROUND: Prophylaxis for venous thromboembolism is routinely performed for all patients undergoing bariatric surgery. However, there is disagreement regarding the optimal dosing and duration of anticoagulant therapy. Furthermore, there is little data regarding the incidence of asymptomatic deep venous thrombosis (DVT) in this population. Our objective was to conduct a pilot randomized double blind study to evaluate the pharmacodynamic parameters of 2 different anticoagulation medications (enoxaparin and fondaparinux) administered to patients undergoing bariatric surgery...
May 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/24101118/risk-of-major-adverse-cardiac-events-following-noncardiac-surgery-in-patients-with-coronary-stents
#8
Mary T Hawn, Laura A Graham, Joshua S Richman, Kamal M F Itani, William G Henderson, Thomas M Maddox
IMPORTANCE: Guidelines recommend delaying noncardiac surgery in patients after coronary stent procedures for 1 year after drug-eluting stents (DES) and for 6 weeks after bare metal stents (BMS). The evidence underlying these recommendations is limited and conflicting. OBJECTIVE: To determine risk factors for adverse cardiac events in patients undergoing noncardiac surgery following coronary stent implantation. DESIGN, SETTING, AND PARTICIPANTS: A national, retrospective cohort study of 41,989 Veterans Affairs (VA) and non-VA operations occurring in the 24 months after a coronary stent implantation between 2000 and 2010...
October 9, 2013: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/25523415/2014-acc-aha-guideline-on-perioperative-cardiovascular-evaluation-and-management-of-patients-undergoing-noncardiac-surgery-executive-summary-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-practice-guidelines-developed
#9
Lee A Fleisher, Kirsten E Fleischmann, Andrew D Auerbach, Susan A Barnason, Joshua A Beckman, Biykem Bozkurt, Victor G Davila-Roman, Marie D Gerhard-Herman, Thomas A Holly, Garvan C Kane, Joseph E Marine, M Timothy Nelson, Crystal C Spencer, Annemarie Thompson, Henry H Ting, Barry F Uretsky, Duminda N Wijeysundera
No abstract text is available yet for this article.
February 2015: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/25091542/clinical-practice-guidelines-on-perioperative-cardiovascular-evaluation-collaborative-efforts-among-the-acc-aha-and-esc
#10
EDITORIAL
Jeffrey L Anderson, Elliott M Antman, John G Harold, Mariell Jessup, Patrick T O'Gara, Fausto J Pinto, Panos E Vardas, Jose L Zamorano
No abstract text is available yet for this article.
December 9, 2014: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/23904357/meta-analysis-of-secure-randomised-controlled-trials-of-%C3%AE-blockade-to-prevent-perioperative-death-in-non-cardiac-surgery
#11
REVIEW
Sonia Bouri, Matthew James Shun-Shin, Graham D Cole, Jamil Mayet, Darrel P Francis
BACKGROUND: Current European and American guidelines recommend the perioperative initiation of a course of β-blockers in those at risk of cardiac events undergoing high- or intermediate-risk surgery or vascular surgery. The Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography (DECREASE) family of trials, the bedrock of evidence for this, are no longer secure. We therefore conducted a meta-analysis of randomised controlled trials of β-blockade on perioperative mortality, non-fatal myocardial infarction, stroke and hypotension in non-cardiac surgery using the secure data...
March 2014: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/25211171/perioperative-management-of-the-patient-with-a-coronary-artery-stent
#12
REVIEW
Thomas R Vetter, Roland T Short, Mary T Hawn, Marisa B Marques
No abstract text is available yet for this article.
November 2014: Anesthesiology
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