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Cardiac Risk Management

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1. CCS guidelines on perioperative cardiac risk assessment and management for patients undergoing noncardiac surgery

CCS guidelines on perioperative cardiac risk assessment and management for patients undergoing noncardiac surgery Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery - Canadian Journal of Cardiology Email/Username: Password: Remember me Search Terms Search within Search Share this page Access provided by Volume 33, Issue 1, Pages 17–32 Canadian Cardiovascular Society Guidelines on Perioperative Cardiac (...) ., Djulbegovic, B., and Akl, E.A. Guideline panels should not GRADE good practice statements. J Clin Epidemiol . 2015 ; 68 : 597–600 | | | | | Preoperative Cardiac Risk Assessment Accurate preoperative cardiac risk estimation can serve several functions. Valid estimates of the risks and benefits of surgery can facilitate informed decision-making about the appropriateness of surgery. Accurate cardiac risk estimation can also guide management decisions (eg, consideration of endovascular vs open surgical

2016 Canadian Cardiovascular Society

2. Preoperative cardiac risk assessment

Preoperative cardiac risk assessment Preoperative cardiac risk assessment - Medical information | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Preoperative cardiac risk assessment Last reviewed: February 2019 Last updated: June 2018 Summary Approximately 27 million patients undergo non-cardiac surgery every year in the US. Gregoratos G. Current guideline-based preoperative evaluation provides the best management of patients undergoing noncardiac (...) . Patients over 65 years of age are at higher risk of cardiac disease, cardiac morbidity, and death. Considering that this patient population will greatly increase over the coming decades, the number of patients with significant perioperative cardiac risk undergoing non-cardiac surgery can be expected to increase globally. Most perioperative cardiac morbidity and mortality is related to MI, heart failure, or arrhythmias. Therefore, preoperative evaluation and perioperative management emphasise

2018 BMJ Best Practice

3. Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation

Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2013 PedsCCM Evidence-Based Journal Club

4. Subjective correlates of stress management in outpatient cardiac rehabilitation: the predictive role of perceived heart risk factors (PubMed)

Subjective correlates of stress management in outpatient cardiac rehabilitation: the predictive role of perceived heart risk factors Introduction: The causal attributions and perceived risk factors can affect patients' health behaviors. Therefore, the present study aimed to assess (i) the effect of an outpatient cardiac rehabilitation (CR) program on perceived heart risk factors (PHRFs) and on psychological stress, and (ii) the role of changes of PHRFs at pre-post CR in predicting changes (...) components of CR's stress reduction. Practitioners should focus on patients' perception of risk factors to facilitate stress management in CR program.

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2018 Journal of cardiovascular and thoracic research

5. Osborn waves following out-of-hospital cardiac arrest-Effect of level of temperature management and risk of arrhythmia and death. (PubMed)

Osborn waves following out-of-hospital cardiac arrest-Effect of level of temperature management and risk of arrhythmia and death. The Osborn or J-wave, an upright deflection of the J-point on the electrocardiogram (ECG), is often observed during severe hypothermia. A possible relation between Osborn waves (OW) and increased risk of ventricular arrhythmia has been reported. We sought to determine whether the level of targeted temperature management (TTM) following out-of-hospital cardiac arrest (...) (OHCA) affects the prevalence of OW and to assess the associations between OW and risk of ventricular arrhythmia and death.The present study is part of the TTM-trial ECG-substudy (including OHCA-patients randomized to TTM at 33 °C vs. 36 °C from 24 of 36 sites). Serial 12-lead ECGs from 680 (94%) patients were analysed and stratified by OW at predefined time-points (0, 4, 28, 36, 72-h after admission). On admission, the overall prevalence of OW was 16%, increasing to 32% at target temperature

2018 Resuscitation

6. Management of Antiplatelet Therapy among Patients Undergoing Elective Non-Cardiac Surgery

of Antiplatelet Therapy among Patients Undergoing Elective Non-Cardiac Surgery The perioperative management of antiplatelet therapy (APT) for patients with cerebrovascular or peripheral vascular diseases remains unclear. All patients with symptomatic peripheral artery disease are recommended to be on APT, typically monotherapy with either aspirin or clopidogrel. However, dual APT (DAPT, typically with aspirin and clopidogrel) is common, especially among the highest-risk patients – those following endovascular (...) procedures for critical limb ischemia. The duration of APT for vascular disease is usually life-long unless a significant bleeding event occurs. The perioperative management of APT in the setting of elective non-cardiac surgery, specifically the decision about whether to stop APT before surgery and for how long, requires balancing overall thrombotic risk against the risk of bleeding with surgery. To help clinicians, patients, and policymakers with this important decision, this systematic review examined

2017 Veterans Affairs - R&D

7. Randomised controlled trial: Stress management training should be an integral component of cardiac rehabilitation

be an integral component of cardiac rehabilitation Barbara M Murphy 1 , 2 , 3 , 4 Statistics from Altmetric.com Commentary on: Blumenthal JA , Sherwood A , Smith PJ , et al . Enhancing cardiac rehabilitation with stress management training: a randomized, clinical efficacy trial . Context There is mounting evidence that psychosocial risk factors, including stress, anxiety, depression and social isolation, impede recovery after acute cardiac events and are associated with increased morbidity and premature (...) death. 1 While cardiac rehabilitation (CR) is the standard care for patients after an acute event, and has been shown to improve survival, 2 it does not routinely address psychosocial risks or assist patients in self-management of these factors. The present study investigated the impact of including stress management training (SMT) within CR, in terms of stress … Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright

2017 Evidence-Based Medicine (Requires free registration)

8. 2017 ACC/AHA/HFSA/ISHLT/ACP Advanced Training Statement on Advanced Heart Failure and Transplant Cardiology (Revision of the ACCF/AHA/ACP/HFSA/ISHLT 2010 Clinical Competence Statement on Management of Patients With Advanced Heart Failure and Cardiac Trans

2017 ACC/AHA/HFSA/ISHLT/ACP Advanced Training Statement on Advanced Heart Failure and Transplant Cardiology (Revision of the ACCF/AHA/ACP/HFSA/ISHLT 2010 Clinical Competence Statement on Management of Patients With Advanced Heart Failure and Cardiac Trans 2017 Advanced Training Statement on Advanced Heart Failure and Transplant Cardiology - American College of Cardiology ') ') } Search All Types Search or Menu Share via: Print Font Size A A A Authors: Jessup M, Drazner MH, Book W, et al (...) . Citation: The following are key points to remember about this revised Advanced Training Statement on Advanced Heart Failure and Transplant Cardiology (AHFTC): This Advanced Training Statement addresses the added competencies required of subspecialists in AHFTC for diagnosis and management at a high level of skill of patients with heart failure who may also undergo placement of mechanical circulatory support (MCS) devices or cardiac transplantation. The training is intended to complement the basic

2017 American Heart Association

9. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Gui

2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Gui 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search (...) March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: Executive Summary A Report of the American

2017 American Heart Association

10. 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Hea

, the AHA, and the HRS; and endorsed by the HFSA. 1.4. Scope of the Guideline The purpose of this AHA/ACC/HRS document is to provide a contemporary guideline for the management of adults who have VA or who are at risk for SCD, including diseases and syndromes associated with a risk of SCD from VA. This guideline supersedes the “ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.” It also supersedes some sections of the “ACC/AHA (...) 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Hea 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019

2017 American Heart Association

11. Systematic Review for the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Pract

Systematic Review for the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Pract Systematic Review for the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death | Circulation Search Hello Guest! Login to your account Email Password Keep me logged (...) in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019 January 2019 January 2019 January 2019 This site uses cookies. By continuing to browse this site you are agreeing to our use of cookies. Free Access article Share on Jump to Free Access article Systematic Review for the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death A Report

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2017 American Heart Association

12. Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association

in severity but complicates the evaluation and management. Emery-Dreifuss Muscular Dystrophy EDMD is another nondystrophinopathy with associated cardiac involvement characterized by early-onset joint contractures (elbows, ankles, and cervical spine), slowly progressive muscle weakness, and cardiac conduction defects that increase the risk of sudden death. EDMD has significant clinical variability and is caused by mutations in genes that code for nuclear envelope proteins. X-linked EDMD, the prevalence (...) Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association Management of Cardiac Involvement Associated With Neuromuscular Diseases: A Scientific Statement From the American Heart Association | Circulation Search Hello Guest! Login to your account Email Password Keep me logged in Search March 2019 March 2019 March 2019 March 2019 March 2019 February 2019 February 2019 February 2019 February 2019 January 2019 January 2019

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2017 American Heart Association

13. Management of Cardiac Arrest due to Trauma

and hospital teams managing trauma patients who are peri-arrest or in cardiac arrest. However, the equipment, skills and experience required to provide many of the interventions described will not exist in all circumstances. Nothing in this guideline suggests that first-aiders or clinicians should work outside their scope of practice, or perform procedures for which they have insufficient training. Particularly with respect to highly invasive procedures such as resuscitative thoracotomy, the risk (...) Management of Cardiac Arrest due to Trauma ANZCOR Guideline 11.10.1 April 2016 Page 1 of 11 ANZCOR Guideline 11.10.1 Management of Cardiac Arrest due to Trauma Summary To whom does this guideline apply? This guideline applies to adult and paediatric patients in cardiac arrest, or peri-arrest, due to physical trauma. Specific isolated traumatic mechanisms such as near-hanging and burns are not addressed. Who is the audience for this guideline? This guideline applies to first-aiders, prehospital

2016 Australian Resuscitation Council

14. Impella 2.5 System (Abiomed Inc.) for cardiac support in patients undergoing high-risk percutaneous coronary intervention

Impella 2.5 System (Abiomed Inc.) for cardiac support in patients undergoing high-risk percutaneous coronary intervention Impella 2.5 System (Abiomed Inc.) for cardiac support in patients undergoing high-risk percutaneous coronary intervention Impella 2.5 System (Abiomed Inc.) for cardiac support in patients undergoing high-risk percutaneous coronary intervention HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Impella 2.5 System (Abiomed Inc.) for cardiac support in patients undergoing high-risk percutaneous coronary intervention. Lansdale: HAYES, Inc. Healthcare Technology Brief Publication. 2017 Authors' conclusions Health Problem: Patients undergoing percutaneous coronary intervention (PCI) may be considered high risk based on a variety of factors, including advanced age, comorbidities, and lesion-specific

2017 Health Technology Assessment (HTA) Database.

15. Predicting risk of cardiac events among ST-segment elevation myocardial infarction patients with conservatively managed non-infarct-related artery coronary artery disease: An analysis of the Duke Databank for Cardiovascular Disease. (PubMed)

Predicting risk of cardiac events among ST-segment elevation myocardial infarction patients with conservatively managed non-infarct-related artery coronary artery disease: An analysis of the Duke Databank for Cardiovascular Disease. Recent randomized evidence has demonstrated benefit with complete revascularization during the index hospitalization for multivessel coronary artery disease ST-segment elevation myocardial infarction (STEMI) patients; however, this benefit likely depends on the risk (...) of future major adverse cardiovascular events (MACE).Using data from Duke University Medical Center (2003-2012), we identified those at high risk for 1-year MACE among 664 STEMI patients with conservatively managed non-infarct-related artery (non-IRA) lesions. Using multivariable logistic regression, we identified clinical and angiographic characteristics associated with MACE (death, myocardial infarction, urgent revascularization) to 1 year and developed an integer-based risk prediction model

2017 American Heart Journal

16. Alternative sedative reduces the risk of acute kidney injury following cardiac surgery

assessment of risk factors, to inform a clinical management plan. At present, no specific advice is given regarding pharmacological interventions to reduce the risk of kidney injury. There is no plan to update this guideline in the near future. What are the implications? Renal protection during cardiac and aortic surgery has been extensively studied. This meta-analysis provides a good foundation for future investigations of a new class of drug in this setting. The included trials were of variable quality (...) Alternative sedative reduces the risk of acute kidney injury following cardiac surgery Alternative sedative reduces the risk of acute kidney injury following cardiac surgery Discover Portal Discover Portal Alternative sedative reduces the risk of acute kidney injury following cardiac surgery Published on 10 July 2018 doi: The sedative drug dexmedetomidine can reduce the risk of acute kidney injury when given during non-emergency cardiac surgery. Trial participants who received dexmedetomidine

2019 NIHR Dissemination Centre

17. Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. (PubMed)

Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study. To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest.Cohort study between January 2014 and December 2016.Nationwide, population based registry in Japan (All-Japan Utstein Registry).Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first (...) ). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35).In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.Published by the BMJ Publishing Group Limited. For permission

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2019 BMJ

18. Prevention and Management of Cardiovascular Disease Risk in Primary Care

Prevention and Management of Cardiovascular Disease Risk in Primary Care PEER SIMPLIFIED GUIDELINE: PREVENTION AND MANAGEMENT OF CARDIOVASCULAR DISEASE RISK IN PRIMARY CARE Clinical Practice Guideline | February 2015 These recommendations are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. They should be used as an adjunct to sound clinical decision making. OBJECTIVE Alberta primary care (...) clinicians and their teams offer primary and secondary prevention for cardiovascular disease (CVD) focused on CVD risk estimation and lipid management. TARGET POPULATION Men aged 40-75 Women aged 50-75 (optional start at age 40 for simplicity) EXCLUSIONS Men and women of any age with previously diagnosed familial hypercholesterolemia RECOMMENDATIONS ? Screen for CVD risk beginning at age 40 for men and 50 for women. PRACTICE POINT Always use a risk calculator with every lipid measurement to assess CVD

2016 Toward Optimized Practice

19. High-Target Versus Low-Target Blood Pressure Management During Cardiopulmonary Bypass to Prevent Cerebral Injury in Cardiac Surgery Patients: A Randomized Controlled Trial

High-Target Versus Low-Target Blood Pressure Management During Cardiopulmonary Bypass to Prevent Cerebral Injury in Cardiac Surgery Patients: A Randomized Controlled Trial Cerebral injury is an important complication after cardiac surgery with the use of cardiopulmonary bypass. The rate of overt stroke after cardiac surgery is 1% to 2%, whereas silent strokes, detected by diffusion-weighted magnetic resonance imaging, are found in up to 50% of patients. It is unclear whether a higher versus (...) diffusion-weighted imaging conducted preoperatively and again postoperatively between days 3 and 6. Secondary outcomes included diffusion-weighted imaging-evaluated total number of new ischemic lesions.Among the 197 enrolled patients, mean (SD) age was 65.0 (10.7) years in the low-target group (n=99) and 69.4 (8.9) years in the high-target group (n=98). Procedural risk scores were comparable between groups. Overall, diffusion-weighted imaging revealed new cerebral lesions in 52.8% of patients in the low

2018 EvidenceUpdates

20. Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. (PubMed)

Dabigatran in patients with myocardial injury after non-cardiac surgery (MANAGE): an international, randomised, placebo-controlled trial. Myocardial injury after non-cardiac surgery (MINS) increases the risk of cardiovascular events and deaths, which anticoagulation therapy could prevent. Dabigatran prevents perioperative venous thromboembolism, but whether this drug can prevent a broader range of vascular complications in patients with MINS is unknown. The MANAGE trial assessed the potential (...) of dabigatran to prevent major vascular complications among such patients.In this international, randomised, placebo-controlled trial, we recruited patients from 84 hospitals in 19 countries. Eligible patients were aged at least 45 years, had undergone non-cardiac surgery, and were within 35 days of MINS. Patients were randomly assigned (1:1) to receive dabigatran 110 mg orally twice daily or matched placebo for a maximum of 2 years or until termination of the trial and, using a partial 2-by-2 factorial

2018 Lancet

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