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Myocardial Infarction Stabilization

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261. Considerations for cardiac catheterization laboratory procedures during the COVID?19 pandemic: perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates Full Text available with Trip Pro

or Person under investigation (PUI) as defined by the presence of Fever. Respiratory symptoms (cough, shortness of breath, and sore throat). Either foreign travel within 14 days to a country with a Level 2–4 travel alert health notice (centres for disease control and prevention (CDC) website) or exposure to a confirmed case or cluster of suspected COVID‐19 illness. 3 GUIDING PRINCIPLES FOR CONFIRMED OR SUSPECTED COVID‐19 PATIENTS All ST‐elevation myocardial infarction (STEMI) patients including (...) increases causing systematic and infrastructural bottlenecks for care, especially given regional variations, the primary therapeutic options may have to change (Appendix A). Alternative therapeutic options such as systemic fibrinolytic therapy may be considered for low risk STEMI (e.g., inferior STEMI without right ventricular involvement or lateral myocardial infarction without hemodynamic compromise) depending on local availability of expertise and the prevalence and effects of the COVID‐19 disease

2020 Society for Cardiovascular Angiography and Interventions

262. Covid-19: Society of Family Planning interim clinical recommendations: Contraceptive provision when healthcare access is restricted due to pandemic response

, including stroke and myocardial infarction, and recommend that she schedule a non-urgent visit with a healthcare provider for blood pressure check once usual healthcare access resumes. Contraceptive counseling prior to IUD or implant placement and removal. An initial telemedicine visit can be useful for assessing potential contraindications, reviewing alternative methods, and counseling the patient as part of informed consent. This step confirms that an in-person visit is required, and minimizes (...) as substitute for clinical judgement. Due to geographic variability in both the pandemic and the legislative environment, not all recommendations will apply to all providers. This document will be revised and revisited as conditions stabilize and additional evidence emerges. Recommendations in this document may also reduce barriers to care in a post-pandemic state. References [1] Ahmed Z, Sonfield A. The COVID-19 Outbreak: Potential Fallout for Sexual and Reproductive Health and Rights. Guttmacher Institute

2020 Society of Family Planning

264. AACE Clinical Practice Guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis

- ment (7). A recent retrospective analysis demonstrated that the annual cost of caring for osteoporotic fractures exceeds the annual costs of caring for breast cancer, myocardial infarction, or stroke in women aged 55 years and older (8). Osteoporosis is preventable and treatable, but only a small proportion of those at increased risk for fracture are evaluated and treated. Age is an important risk factor for bone loss; by age 60 years, half of white women have low bone mass (osteopenia (...) years of stability in patients with very high fracture risk (Grade B; BEL 2). R38. For zoledronate, consider a bisphosphonate holiday after 3 years in high-risk patients or until fracture risk is no longer high, and continue for up to 6 years in very-high- risk patients (Grade A; BEL 1). R39. The ending of a bisphosphonate holiday should be based on individual patient circumstances such as an increase in fracture risk, a decrease in bone mineral density beyond the least significant change (LSC

2020 American Association of Clinical Endocrinologists

265. Cardiovascular Considerations in Caring for Pregnant Patients: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

published 4 May 2020 Circulation. 2020;141:e884–e903 Abstract Cardio-obstetrics has emerged as an important multidisciplinary field that requires a team approach to the management of cardiovascular disease during pregnancy. Cardiac conditions during pregnancy include hypertensive disorders, hypercholesterolemia, myocardial infarction, cardiomyopathies, arrhythmias, valvular disease, thromboembolic disease, aortic disease, and cerebrovascular diseases. Cardiovascular disease is the primary cause (...) treatment before pregnancy. Current treatment options for pregnant women with familial hypercholesterolemia include bile acid sequestrants, which lack systemic circulation, and, as last resort, low-density lipoprotein apheresis in severe cases ( ). , Ischemic Heart Disease in Pregnancy Ischemic heart disease during pregnancy constitutes a rare but potentially fatal condition. The risk of acute myocardial infarction (MI) is 3- to 4-fold higher in pregnant women compared with their nonpregnant

2020 American Heart Association

266. Call to Action to Prevent Venous Thromboembolism in Hospitalized Patients: A Policy Statement From the American Heart Association

. In an analysis of 2.5 million hospital discharges, hospitalized patients with cancer had the lowest rates of prophylaxis compared with patients with other conditions such as myocardial infarction or severe lung disease. Even when VTE prophylaxis was administered to hospitalized patients with cancer, it was frequently not targeted to those at highest risk. This practice may reflect insufficient clinical trial evidence in this patient population. Specifically, although there are emerging data evaluating (...) Previous VTE (with the exclusion of superficial vein thrombosis) 3 Reduced mobility 3 Already known thrombophilic condition 3 Recent (≤1 mo) trauma or surgery 2 Elderly age (≥70 y) 1 Heart or respiratory failure 1 Acute myocardial infarction or ischemic stroke 1 Acute infection or rheumatological disorder 1 Obesity (BMI ≥30 kg/m 2 ) 1 Ongoing hormonal treatment 1 BMI indicates body mass index; and VTE, venous thromboembolism. Adapted from Barbar et al with permission. Copyright © 2010, International

2020 American Heart Association

267. Position Statement on the Management of Cardiac Electrophysiology and Cardiac Implantable Electronic Devices in Australia During the COVID-19 Pandemic: A Living Document Version 2

in an intensive care unit. 5 In Influenza infection, cardiovascular complications include myocarditis, acute myocardial infarction (plaque rupture secondary to viral inflammation) and exacerbation of heart failure. Previous coronavirus infections have also been associated with cardiovascular complications. The risk of adverse outcomes and the severity of adverse outcomes are increased by pre-existing cardiovascular disease. SARS has previously been associated with hypotension, tachycardia, bradycardia, atrial (...) of patients admitted to ICU. 5 HRC COVID-19 9/4/2020, version 2 16 A separate single-centre retrospective analysis also from Wuhan demonstrates correlation between underlying cardiovascular disease (CVD) and myocardial injury with increased mortality and malignant arrhythmias. One third of the patients (35.3%) had previous CVD, and 52 (27.8%) patients experienced an acute myocardial injury. Troponin T (TnT) elevation likely represents myocardial injury from either myocarditis, infarction with plaque

2020 Cardiac Society of Australia and New Zealand

268. Unhealthy Drug Use: Screening

use can cause many serious health effects that vary by drug type, administration mode, amount, and frequency of use, as well as pregnancy status. Opioid use can cause drowsiness, slowed breathing, constipation, coma, and fatal overdose. Stimulants such as cocaine can cause arrhythmias, myocardial infarction, seizures, and other complications. Marijuana use is associated with slowed reaction time; problems with balance, coordination, learning, and memory; and chronic cough and frequent respiratory (...) . Treatment Treatment of drug use disorders is based on the type of drug used, the severity of drug use, and the type of use disorder. Many drug use disorders are chronic, relapsing conditions, and many persons who start treatment do not complete treatment. Therefore, treatment must often be repeated to stabilize current drug use, reduce relapse, and achieve abstinence or other treatment goals. Some patients, such as those who are pregnant, nursing, or caring for ill or healthy neonates, may require

2020 U.S. Preventive Services Task Force

269. Endovascular Aortic Repair of Aneurysms Involving the Renal-Mesenteric Arteries (FEVAR) Full Text available with Trip Pro

Heart J. 2014; 35 : 2342-2343 ) Previously described cardiac scoring systems include several overlapping clinical conditions, including prior myocardial infarction, history of angina and prior congestive heart failure, which have been found to be associated with higher rates of perioperative cardiac events. The American Association of Anesthesiology (ASA) grading system has been widely utilized for endovascular procedures and has advantages in terms of simplicity, but mainly relies on subjective (...) echocardiogram 0 1 Asymptomatic but with either remote myocardial infarction by history (>6 months), occult myocardial infarction by electrocardiogram, or fixed defect on dipyridamole thallium or similar scan 4 2 Any of the following: stable angina, no angina but significant reversible perfusion defect on dipyridamole thallium scan, significant silent ischemia (1% of time) on holter monitoring, ejection fraction of 25% to 45%, controlled ectopy or asymptomatic arrhythmia, or history of congestive heart

2020 Society for Vascular Surgery

271. Crizanlizumab, Voxelotor, and L-Glutamine for Sickle Cell Disease: Effectiveness and Value

complications and comorbidities MI Myocardial Infarction NICE National Institute for Health and Care Excellence No. Number NS Not significant NR Not reported PICOTS Population, Interventions, Comparisons, Outcomes, Timing, Setting, and Study Design PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses QALY Quality-adjusted life year QOL Quality of life RCT Randomized controlled trial SAE Serious adverse event SCD Sickle cell disease SF-36 36-Item Short Form Survey TEAE Treatment-emergent (...) by the FDA on November 15, 2019 to reduce the frequency of vaso-occlusive crises in adults and pediatric patients ages 16 years and older with SCD. Voxelotor (Global Blood Therapeutics, Inc.) is an HbS polymerization inhibitor that reversibly binds to hemoglobin to stabilize the oxygenated hemoglobin state, thus shifting the oxyhemoglobin dissociation curve. 11 Voxelotor was approved by the FDA on November 25, 2019 for the treatment of SCD in adults and pediatric patients 12 years of age and older. ©

2020 California Technology Assessment Forum

272. Guideline on the diagnosis and management of chronic myeloid leukaemia Full Text available with Trip Pro

·1%) Uncommon 0·4% G1–2 0·1% G3 0 G4 Common 1% G1–2 1% G3–4 Not known Common (<10%) Suspend TKI, consider alternative TKI at standard dose when resolved Heart failure Uncommon (<1%) Not reported Common 1% G1–2 0% G3–4 Uncommon (<1%) Common (2%) Suspend TKI, heart failure symptoms due to left ventricular systolic dysfunction require cardiological investigation and treatment according to NICE guidance Arterial thrombosis Not known Not reported Uncommon (<1%) Angina, myocardial infarction common 6·1 (...) % Angina, myocardial infarction common 9·6% Suspend TKI, specialist investigation and treatment according to NICE guidance Cerebrovascular events Common 2·2% Cerebrovascular events Common 7·3% Peripheral arterial occlusive disease Uncommon 1·4% G3–4 Peripheral arterial occlusive disease Common 6·9% Venous thrombosis Not known Not reported Rare (<0·1%) Not known DVT/PE Common 5% Suspend TKI, specialist investigation and treatment according to NICE guidance QT prolongation Not reported Common 1·0% G1–2 0

2020 British Committee for Standards in Haematology

273. Obeticholic Acid for the Treatment of Nonalcoholic Steatohepatitis with Fibrosis

with NASH with fibrosis. The model estimated outcomes that included life years (LYs), equal value life years gained (evLYG), quality adjusted life years (QALYs), cardiovascular (CV) events (myocardial infarctions [MIs] and strokes), hepatic complications (decompensated cirrhosis, hepatocellular carcinoma [HCC], and liver transplants), and total costs for OCA and standard care over a lifetime time horizon. The base-case analysis took a health care sector perspective, focused on direct medical care costs (...) The prognosis of NAFLD is variable. Most patients with NAFL and with NASH without fibrosis do not progress, and while some patients with NASH and fibrosis do progress to advanced liver disease, many stabilize or regress without pharmacotherapy. 4,5 However, NASH has become a major cause of cirrhosis and, as effective treatment of hepatitis C is now available, it is expected to become the leading reason for liver transplantation in the US. 2 The diagnosis and assessment of NAFLD can involve invasive

2020 California Technology Assessment Forum

274. Management of Bleeding in Patients on Oral Anticoagulants

to determine the site or clinical impact of bleeding warranted? Doesthepatienthavebaselinesevereanemiarequiring transfusion of$1unitsofRBCs? Does the patient have relevant medical comorbidities, frailty, or other active medical issues (e.g., myocardial infarction, demand ischemia) requiring observation and treatment? Is there concern for a slow bleed from a critical site requiringrepeatimaging(e.g.,headtraumaconcerning for subdural hematoma development with an early negative scan)? (48,49). For any (...) restarting anticoagulation Suggest delaying restart of anticoagulation Did above measures control bleeding? ? Stop OAC ? Initiate appropriate measures to control bleeding ? Stop OAC ? Initiate appropriate measures to control bleeding Administer suggested reversal/hemostatic agent* to control bleeding and stabilize patient ? Stop OAC ? Initiate appropriate measures to control bleeding ? Continue OAC ? Initiate appropriate measures to control bleeding DOES =1 OF THE FOLLOWING FACTORS APPLY? ? Bleed

2020 American College of Cardiology

275. Mitral Regurgitation Management

-to-normal afterload, augments LV ejec- tion fraction (EF), which is typically supranormal. As the LV dilates, LV wall stress increases. Incipient and irreversible myocardial dysfunction may occur with longstanding LV volume overload. Because EF is a load- dependent measure of LV systolic function, it can be preserved even as myocardial contractile function begins to decline. Thus, although symptoms are a strong indi- cation for MV surgery, current clinical practice guidelines recommend surgical (...) gadolinium enhancement (myocardial ?brosis) on cardiac magnetic resonance imaging. AF¼ atrial ?brillation; CAD¼ coronary artery disease; EF¼ ejection fraction; LA¼ left atrium; LV¼ left ventricle; LVESD¼ left ventricular end-systolic diameter; MR¼ mitral regurgitation; MV¼ mitral valve; MVP, mitral valve prolapse. FIGURE 9B Intervention for Symptomatic Secondary MR AAD¼ antiarrhythmic drug; AF, atrial ?brillation; CABG¼ coronary artery bypass graft; CRT¼ cardiac resynchronization therapy; GDMT¼ guideline

2020 American College of Cardiology

276. Donor heart and lung procurement: A consensus statement Full Text available with Trip Pro

the procuring teams. Table 1 Causes of Death Affecting the Thoracic Organ Donor Cause Description Trauma Cardiac and pulmonary contusions, myocardial stunning, neurogenic pulmonary edema CVA Indication of possible hypertension in the donor, left ventricular hypertrophy, coronary artery disease, peripheral arterial disease Asphyxia Primary respiratory failure, if unwitnessed unknown downtime Drug intoxication Possible drug-induced problems. That is, cocaine, methamphetamines—coronary artery disease—indicates (...) , necessitating vasopressor support. Munshi L Murugan L Intensive care of the deceased multiorgan donor: one donor, nine lives. in: Subramanian K Sakai T Anesthesia and perioperative care for organ transplantation. Springer , New York 2017 : 51-61 , Baroldi G Di Pasquale G Silver MD Pinelli G Lusa AM Fineschi V Type and extent of myocardial injury related to brain damage and its significance in heart transplantation: a morphometric study. J Heart Lung Transplant. 1997; 16 : 994-1000 There is no consensus

2020 International Society for Heart and Lung Transplantation

277. Management of Adult Overweight and Obesity (OBE)

• Ziprasidone Antidepressants • Mirtazapine • Selective serotonin reuptake inhibitor (e.g., paroxetine, sertraline, citalopram b , escitalopram b , fluoxetine b ) • MAOIs (e.g., phenelzine) • Tricyclic anti-depressants (e.g., amitriptyline, clomipramine, doxepin, imipramine, nortriptyline, protriptyline b ) • Bupropion • Desvenlafaxine • Venlafaxine Antiepileptic drugs or mood stabilizing agents • Gabapentin • Pregabalin • Carbamazepine • Divalproex • Lithium • Valproic acid • Vigabatrin • Topiramate

2020 VA/DoD Clinical Practice Guidelines

278. The Management of Dyslipidemia for Cardiovascular Risk Reduction (Lipids)

, and inflammatory cells) in the walls of arteries. This plaque can narrow the lumen of arteries, limiting the flow of oxygenated blood and increasing the risk of chronic and acute ischemia. If a plaque ruptures within a vital artery, a blood clot forms and may obstruct the flow of oxygenated blood to the heart or brain, resulting in an acute coronary syndrome (ACS), myocardial infarction (MI), or stroke, with potentially irreversible damage to the tissue of the heart or brain. Control and reduction of CVD risk (...) a structured, exercise-based cardiac rehabilitation program for patients with recent occurrence of coronary heart disease (i.e., myocardial infarction, diagnosis of coronary artery disease, coronary artery bypass grafting, or percutaneous coronary intervention) to reduce cardiovascular morbidity and mortality. Strong for Reviewed, New- added a For additional information, see Grading Recommendations. b For additional information, see Recommendation Categorization and Appendix G. * Statin doses listed

2020 VA/DoD Clinical Practice Guidelines

279. The Non-Surgical Management of Hip & Knee Osteoarthritis (OA)

with the above to help decrease weight burden/provide stability for knee OA) • Offer referral for physical therapy b Pharmacotherapy: • Initial treatments: ? Topical agents for OA of the knee (e.g., NSAIDs, capsaicin) ? Acetaminophen ? NSAIDs or COX-2 inhibitors a See the VA/DoD Clinical Practice Guidelines for the Management of Adult Overweight and Obesity. Available at: https://www.healthquality.va.gov/guidelines/CD/obesity b Consider early referral to physical therapy based on pain severity, functional

2020 VA/DoD Clinical Practice Guidelines

280. National Practice Guideline For the Treatment of Opioid Use Disorder

, without necessarily requiring abstinence. A range of treatment and recovery support activities may be included in a harm reduction strategy. Initiation (office and home): The phase of opioid use disorder treatment during which medication dosage levels are adjusted until a patient attains stabilization. Buprenorphine initiation may take place in an office-based setting or home- based setting. By regulation, methadone initiation must take place in an OTP or acute care setting (under limited circum (...) of functioning that is free of active symptoms and/or is marked by stability in the chronic signs and symptoms that characterize active addiction. Relapse: A process in which an individual who has established disease remission experiences recurrence of signs and symptoms of active addiction, often including resumption of the pathological pursuit of reward and/or relief through the use of substances and other behaviors. When in relapse, there is often disengagement from recovery activities. Relapse can

2020 Publication 4891078

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