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Myocardial Infarction Stabilization

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401. Length of stay following percutaneous coronary intervention: An expert consensus document update from the society for cardiovascular angiography and interventions

following PCI has declined. The overall incidence of in‐hospital complications in the most recent report of the NCDR CathPCI registry (2016 Q4–2017 Q3) comprising over 600,000 patients without ST‐segment elevation myocardial infarction (STEMI) or coronary artery bypass surgery (CABG) was 4.8%. Specifically, stroke was 0.2%, bleeding within 72 hr was 1.4%, pericardial tamponade was 0.1%, heart failure was 0.9%, and acute kidney injury (AKI) requiring hemodialysis was 0.2%. PCI complications that resulted (...) for pain, tenderness, numbness, bruising • No difference in adverse events at 7 and 30 days • 6/7 events were related to femoral access site complications 3 hr after PCI • ≤75 years of age • Type A or B lesion • Femoral access siteamenable to vascularclosure device • >2 hr since PCI • Life expectancy <12 months • Acute myocardial infarction • Anticoagulants besides heparin or bivalirudin used during procedure • PCI to nonnative vessel • Evidence of thrombus • Implantation of >3 stents • INR ≥2

2018 Society for Cardiovascular Angiography and Interventions

402. ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement Full Text available with Trip Pro

postcardiac arrest physiology could be significant. Emergency Angiography in Comatose Patients After ROSC Numerous observational studies have shown the consistent benefit of emergency angiography and primary percutaneous coronary intervention in comatose patients with ST-segment–elevation myocardial infarction who have achieved ROSC, and a meta-analysis supports use for patients with a mixed pathogenesis of OHCA. The most recent systematic review completed as part of the 2015 CoSTR also confirmed (...) capabilities and survival outcomes. Consistent with other emergent conditions such as trauma and acute myocardial infarction, the concept of cardiac arrest centers that deliver evidence-based postresuscitation care is intuitively appealing. However, as identified in the 2010 and 2015 , CoSTR, there are multiple specific knowledge gaps: the particular treatments to be provided by a cardiac arrest center, the safe patient transport interval (time taken to travel from scene to hospital), the optimal mode

2018 American Heart Association

403. Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments: A Scientific Statement From the American Heart Association

better cardiovascular outcomes in South Asians. Studies evaluating cardiovascular events and mortality after isolated coronary artery bypass graft have shown consistently poorer outcomes for South Asians compared with NHW populations. Biological and Nonbiological Mechanisms Contributing to the Excess Risk of ASCVD in South Asians The INTERHEART case-control study enrolled 15 152 cases of first acute myocardial infarction (AMI) and 14 820 sex-matched controls from 52 countries, including 1732 AMI (...) cases and 2204 controls recruited from 5 South Asian countries. The INTERHEART study demonstrated that modifiable risk factors had similar contributions to ASCVD among native South Asians and that the prevalence of traditional risk factors largely accounts for the differences in the earlier age at onset of myocardial infarction (MI) between South Asians and other racial/ethnic groups. Collectively, these traditional risk factors accounted for approximately the same population-attributable risk

2018 American Heart Association

404. Seafood Long-Chain n-3 Polyunsaturated Fatty Acids and Cardiovascular Disease: A Science Advisory From the American Heart Association Full Text available with Trip Pro

myocardial infarction, despite the strong inverse association with sudden cardiac death. Similar findings have been seen in multiple other prospective cohorts. This observation was attributed in part to the antiarrhythmic properties of the LC n-3 PUFAs. Higher seafood intakes have been associated with greater myocyte electric stability, reduced vulnerability to fatal and nonfatal ventricular arrhythmias, , lower heart rate, and improved heart rate variability, each of which is a risk factor (...) , cardiovascular disease; DART, Diet and Reinfarction Trial; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; MI, myocardial infarction; NS, nonsignificant; PUFA, polyunsaturated fatty acid; Q, quartile; RR, relative risk; and SD, standard deviation. *Several design and implementation limitations were evident, including lack of a prespecified primary outcome, lack of participant blinding, midtrial revision of randomization procedures to switch from subject choice to take fish advice or fish oil

2018 American Heart Association

405. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease Full Text available with Trip Pro

that the recommendation is weak. Many important clinical questions addressed in the guidelines do not lend themselves to clinical trials. Although randomized trials are unavailable, there may be a very clear clinical consensus that a particular test or therapy is useful or effective. *Data available from clinical trials or registries about the usefulness/efficacy in different subpopulations such as sex, age, history of diabetes mellitus, history of prior myocardial infarction, history of heart failure, and prior (...) or de- velop new problems over time, with an increased risk of cardiac arrest. This population commonly develops myocardial dysfunction, arrhythmia, and unbalanced pulmonary and systemic circulation. Specific drugs and the indications for administration and dosing can differ for infants and children with heart disease. In addition, there are many variations of CHD, and the underlying physiological substrates can have a significant impact on systemic perfusion and pulmonary blood flow (PBF

2018 American Heart Association

407. Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder: A Systematic Review Update

G1: 3 G2: 2 NR NR NR NR NR NS between groups NS differences on Barnes Akathisia Scale, Columbia Scale, or Abnormal Involuntary Movement Scale F-220 Author Year Intervention Groups Overall AE Withdrawal Due to AE Mortality Suicidality Disturbed Sleep Agitation Sedation Weight Gain Other Adverse Effects Batki et al., 2014 165 G1: Topiramate 25 to 300mg G2: Placebo G1: 12 (85.7%) G2: 13 (81.3%) NS NR G1: 0 G2: 1 due to myocardi al infarction (judged to be unrelated to study) NS Suicidal ideation G1 (...) of Pharmacological Treatments 75 Detailed Synthesis: Placebo-Controlled Trials of Alpha-Blockers 76 Detailed Synthesis: Placebo-Controlled Trials of Anticonvulsants/Mood Stabilizers 77 Detailed Synthesis: Placebo-Controlled Trials of Atypical Antipsychotics 78 Detailed Synthesis: Placebo-Controlled Trials of Benzodiazepines 82 Detailed Synthesis: Selective Serotonin Reuptake Inhibitors 82 Detailed Synthesis: Serotonin and Norepinephrine Reuptake Inhibitors 87 Detailed Synthesis: Placebo-Controlled Trials

2018 Effective Health Care Program (AHRQ)

408. Evaluation and Management of Testosterone Deficiency

that, at this time, it cannot be stated definitively whether testosterone therapy increases or decreases the risk of cardiovascular events (e.g., myocardial infarction, stroke, cardiovascular-related death, all-cause mortality). (Moderate Recommendation; Evidence Level: Grade B) 21. All men with testosterone deficiency should be counseled regarding lifestyle modifications as a treatment strategy. (Conditional Recommendation; Evidence Level: Grade B) Treatment of Testosterone Deficiency 22. Clinicians should

2018 American Urological Association

409. Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

in this patient population. Low-dose ASA, when used for secondary prophylaxis, has been shown to reduce the risk of stroke and myocardial infarction in the range of 25% to 30%. Furthermore, the discontinuation of ASA for secondary prophylaxis is associated with significant risk. The lowest effective ASA daily dose for the prevention of TIA and ischemic stroke is 50 mg. For men at high risk of cardiovascular disease, the recommended dose increases to 75 mg. The routine long-term use of doses greater than 75 (...) inhibition of platelet aggregation in healthy volunteers taking an 81-mg dose, ASA demonstrated a 66.0% ± 18.6% inhibition measured with optical aggregometry with the agonist arachidonic acid. Aspirin also influences coagulation through non–TXA 2 -mediated effects, including dose-dependent inhibition of platelet function, suppression of plasma coagulation, and enhancement of fibrinolysis. Secondary hemostasis and thrombus stability are also impaired, because of ASA's acetylation of fibrinogen and its

2018 American Society of Regional Anesthesia and Pain Medicine

410. Consensus Guidelines on the Use of Intravenous Ketamine Infusions for Chronic Pain Full Text available with Trip Pro

signaling, including TORC1 (mammalian target of rapamycin complex 1) and brain-derived neurotrophic factor pathways; (5) increased GABA-B levels; and (6) inhibition of brain glycogen synthase kinase 3 (GSK-3B). Inhibition of GSK-3 is a mechanism shared by the mood-stabilizing drug lithium, and the use of adjunct GSK-3B inhibitors such as lithium may augment and prolong ketamine's antidepressant effects. Clinical trials and anecdotal experience have demonstrated efficacy not only for depression, but also (...) channels that mediate “sag” currents, which help regulate and stabilize membrane potential. The mechanisms behind the amnestic effects of ketamine are multifactorial in nature and probably the result of interactions at an assortment of receptors that include NMDA, serotonin, and nicotinic cholinergic. There is growing evidence for ketamine as a treatment for refractory seizures as well as for its use during electroconvulsive therapy. The anticonvulsant effects may be attributable not only to its

2018 American Society of Regional Anesthesia and Pain Medicine

411. Management of Hypertension (5th Edition)

The relationship between BP and risk of cardiovascular events is continuous, consistent and independent of other risk factors. The higher the BP, the greater the chance of myocardial infarction, heart failure, stroke and kidney diseases. The presence of each additional risk factor, such as dyslipidaemia, diabetes mellitus or smoking status, compounds the risk. Therefore the main aim of identifying and treating high BP is to reduce these risks of end organ damage or end organ complications. Table 1 (...) of antihypertensives, it appears that the benefits are achieved predominantly by lowering the blood pressure rather than the use of any specific class of antihypertensive agent. 73,166 Following any coronary event, patients will be at high risk of subsequent events, especially if the hypertension is not controlled. There are clinical trials showing morbidity and mortality benefits of anti-hypertensive agents like ß-blockers, 167 ACEIs 168 and ARBs, 169 following myocardial infarction. 8.5.2 Hypertension and Heart

2018 Ministry of Health, Malaysia

413. Stroke Prevention in Patients With Atrial Fibrillation: A Systematic Review Update

—dabigatran 150mg and 110mg vs. warfarin 122 Table 52. Observational studies: myocardial infarction—dabigatran 150mg or 110mg vs. warfarin 123 viii Table 53. Strength of evidence—thrombin inhibitor (dabigatran) vs. warfarin 126 Table 54. Outcomes of interest within rct studies evaluating factor Xa inhibitors: apixaban, rivaroxaban, or edoxaban vs. warfarin 132 Table 55. Observational studies: stroke or systemic embolism—apixaban, rivaroxaban, or edoxaban vs. warfarin 137 Table 56. Observational studies (...) , or edoxaban vs. warfarin 156 Table 61. Observational studies: GI bleeding—apixaban, rivaroxaban, or edoxaban vs. warfarin 158 Table 62. Observational studies, all-cause mortality—apixaban, rivaroxaban, or edoxaban vs. warfarin 161 Table 63. Observational studies: myocardial infarction—apixaban, rivaroxaban, or edoxaban vs. warfarin 164 Table 64. Observational studies: medication non-persistence—apixaban, rivaroxaban, or edoxaban vs. warfarin 166 Table 65. Strength of evidence—factor Xa inhibitors vs

2018 Effective Health Care Program (AHRQ)

414. ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay

-elevation acute coronary syndromes AHA/ACC 2014 (S1.4-9) Heart failure ACC/AHA 2013 (S1.4-10) ST-elevation myocardial infarction ACC/AHA 2013 (S1.4-11) Device-based therapy for cardiac rhythm abnormalities ACC/AHA/HRS 2013 (S1.4-2) Coronary artery bypass graft surgery ACC/AHA 2011 (S1.4-12) Hypertrophic cardiomyopathy ACC/AHA 2011 (S1.4-13) Percutaneous coronary intervention ACC/AHA/SCAI 2011 (S1.4-14) Guidelines for CPR and emergency cardiovascular care—part 9: post-cardiac arrest care AHA 2010 (S1.4 (...) ). The intrinsic sinus and atrioventricular nodal diseases present in a similar clinical manner to extrinsic/secondary processes that can injure the sinus node, atrioventricular node or conduction system tissues. Multiple pathophysiologic processes (e.g., myocardial ischemia or infarction, infiltrative diseases, collagen vascular disease, surgical trauma, endocrine abnormalities, autonomic effects, neuromuscular disorders (S2.1-2, S2.1-8–S2.1-10), individually or in combination, can compromise impulse

2018 American College of Cardiology

415. Evaluation and Management of Right-Sided Heart Failure: A Scientific Statement From the American Heart Association Full Text available with Trip Pro

cardiac output and progressive end-organ damage (caused by a combination of end-organ venous congestion and underperfusion), and cachexia resulting from poor absorption of nutrients, as well as a systemic proinflammatory state. It is the principal cause of death in patients with pulmonary arterial hypertension. Similarly, acute RHF is associated with hemodynamic instability and is the primary cause of death in patients presenting with massive pulmonary embolism, RV myocardial infarction (...) options and enhanced outcomes in patients with acute and chronic disorders of the right side of the heart. RV dysfunction (RVD), defined here as evidence of abnormal RV structure or function, is associated with poor clinical outcomes independently of the underlying mechanism of disease: across the spectrum of left ventricular (LV) ejection fraction (EF) in patients with acute and chronic heart failure (HF), after cardiac surgery, acute myocardial infarction (MI), congenital heart disease (CHD), and PH

2018 American Heart Association

416. Stable Coronary Artery Disease (2nd Edition)

Density Lipoprotein Cholesterol LV Left Ventricle LVEF Left Ventricular Ejection Fraction LVH Left Ventricular Hypertrophy MET Metabolic Equivalent MI Myocardial Infarction MPI Myocardial Perfusion Imaging MRI Magnetic Resonance Imaging MUFA Monounsaturated Fatty Acid NCVD National Cardiovascular Disease Registry NOAC Newer Oral Anticoagulant NSTEMI Non-st Elevation Myocardial Infarction OMT Optimal Medical Therapy OSA Obstructive Sleep Apnea PA Physical Activity PCI Percutaneous Coronary Intervention (...) PDE5 Phosphodiesterase Type 5 Inhibitor PET Positron Emission Tomography PTP Pre-test Probability PUFA Polyunsaturated Fatty Acid SCAD Stable Coronary Artery Disease SCD Sudden Cardiac Death SFA Saturated Fatty Acid SLE Systemic Lupus Erythematosus SPECT Single-Photon Emission Computed Tomography STEMI ST Elevation Myocardial Infarction TIA Transient Ischemic Attack TFA Trans Fatty Acid TMR Transmyocardial Revascularization UA Unstable Angina Rationale: Coronary Artery Disease (CAD) covers a wide

2018 Ministry of Health, Malaysia

418. Male Sexual Dysfunction

-onset hypogonadism in males: ISA, ISSAM, EAU, EAA, and ASA recommendations. Eur Urol, 2009. 55: 121. 147. Khera, M., et al. A new era of testosterone and prostate cancer: from physiology to clinical implications. Eur Urol, 2014. 65: 115. 148. Corona, G., et al. Cardiovascular risk associated with testosterone-boosting medications: a systematic review and meta-analysis. Expert Opin Drug Saf, 2014. 13: 1327. 149. Baillargeon, J., et al. Risk of Myocardial Infarction in Older Men Receiving Testosterone (...) and meta-analysis. J Clin Endocrinol Metab, 2010. 95: 2560. 153. Haddad, R.M., et al. Testosterone and cardiovascular risk in men: a systematic review and meta-analysis of randomized placebo-controlled trials. Mayo Clin Proc, 2007. 82: 29. 154. Vigen, R., et al. Association of testosterone therapy with mortality, myocardial infarction, and stroke in men with low testosterone levels. JAMA, 2013. 310: 1829. 155. Sohn, M., et al. Standard operating procedures for vascular surgery in erectile dysfunction

2018 European Association of Urology

420. Evaluation and Management of Right-Sided Heart Failure

of nutrients, as well as a systemic proinflammatory state. It is the principal cause of death in patients with pulmonary arterial hypertension. Similarly, acute RHF is associated with hemodynamic instability and is the primary cause of death in patients presenting with massive pulmonary embolism, RV myocardial infarction, and postcardiotomy shock associated with cardiac surgery. Functional assessment of the right side of the heart can be hindered by its complex geometry. Multiple hemodynamic (...) , is associated with poor clinical outcomes independently of the underlying mechanism of disease: across the spectrum of left ventricular (LV) ejection fraction (EF) in patients with acute and chronic heart failure (HF), after cardiac surgery, acute myocardial infarction (MI), congenital heart disease (CHD), and PH. To distinguish right-sided HF (RHF) from structural RVD, we define RHF as a clinical syndrome with signs and symptoms of HF resulting from RVD. RHF is caused by the inability of the RV to support

2018 International Society for Heart and Lung Transplantation

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