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241. Coronary Artery Bypass Graft Surgery: Guideline For

and is per- formed in about 80% of subjects undergoing the procedure in the United States. Despite the excellent results that have been achieved, the use of CPB and the associated manipu- lation of the ascending aorta are linked with certain peri- operative complications, including myonecrosis during aor- tic occlusion, cerebrovascular accidents, generalized neurocognitive dysfunction, renal dysfunction, and SIRS. In an effort to avoid these complications, off-pump CABG was developed (58,66). Off-pump (...) 5.2.1. Adverse Cerebral Outcomes e159 STROKE e159 USE OF EPIAORTIC ULTRASOUND IMAGING TO REDUCE STROKE RATES: RECOMMENDATION e159 THE ROLE OF PREOPERATIVE CAROTID ARTERY NONINVASIVE SCREENING IN CABG PATIENTS: RECOMMENDATIONS..e160 DELIRIUM e161 POSTOPERATIVE COGNITIVE IMPAIRMENT e161 e124 Hillis et al. JACC Vol. 58, No. 24, 2011 2011 ACCF/AHA CABG Guideline December 6, 2011:e123–2105.2.2. Mediastinitis/Perioperative Infection: Recommendations e161

2011 American College of Cardiology

242. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention Full Text available with Trip Pro

Considerations . . . . . . . . . . . . . . . . . . .e595 5.1. Vascular Access: Recommendation . . . . . . . .e595 5.2. PCI in Specific Clinical Situations . . . . . . . . .e596 5.2.1. UA/NSTEMI: Recommendations . . . . .e596 5.2.2. ST-Elevation Myocardial Infarction . . .e597 Coronary Angiography Strategies in STEMI: Recommendations . . . . . . . . .e597 Primary PCI of the Infarct Artery: Recommendations . . .e598 Delayed or Elective PCI inPatients With STEMI: Recommendations (...) angioplasty , randomized controlled trial (RCT) , percutaneous coronary intervention (PCI) and angina , angina reduction , antiplatelet therapy , bare-metal stents (BMS) , cardiac rehabilitation , chronic stable angina , complication , coronary bifurcation lesion , coronary calcified lesion , coronary chronic total occlusion (CTO) , coronary ostial lesions , coronary stent (BMS and drug-eluting stents [DES]; and BMS versus DES) , diabetes , distal embolization , distal protection , elderly , ethics , late

2011 American Heart Association

243. Acute Low Back Pain

overall risk of heart attack or stroke. * Approximate Retail Cost - May vary from store to store. For brand drugs, Average Wholesale Price minus 10%. AWP from Amerisource Bergen Wholesale Catalog 03/09. The cost of generic products is calculated as MAC plus $3.00 based on the Michigan Department of Community Health M.A.C. Manager, 3/09. ** Hepatotoxicity has been observed with use, primarily during the first month. Prescribing physicians should be aware and should check transaminases within four weeks (...) ) selective inhibitor (similar action, cost may differ). However, if: - NSAID not tolerated: COX-2. - Very high GI risk (e.g., prior GI bleed): if possible avoid NSAIDs/COX-2. If cannot avoid, then COX-2 plus PPI. ? If also elevated cardiovascular risk 2, 3 (assume on low-dose aspirin or other antiplatelet medication): If possible avoid NSAIDs/COX-2 due to greater likelihood of heart attack or stroke following NSAID use. . If cannot avoid, then assess patient to prioritize GI and cardiovascular risks

2011 University of Michigan Health System

244. Diagnosis and Management of Cerebral Venous Thrombosis Full Text available with Trip Pro

. This may result in an overestimation of risk associated with the various conditions owing to referral and ascertainment biases. In the Registro Nacional Mexicano de Enfermedad Vascular Cerebral (RENAMEVASC), a multihospital prospective Mexican stroke registry, 3% of all stroke cases were CVT. A clinic-based registry in Iran reported an annual CVT incidence of 12.3 per million. In a series of intracerebral hemorrhage (ICH) cases in young people, CVT explained 5% of all cases. Figure 1. Age and sex (...) Diagnosis and Management of Cerebral Venous Thrombosis Diagnosis and Management of Cerebral Venous Thrombosis | Stroke Search Hello Guest! Login to your account Email Password Keep me logged in Search April 2019 March 2019 February 2019 February 2019 January 2019 Free Access article Share on Jump to Free Access article Diagnosis and Management of Cerebral Venous Thrombosis A Statement for Healthcare Professionals From the American Heart Association/American Stroke Association , MD, MSc, FAHA

2011 Congress of Neurological Surgeons

245. Quality Improvement Guidelines for Angiography, Angioplasty, and Stent Placement for the Diagnosis and Treatment of Renal Artery Stenosis in Adults

to renalarteryperforation,cholesterolembo- lization, acute renal failure, and arterial access puncture above the inguinal liga- ment. A surgical salvage operation was necessary in 1%–2.5% (46,54). Symptom- atic embolization occurred in 1%–8% of thepatients(46,82).Occlusionofthemain renal artery was reported in 0.8%–2.5% and occlusion of a renal artery branch causing a segmental infarction in 1.1%– 1.7% (46,54). Cholesterol embolization resulting in decreasedrenalfunctionorvisceralorpe- ripheral symptoms is expected (...) , Marinelli DL, Martin LG, Spies JB. Reporting standards for clinical evaluation of new peripheral arterial re- vascularization devices. Technology As- Specific Major Complications from Percutaneous Renal Revascularization Complication Reported Rate (%) Threshold (%) Mortality at 30 d 1 1 Secondary nephrectomy 11 Surgical salvage operation 1 2 Symptomatic embolization 3 3 Main renal artery occlusion 2 2 Branch renal artery occlusion 2 2 Access site hematoma requiring surgery or transfusion or prolonging

2010 Society of Interventional Radiology

246. Hypertrophic Cardiomyopathy: Guideline For the Diagnosis and Treatment of

of the heart, with chest pain and/or an increase in pulmonary venous pressure causing dyspnea. 4.3. Myocardial Ischemia Severe myocardial ischemia and even infarction may occur in HCM (85,86). The myocardial ischemia is frequently unre- lated to the atherosclerotic epicardial coronary artery disease (CAD) but is caused by supply–demand mismatch. Patients with HCM of any age have increased oxygen demand caused by the hypertrophy and adverse loading conditions. They also have compromised coronary blood ?ow (...) and Natural History, Including Absence of Complications .e218 4. Pathophysiology .e219 4.1. LVOT Obstruction e219 4.2. Diastolic Dysfunction e220 4.3. Myocardial Ischemia e220 4.4. Autonomic Dysfunction e220 4.5. Mitral Regurgitation e220 5. Diagnosis .e220 5.1. Genetic Testing Strategies/Family Screening— Recommendations e220 5.1.1. Genotype-Positive/Phenotype-Negative Patients—Recommendation e222 5.2. Electrocardiography—Recommendations e222 5.3. Imaging e223 5.3.1. Echocardiography—Recommendations e223

2011 American College of Cardiology

247. Percutaneous Coronary Intervention: Guideline For

, multiple lesions, multi- vessel, myocardial infarction (MI), non–ST-elevation myocar- dial infarction (NSTEMI), no-re?ow, optical coherence tomog- raphy, proton pump inhibitor (PPI), return to work, same-day angioplasty and/or stenting, slow ?ow, stable ischemic heart disease (SIHD), staged angioplasty, STEMI, survival, and unstable angina (UA). Additional searches cross-referenced these topics with the following subtopics: anticoagulant therapy, contrast nephropathy, PCI-related vascular complica (...) . Radiation Safety: Recommendation e63 4.4. Contrast-Induced AKI: Recommendations e63 4.5. Anaphylactoid Reactions: Recommendations e64 4.6. Statin Treatment: Recommendation e65 4.7. Bleeding Risk: Recommendation e65 4.8. PCI in Hospitals Without On-Site Surgical Backup: Recommendations e65 5. Procedural Considerations e65 5.1. Vascular Access: Recommendation e65 5.2. PCI in Speci?c Clinical Situations e66 5.2.1. UA/NSTEMI: Recommendations e66 5.2.2. ST-Elevation Myocardial Infarction e68

2011 American College of Cardiology

248. 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

systolic function, advanced age, female sex, and increased CPB time are at higher risk for life-threatening arrhythmias in the early postoperative period. Given the poor short-term prognosis of those with these arrhythmias, mechanical and ischemic causes should be considered in the postoperative setting. 277–279 2.2.3. Emergency CABG After Failed PCI: Recommendations Class I 1. Emergency CABG is recommended after failed PCI in the presence of ongoing ischemia or threatened occlusion with substantial (...) of Cardiac Surgery Outcomes: Recommendation .e685 5.1.1. Use of Outcomes or Volume as CABG Quality Measures: Recommendations .e686 5.2. Adverse Events .e687 5.2.1. Adverse Cerebral Outcomes .e687 Stroke .e687 Use of Epiaortic Ultra- sound Imaging to Reduce Stroke Rates: Recom- mendation .e687 The Role of Preoperative Carotid Artery Noninva- sive Screening in CABG Patients: Recommenda- tions .e687 Delirium .e689 Postoperative Cognitive Impairment .e689

2011 American Heart Association

249. Secondary Prevention For Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Guideline Update

intervention; TIA, transient ischemic attack; INR, international normalized ratio; and ARB, angiotensin receptor blocker. *Presence of established CVD plus 1) multiple major risk factors (especially diabetes), 2) severe and poorly controlled risk factors (especially continued cigarette smoking), 3) multiple risk factors of the metabolic syndrome (especially high triglycerides200 mg/dL plus non–HDL-C130 mg/dL with low HDL-C40 mg/dL), and 4) patients with ACSs. †Non–HDL-Ctotal cholesterol minus HDL-C (...) guideline for management of patients with peripheral artery disease (175,176), the AHA effectiveness-based guidelines for cardiovascular disease prevention in women (46), and in the AHA/American Stroke Association guidelines for the prevention of stroke in patients with stroke or transient ischemic attack (123). Finally, the practitioner should exercise judgment in initi- ating the various recommendations if the patient has recently experienced an acute event. 2438 Smith Jr. et al. JACC Vol. 58, No. 23

2011 American College of Cardiology

250. ACC/AHA/SCAI/AMA?Convened PCPI/NCQA 2013 Performance Measures for Adults Undergoing Percutaneous Coronary Intervention

with Unstable Angina/Non-–ST-Elevation Myocardial Infarction (updating the 2007 guideline) (7) ACCF/AHA 2012 Focused Update of the Guideline for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (updating the 2007 guideline and replacing the 2011 focused update) (8) AHA/ACCF 2011 Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 Update ( 9) ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria (...) for Cardiovascular Angiography and Interventions, the American Medical Association–Convened Physician Consortium for Performance Improvement, and the National Committee for Quality Assurance Developed in Collaboration With the American Association of Cardiovascular and Pulmonary Rehabilitation and Mended Hearts Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and Mended Hearts Writing Committee Members Brahmajee K. Nallamothu, MD, MPH, FACC, FAHA, Co-Chair* Carl L. Tommaso, MD

2013 Society for Cardiovascular Angiography and Interventions

251. 2013 ACC/AHA Guideline for the Management of ST-Elevation Myocardial Infarction - Focused Update

THROMBOCYTOPENIA .e111 9.7.2. Bleeding Complications .e111 TREATMENT OF ICH .e112 VASCULAR ACCESS SITE BLEEDING .e112 9.8. Acute Kidney Injury .e112 9.9. Hyperglycemia .e112 10. Risk Assessment After STEMI .e113 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations . .e113 10.2. Assessment of LV Function: Recommendation .e114 10.3. Assessment of Risk for SCD: Recommendation .e114 11. Posthospitalization Plan of Care .e114 11.1. Posthospitalization Plan of Care (...) is a clinical syndrome de?ned by characteristic symptoms of myocardial ischemia in association with persis- tent electrocardiographic (ECG) ST elevation and subsequent release of biomarkers of myocardial necrosis. Diagnostic ST elevation in the absence of left ventricular (LV) hypertrophy or left bundle-branch block (LBBB) is de?ned by the Euro- pean Society of Cardiology/ACCF/AHA/World Heart Feder- ation Task Force for the Universal De?nition of Myocardial Infarction as new ST elevation at the J point

2013 Society for Cardiovascular Angiography and Interventions

252. An Update of Comprehensive Evidence-Based Guidelines for Interventional Techniques in Chronic Spinal Pain - Part 1 - Introduction and General Considerations

procedures per year in the U.S. population. From 2000 to 2011, increases for specialties including interventional pain management, anesthesiology, physical medicine and rehabilitation, and neurology were 199% per 100,000 in the Medicare population, compared to 98% for neurological and or- thopedic surgery, 166% for radiologic specialties, 48% for other physicians, and 246% for non-physician pro- viders (Fig. 4). The Office of Inspector General (OIG), Department of Health and Human Services (HHS), has

2013 American Society of Interventional Pain Physicians

253. Recommendations for the Use of Nonpharmacologic and Pharmacologic Therapies in Osteoarthritis of the Hand, Hip, and Knee

upper GI events. In the clinical scenario where the patient with OA is taking low-dose aspirin (325 mg per day) for cardiopro- tection and the practitioner chooses to use an oral NSAID, the TEP strongly recommends using a nonselective NSAID other than ibuprofen in combination with a proton-pump inhibitor. This recommendation is based, in part, on the FDA warning that the concomitant use of ibuprofen and low-dose aspirin may render aspirin less effective when used for cardioprotection and stroke

2012 American College of Rheumatology

254. Management of Hyperglycemia in Hospitalized Patients in Non-critical Care Setting Full Text available with Trip Pro

; 95% confidence interval, 0.21–0.77). There was a trend for increased risk of hypoglycemia (relative risk, 1.58; 95% confidence interval, 0.97–2.57) that was most common in surgical studies. There was no significant effect on death, myocardial infarction, or stroke. The definition of “intensive control” varied across studies but was generally consistent with BG targets in the ADA/American Association of Clinical Endocrinologists Practice Guideline ( , ). That guideline recommended a premeal

2012 The Endocrine Society

255. 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction Full Text available with Trip Pro

STEMI e397 10.1. Use of Noninvasive Testing for Ischemia Before Discharge: Recommendations e397 10.2. Assessment of LV Function: Recommendation e398 10.3. Assessment of Risk for SCD: Recommendation e398 11. Posthospitalization Plan of Care e399 11.1. Posthospitalization Plan of Care: Recommendations e399 11.1.1. The Plan of Care for Patients With STEMI e399 11.1.2. Smoking Cessation e399 11.1.3. Cardiac Rehabilitation e399 11.1.4. Systems of Care to Promote Care Coordination e399 12. Unresolved (...) • Daiichi-Sankyo None None Steven M. Ettinger Penn State Heart & Vascular Institute—Professor of Medicine and Radiology None None None • Medtronic None None 4.3.1 James C. Fang University Hospitals Case Medical Center—Director, Heart Transplantation • Accorda• Novartis• Thoratec None None None • Medtronic None Francis M. Fesmire Heart Stroke Center—Director • Abbott None None None None • Plaintiff, Missed ACS, 2010 8.3 Barry A. Franklin William Beaumont

2012 American Heart Association

256. 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities Full Text available with Trip Pro

in destruction of sinus node cells, such as ischemia or infarction, infiltrative disease, collagen vascular disease, surgical trauma, endocrinologic abnormalities, autonomic insufficiency, and others. The clinical manifestations of SND are diverse, reflecting the range of typical sinoatrial rhythm disturbances. The most dramatic presentation is syncope. The mechanism of syncope is a sudden pause in sinus impulse formation or sinus exit block, either spontaneously or after the termination of an atrial (...) judgment and available data in deciding when a condition is persistent or when it can be expected to be transient. Section 2.1.4, “Pacing for Atrioventricular Block Associated With Acute Myocardial Infarction,” overlaps with the “ACC/AHA Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction” and includes expanded indications and stylistic changes. The statement “incidental finding at electrophysiological study” is used several times in this document and does not mean

2012 American Heart Association

257. Intravenous immunoglobulin in the treatment of neuromuscular disorders

in the treatment of LEMS (Level C). Adverse effects of IVIg. Eighteen of the 22 prospective studies reviewed recorded the number of serious and minor AEs from 632 patients receiving IVIg (total dose 2.0–2.5 g/kg). There were no IVIg-related deaths in these studies. Most studies concluded that IVIg was well-tolerated and AEs were either transient or manageable. Serious AEs related to IVIg were rare and included aseptic meningitis (n = 3), urticaria (n = 2), heart failure (n = 1), myocardial infarction (n = 1 (...) ), and renal failure (n = 1). These findings do not exclude the possibility of rare AEs such as stroke and thrombotic events, which have been previously reported with IVIg. It is important to screen for vascular risk factors before infusion and to monitor carefully during and after infusion. , , The most common IVIg-related AEs included headache (16.1%), fever (6.6%), mild hypertension (4.6%), chills (3.3%), nausea (3.2%), asthenia (1.4%), arthralgia (1.3%), anorexia (1.1%), dizziness (1.1%), malaise (1.1

2012 American Academy of Neurology

258. Clinical Practice Guideline for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit

, but is not associated with an increased incidence of myocardial ischemia (B). The association between depth of sedation and psychological stress in these patients remains unclear (C). We recommend that sedative medications be titrated to maintain a light rather than a deep level of sedation in adult ICU patients, unless clinically contraindicated (+1B). Monitoring depth of sedation and brain function The Richmond Agitation - Sedation Scale (RASS) and Sedation - Agitation Scale (SAS) are the most valid and reliable

2013 Society of Critical Care Medicine

259. Evidence-Based Guideline: Diagnosis and Treatment of Limb-Girdle and Distal Dystrophies

of Neurology, Mayo Clinic, Rochester, MN (4) Department of Neurology, Massachusetts General Hospital, Boston, MA/Harvard Medical School, Boston, MA (5) St Luke's Rehabilitation Institute, Spokane, WA (6) Department of Neurology, Penn State Hershey Medical Center, Hershey, PA (7) Department of Neurology, University of Kansas Medical Center, Kansas City, KS (8) Neuromuscular Center, Boston VA Medical Center, Boston, MA (9) Department of Neurology, University of Rochester Medical Center, Rochester, NY 2 (10 (...) for Disease Control and Prevention. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. The remaining funding was provided by the American Academy of Neurology. This guideline was endorsed by the American Academy of Physical Medicine and Rehabilitation on April 17, 2014; by the Child Neurology Society on July 11, 2014; by the Jain Foundation on March 14, 2013; and by the Muscular

2013 American Association of Neuromuscular & Electrodiagnostic Medicine

260. 2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Acute Coronary Syndromes and Coronary Artery Disease Full Text available with Trip Pro

standards—sets of standardized data elements and corresponding definitions—to collect data relevant to cardiovascular conditions. The ultimate purpose of clinical data standards is to contribute to the infrastructure necessary to accomplish the ACCF/AHA mission of fostering optimal cardiovascular care and disease prevention and building healthier lives, free of cardiovascular diseases and stroke. The specific goals of clinical data standards are To establish a consistent, interoperable, and universal (...) a wealth of data on the treatment and outcomes for hundreds of thousands of patients. Many of these efforts have focused on patients with acute coronary syndromes (ACS), which range from ST-segment elevation myocardial infarction (STEMI) to non–ST-segment elevation myocardial infarction (NSTEMI) to unstable angina (UA). These data have been used to evaluate the effectiveness of the pharmacological and interventional management of these patients, define new therapies, and guide clinical care through

2013 American Heart Association


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