Unique use of heart-lung machine saves heart attack victim at UCLA emergency room
James Manzi is lucky to be alive. When the 79-year-old Brentwood, Calif., resident arrived at Ronald Reagan UCLA Medical Center's emergency room in full cardiac arrest, the medical team tried everything to stabilize him, including shocking his heart 29 times with a defibrillator in an attempt to restore a normal rhythm. Often, patients whose heart attacks are as severe as Manzi's don't survive. Only one out of every 10 people who suffer cardiac arrest outside the hospital lives through the ordeal. As the team worked, UCLA emergency medicine physician Dr. Eric Savitsky monitored Manzi's diminishing response to their resuscitative efforts using a combination of bedside ultrasound of the heart and clinical indicators. This led to an emergeny request for a rarely used but potentially lifesaving technology known as extracorporeal membrane oxygenation, or ECMO. ECMO involves the use of a sophisticated pump that takes over the functions of the heart and lungs, essentially breathing for the patient by pumping oxygenated blood to vital organs so the lungs can rest. This helps reduce stress on the heart. The device is traditionally used to support adults in cardiac failure waiting for a heart transplant and to help protect the delicate respiratory systems of infants born prematurely. Fortunately, it worked in Manzi's case too. His heart stabilized, allowing the cardiac team to transport him to the cardiac catheterization lab, where he underwent...
Authors: Ha KH, Kim B, Shin HS, Lee J, Choi H, Kim HC, Kim DJ Abstract BACKGROUND AND OBJECTIVES: To compare cardiovascular disease (CVD) risk associated with 5 different dipeptidyl peptidase-4 inhibitors (DPP-4is) in people with type 2 diabetes. METHODS: We identified 534,327 people who were newly prescribed sitagliptin (n=167,157), vildagliptin (n=67,412), saxagliptin (n=29,479), linagliptin (n=220,672), or gemigliptin (n=49,607) between January 2013 and June 2015 using the claims database of the Korean National Health Insurance System. A Cox proportional hazards model was used to estimate hazard ratios (HRs)...
In this study, we used samples of white blood cells collected from 225 patients with myocardial infarction and 239 control persons with no health complaints. DNA was isolated from the blood leukocyte samples. Then, PCR fragments of DNA were obtained. They contained the investigated regions of 11 mitochondrial genome mutations (m.5178C>A, m.3336T>C, m.652delG, m.12315G>A, m.14459G>A, m.652insG, m.14846G>A, m.13513G>A, m.1555A>G, m.15059G>A, m.3256C>T). According to the obtained results, three mutations of the human mitochondrial genome correlated with myocardial infarction. A positive correlation ...
CONCLUSIONS: Although platelet aggregation did not increase, there was an increase in serum COX-metabolized eicosanoid mediators such as TxB2 in healthy medical staff after night-shift work. This platelet hypersensitivity may be one of the mechanisms underlying the significant association between night-shift work and adverse cardiovascular outcomes. PMID: 29669967 [PubMed - as supplied by publisher]
This study compared the midterm outcomes of patients undergoing TAVI with or without previous CABG surgery. Between October 2013 and July 2016, 1,613 patients underwent TAVI according to the Optimized CathEter vAlvular iNtervention (OCEAN)-TAVI registry (previous CABG:n = 120; no previous CABG:n = 1493). The propensity score comprised the variables of the Society of Thoracic Surgeons Score, previous myocardial infarction, peripheral artery disease, chronic kidney disease > stage 2 (estimated glomerular filtration rate
CONCLUSION: Decreased SpO2 was a significant predictor of abnormal mitral Doppler flow. Diastolic dysfunction should be considered when SpO2 ≤ 95% is found. PMID: 29671629 [PubMed - as supplied by publisher]
Authors: Bath PM, May J, Heptinstall S Abstract Vascular diseases such as myocardial infarction and ischemic stroke are associated with increased platelet function whilst the risk of recurrence is reduced by antiplatelet agents such as aspirin, clopidogrel, and prasugrel. However, some patients exhibit high platelet reactivity, especially with clopidogrel. Existing platelet function tests may not be ideal in that they can be expensive, are often time consuming, and measurements must be made near to the patient and within a few hours of blood collection. Platelet activation leads to translocation of P-selectin from ...
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CONCLUSION: In this consecutive real-world cohort of patients, the DCS was safe and efficacious when used for PPCI in patients with STEMI. PMID: 29666900 [PubMed - as supplied by publisher]
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