Factors Associated With Initial Prasugrel Versus Clopidogrel Selection for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From the Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Coronary Heart Disease
We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE‐ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection. Prasugrel use rates and associated 1‐year risk‐adjusted major adverse cardiovascular events and Global Utilization of Streptokinase and t‐PA for Occluded Coronary Arteries (GUSTO) moderate/severe bleeding outcomes were also examined in relation to predicted mortality and bleeding using the validated Acute Coronary Treatment and Intervention Outcomes (ACTION) risk prediction scores. Among 11 969 patients, 3123 (26%) received prasugrel at the time of percutaneous coronary intervention. The strongest factors associated with prasugrel use included cardiogenic shock (odds ratio [OR] 1.68, 95% CI 1.25–2.26), drug‐eluting stent use (OR 1.45, 95% CI 1.31–1.62), and ST‐segment elevation myocardial infarction presentation (OR 1.23, 95% CI 1.12–1.35). Older age (OR 0.57, 95% CI 0.0.53–0.61), dialysis (OR 0.56, 95% CI 0.32–0.96), prior history of stroke/transient ischemic attack (OR 0.52, 95% CI 0.38–0.73), and interhospital transfer (OR 0.50, 95% CI 0.46–0.55) were associated with lowest prasugrel selection. Prasugrel was used less often than clopidogrel in patients at higher predicted bleeding risk (21.9% versus 29...
ConclusionsTEVAR seems to offer advantages in terms of early mortality and complications rate. Moreover, data on late mortality and re-intervention are encouraging to consider endovascular treatment comparable to open repair for acute thoracic aorta emergency on long-term follow-up.
Beaconsfield MP Joy Morrissey said the money would push doctors to see more patients face-to-face in surgeries or at home, taking pressure off hospitals during the busy winter period in the NHS.
Robot-assisted surgery offers the possibility of less perioperative bleeding, lower postoperative morbidity, and faster recovery times.Medscape Medical News
Condition: Stroke Interventions: Device: Cathodal Cerebellar tDCS; Behavioral: Semantic Feature Analysis (SFA); Device: Sham Sponsors: Johns Hopkins University; National Institute on Deafness and Other Communication Disorders (NIDCD) Not yet recruiting
Conditions: Respiratory Muscle; Pulmonary Function Test Interventions: Diagnostic Test: Spirometry and ultrasonography in stroke group; Diagnostic Test: Spirometry and ultrasonography in healthy group Sponsor: Istanbul Physical Medicine Rehabilitation Training and Research Hospital Recruiting
Patients younger than 60 years who have stroke and then experience seizures have a twofold increased risk for dementia, a new study finds.Medscape Medical News
Royal Brompton and Harefield send teams to save cardiogenic shock patients at other hospitals‘People say it ’s a miracle, but it’s not: the Royal Brompton saved Christina’World-leading NHS doctors are using “James Bond medicine” and cutting-edge technology to save the lives of people whose hearts collapse due to a rare and often fatal cardiac condition.Royal Brompton and Harefield hospitals in London have begun sending teams of specialist medical personnel to hospitals in England and Walesto pick up patients who would otherwise die.Continue reading...
A shorter radiotherapy regimen, a genetic biomarker test, and a higher-dos...Read more on AuntMinnie.comRelated Reading: Patients lack knowledge on radiation in medical imaging ASTRO highlights program at 2021 annual meeting Radiology contributes to high spending costs in cancer care ASTRO urges members to oppose Medicare payment cuts Radiation therapy for breast cancer boosts risk of heart disease
Conclusion: AAC progresses rapidly in patients with CKD, and ΔAAC is similar across the CKD treatment groups including transplant recipients. The increment rate is associated with mortality and in transplant recipients with the time on the transplant waiting list.Kidney Blood Press Res