New-onset or Pre-existing Atrial Fibrillation in Acute Coronary Syndromes: Two Distinct Phenomena With a Similar Prognosis

ConclusionsWhile pre-AF is independently associated with in-hospital mortality, new-AF may reflect a worse hemodynamic impact of the acute coronary syndromes, with the latter ultimately driving the prognosis.ResumenIntroducción y objetivosEl tratamiento y la estratificación del riesgo de los pacientes con fibrilación auricular (FA) y síndromes coronarios agudos son todo un reto. El objetivo es evaluar el impacto pronóstico de la FA, ya sea al ingreso como la aparecida durante la hospitalización por síndrome coronario agudo, así como las tendencias en los tratamientos y el resultado.MétodosSe analizaron retrospectivamente los datos procedentes de 35.958 pacientes incluidos entre 2004 y 2015 en el registro AMIS Plus.ResultadosHabía FA preexistente (FApre) en 1.644 pacientes (4,7%), mientras que se evidenció FA de nueva aparición (FAnueva) en 309 (0,8%). La presentación con infarto agudo de miocardio con elevación del segmento ST y la necesidad de asistencia hemodinámica fueron frecuentes en los pacientes con FA, especialmente aquellos con FA nueva. Se observó un cambio en los enfoques médicos e intervencionistas, con un progresivo aumento de la prescripción de anticoagulación oral y las derivaciones para angiografías e intervenciones coronarias percutáneas de pacientes con FApre. A pesar de los diferentes perfiles de riesgo inic...
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research

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Conclusions: Embolism associated with asymptomatic carotid stenosis shows circadian variation with highest rates 4–6 h before midday. This corresponds with peak circadian incidence of stroke and other vascular complications. These and ASED Study results show that monitoring frequency, duration, and time of day are important in ES detection. Introduction Transcranial Doppler (TCD) detected microembolism in the ipsilateral middle cerebral artery (MCA) may help stratify the risk of stroke and other arterial disease complications in persons with advanced (≥60%) asymptomatic carotid stenosis. If so, this techniqu...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions While pre-AF is independently associated with in-hospital mortality, new-AF may reflect a worse hemodynamic impact of the acute coronary syndromes, with the latter ultimately driving the prognosis.
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research
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Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
CONCLUSION:The variables that interplay in cases of severe aortic stenosis are what cause these patients to be so difficult to manage, and specific therapies targeted to fix one issue often worsen the effects of another issue. If someone is in respiratory distress, their airway and breathing needs to be secured, either through non-invasive or invasive means. Next, the patient ’s blood pressure needs to be stabilized. Oftentimes the most appropriate agent will be a positive inotrope, with consideration of a vasoactive agent in persistent hypotension. Once a patient is stabilized, determining the extent of damage to th...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
This study aimed at describing the electrophysiological alterations induced by acute atrial ischemia secondary to atrial coronary branch occlusion during elective coronary angioplasty. METHODS AND RESULTS: -Clinical data, 12-lead ECG, 12-hours Holter recordings, coronary angiography, and serial plasma levels of high sensitivity troponin T and mid-regional proatrial natriuretic peptide were prospectively analyzed in 109 patients undergoing elective angioplasty of right or circumflex coronary arteries. Atrial coronary branches were identified and after the procedure patients were allocated into two groups: atrial branch...
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
In this study, cangrelor was discontinued 1-6 hours prior to surgery, while aspirin was continued throughout the perioperative period. Bridging with cangrelor did not increase major bleeds prior to surgery, though minor bleeds, mostly ecchymosis at venipuncture site, was higher. P2Y12 assay documented sufficient platelet inhibition corresponding to levels required for anti thrombotic effect [1]. Cangrelor is awaiting approval and more large scale trials regarding the use of bridging are needed. Reference 1. Angiolillo DJ et al; BRIDGE Investigators. Bridging antiplatelet therapy with cangrelor in patients undergoing ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
This study found that though it is often associated with coronary artery disease (CAD), it can also occur in those without significant CAD. It was not specifically associated with disease of right coronary artery disease. This cardioinhibitory response may be a manifestation of the Bezold-Jarisch reflex. Bezold-Jarisch reflex inhibits sympathetic activity (sympathetic withdrawal) and increases parasympathetic activity, resulting in bradycardia, which may be associated with vasodilatation, nausea and hypotension. Bezold-Jarisch has been described in the setting of inferior wall infarction and coronary angiography. Origin...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ Cardiology X-ray Featured Source Type: blogs
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardiology Entrance Mock Test 5. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated ...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Featured Source Type: blogs
Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again This mock test has only 10 questions. Future tests will have more questions depending the user response. Click on the 'Start' button to begin the mock test. After answering all questions, click on the 'Get Results' button to display your score and the explanations. There is no time limit for this mock test. Start Congratulations - you have completed DM / DNB Cardi...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiology MCQ DM / DNB Cardiology Entrance Source Type: blogs
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