Comparison of 1-year Major Adverse Cardiac Events in Patients Undergoing Primary Percutaneous Coronary Intervention Receiving Intracoronary Bolus Only Versus Intracoronary Bolus Plus Infusion of Glycoprotein IIb/IIIa Inhibitors
Conclusion: Both univariate analysis and the adjusted model for the potential confounders revealed no significant association between the way of GP IIb/IIIa inhibitors administration and 1-year major adverse cardiac events. Our findings suggested that IV infusion of GP IIb/IIIa inhibitors after the bolus dose is not associated with better 1-year outcome after adjustment for confounding variables. Moreover, IV infusion may increase the risk of major bleedings after primary PCI. This finding implies that the need for IV infusion of GP IIb/IIIa inhibitors in patients undergoing primary PCI is under question. (Source: Critical...
Source: Critical Pathways in Cardiology - August 2, 2016 Category: Cardiology Tags: Original Studies Source Type: research
Bridging Experience With Eptifibatide After Stent Implantation
Conclusions: Within a limited sample size, bridging with an intravenous GPIIb/IIIa inhibitor appeared feasible. Further study is needed on the optimal strategy to manage patients with recent stenting who need surgical procedures. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - August 2, 2016 Category: Cardiology Tags: Original Studies Source Type: research
Idarucizumab (Praxbind) Formulary Review
This study is ongoing, but preliminary results showed reversal efficacy demonstrated a reasonable safety profile from the time of the infusion to 90 days after. The wholesale acquisition cost of two 2.5 g vials of idarucizumab is currently $3482.50. To treat 10 or 20 patients per year with a single 5 g dose is estimated to cost $34,825 and $69,650, respectively. In the clinical trial described above, approximately 20% of patients required a second dose, which would further increase the cost of use. In this formulary review for a health system’s pharmacy and therapeutics committee, idarucizumab clinical trials and med...
Source: Critical Pathways in Cardiology - August 2, 2016 Category: Cardiology Tags: Review Article Source Type: research
An Outpatient Management Protocol for Emergency Department Patients With a Newly Diagnosed Lower Extremity Deep Venous Thrombosis
No abstract available (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - August 2, 2016 Category: Cardiology Tags: Pathway Source Type: research
Effect of Baseline Red Blood Cell Distribution Width on Short- and Intermediate-term Mortality of Patients Under Primary Percutaneous Coronary Intervention: A Survival Analysis
Conclusions: We found a significant association between high RDW and in-hospital and 6-month mortality as well as the occurrence of major adverse cardiac event. Meanwhile RDW was found to be a significant predictor for 6-month mortality independent of anemia. Thus, it would be beneficial to use RDW as a risk stratification index to identify high risk intent-to-treat patients. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Articles Source Type: research
Association of Early Stress Testing with Outcomes for Emergency Department Evaluation of Suspected Acute Coronary Syndrome
Conclusions: Early stress testing is not associated with reduced MACE in patients evaluated for suspected ACS. Early stress testing may have limited value in populations with low MACE rate. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Articles Source Type: research
Utility of the Diamond-Forrester Classification in Stratifying Acute Chest Pain in an Academic Chest Pain Center
Conclusion: In a contemporary low-risk acute chest pain population, typical angina, as defined by the DF classification, was not predictive of CAD or useful for identifying patients with higher symptom burden. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Articles Source Type: research
Prognostic Factors in Chest Pain Patients: A Quantitative Analysis of the HEART Score
Conclusion: The previously chosen weights of the 5 elements of the HEART score are supported by multivariable statistical analyses, although some improvement in calibration and discrimination is possible by adapting the score. The gain in clinical usefulness is relatively small and supports the use of either the original or adjusted HEART score in daily practice. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Articles Source Type: research
Chest Pain Risk Stratification: A Comparison of the 2-Hour Accelerated Diagnostic Protocol (ADAPT) and the HEART Pathway
Conclusions: Within a cohort of ED patients with acute chest pain, ADAPT and the HEART pathway had high sensitivity for MACE. The HEART pathway outperformed ADAPT by correctly identifying more patients as low risk and safe for early discharge. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Articles Source Type: research
Short- and Long-Term Prognostic Utility of the HEART Score in Patients Evaluated in the Emergency Department for Possible Acute Coronary Syndrome
Conclusions: The HEART score is a valuable risk-stratification tool in predicting not only short-term MACE but also long-term mortality in patients evaluated for possible ACS in the ED. The HEART score had a superior prognostic value compared with the TIMI score. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Articles Source Type: research
Postgraduate Education in Quality Improvement Methods: Initial Results of the Fellows’ Applied Quality Training (FAQT) Curriculum
Conclusion: After completion of the FAQT, cardiology fellows reported higher self-confidence to complete QI activities. The increase in self-confidence seemed to be limited to the applied component of the curriculum, with no significant change after the didactic component. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Original Study Source Type: research
Idarucizumab for Dabigatran Reversal Guideline
No abstract available (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - June 1, 2016 Category: Cardiology Tags: Pathway Source Type: research
First Update of the Criteria for Certification of Chest Pain Units in Germany: Facelift or New Model?
Conclusion: Even though the history is short, the concept of certified CPUs in Germany is accepted and successful underlined by its recent implementation in national and international guidelines. First registry data demonstrated a high standard of quality-of-care. The current update provides rational adaptions to new guidelines and developments without raising the level for successful certifications. A periodic release of fast-track updates with shorter time frames and an increase of minimum requirements should be considered. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 17, 2016 Category: Cardiology Tags: Original Articles Source Type: research
There’s Another Observation Unit?: A Case Series Survey of Second Level Observation Units
Conclusions: Second level observation units are still relatively uncommon but are emerging as an extension of hospital-based observation services as an additional resource to cohort observation patients into a dedicated unit. These units share some similarities with traditional OUs, such as the nursing ratio of approximately 4:1 and the preponderance of chest pain pathways; however, they also differ in important ways around key metrics, such as length of stay, attending staffing coverage, and rate of subsequent inpatient admission. Additional study is needed both to fully characterize these units and their potential benefi...
Source: Critical Pathways in Cardiology - February 17, 2016 Category: Cardiology Tags: Original Articles Source Type: research
The Comparison of Physician to Computer Interpreted Electrocardiograms on ST-elevation Myocardial Infarction Door-to-balloon Times
Conclusion: The computer-interpreted ECG failed to identify a significant number of patients with STEMI. The immediate review of ECGs by an emergency physician led to faster activation of the catheterization laboratory, and door-to-balloon times in patients with STEMI. (Source: Critical Pathways in Cardiology)
Source: Critical Pathways in Cardiology - February 17, 2016 Category: Cardiology Tags: Original Articles Source Type: research
