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Ischemic Stroke Management: Posthospitalization and Transition of Care
Am Fam Physician. 2023 Jul;108(1):70-77.ABSTRACTIschemic stroke is a major cause of morbidity and mortality worldwide. Ischemic stroke and transient ischemic attack exist on a continuum of the same disease process. Ischemic stroke is common, and more than 85% of stroke risk is attributed to modifiable risk factors. The initial management of acute stroke is usually performed in the emergency department and hospital settings. Family physicians have a key role in follow-up, ensuring that a complete diagnostic evaluation has been performed, addressing modifiable risk factors, facilitating rehabilitation, and managing chronic s...
Source: Pain Physician - July 13, 2023 Category: Anesthesiology Authors: Scott T Larson Brigit E Ray Jason Wilbur Source Type: research

Mortality in Patients Hospitalized With Acute Myocardial Infarction Without Standard Modifiable Risk Factors: The ARIC Study Community Surveillance
Conclusions Individuals without SMuRFs presenting with AMI have an increased risk of all-cause mortality with an overall lower prescription rate for guideline-directed medical therapy. These findings highlight the need for evidence-based pharmacotherapy during hospitalization and the need to discover new markers and mechanisms for early risk identification in this population.PMID:37382152 | DOI:10.1161/JAHA.122.027851
Source: Pain Physician - June 29, 2023 Category: Anesthesiology Authors: Zainali S Chunawala Melissa C Caughey Deepak L Bhatt Michael Hendrickson Sameer Arora Sripal Bangalore John P Erwin Justin P Levisay Jonathan R Rosenberg Mark J Ricciardi Ron Blankstein Kunihiro Matsushita Sidney Smith Arman Qamar Source Type: research

Impact of Diabetes on Outcomes in Patients Hospitalized With Acute Myocardial Infarction: Insights From the Atherosclerosis Risk in Communities Study Community Surveillance
Conclusions Diabetes is associated with higher risk of death in patients hospitalized with AMI, highlighting the need for adherence to evidence-based therapies in this high-risk population.PMID:37183850 | DOI:10.1161/JAHA.122.028923
Source: Pain Physician - May 15, 2023 Category: Anesthesiology Authors: Vardhmaan Jain Arman Qamar Kunihiro Matsushita Muthiah Vaduganathan Kellan E Ashley Muhammad Shahzeb Khan Deepak L Bhatt Sameer Arora Melissa C Caughey Source Type: research

Aspirin Cessation Before Interventional Procedures: Not Blindly Following Guidelines but Making Test-based Decisions
CONCLUSION: The high prevalence of normal platelet function in patients taking aspirin suggests no necessity of discontinuation before procedures in such patients. Abnormal platelet function can occur even in patients who are not taking aspirin. Therefore, platelet function should be measured and considered on a case-by-case basis prior to interventional procedures, and discontinuation of aspirin should be decided based on these factors.PMID:36122261
Source: Pain Physician - September 19, 2022 Category: Anesthesiology Authors: Kyeong Hwan Seo Francis Sahngun Nahm Woong Ki Han Ho Young Gil Jung Eun Kim Eun Joo Choi Pyung Bok Lee Source Type: research

Top 20 Research Studies of 2021 for Primary Care Physicians
This article summarizes the top 20 research studies of 2021 identified as POEMs (patient-oriented evidence that matters) that did not address the COVID-19 pandemic. Sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide-1 receptor agonists prevent adverse cardiovascular and renal outcomes in patients with type 2 diabetes mellitus and also reduce all-cause and cardiovascular mortality. Most older adults (mean age, 75 years) with prediabetes do not progress to diabetes. Among patients in this age group with type 2 diabetes treated with medication, an A1C level of less than 7% is associated with increased risk of...
Source: Pain Physician - July 15, 2022 Category: Anesthesiology Authors: Mark H Ebell Roland Grad Source Type: research

Center Variation in Use of Preoperative Dual Antiplatelet Therapy and Platelet Function Testing at the Time of Coronary Artery Bypass Grafting in Maryland
CONCLUSIONS: There is significant variability in DAPT usage within 5 days of CABG between hospital centers. Preoperative platelet function testing may allow for earlier timing of surgery for those on DAPT without increased bleeding risks.PMID:35426835 | DOI:10.1213/ANE.0000000000005964
Source: Anesthesia and Analgesia - April 15, 2022 Category: Anesthesiology Authors: Nadia B Hensley Promise T Ariyo Sari D Holmes Marlene S Williams Glenn Joseph Robert Whitman Niv Ad Thomas Stephen Metkus Maryland Cardiac Surgical Quality Initiative Source Type: research

Effect of anti-platelet therapy on peri-operative blood loss in patients undergoing off-pump coronary artery bypass grafting
CONCLUSION: The pre-operative use of clopidogrel and aspirin in patients undergoing OPCABG showed limited clinical benefits; however, its use significantly increased the risk of bleeding and blood transfusion, thus increasing morbidity and resource utilization. Hence, clopidogrel and aspirin should be stopped at least 6 days prior to surgery.PMID:35417965 | DOI:10.4103/aca.aca_12_22
Source: Annals of Cardiac Anaesthesia - April 14, 2022 Category: Anesthesiology Authors: Samir Kapoor Gurmeet Singh Rajesh Chand Arya Vikrampal Singh Arun Garg Sarju Ralhan Vivek Kumar Gupta Bishav Mohan Gurpreet Singh Wander Rajiv Kumar Gupta Source Type: research

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