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Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Clinical Outcomes of Acute Myocardial Infarction Hospitalizations with Systemic Lupus Erythematosus: An Analysis of Nationwide Readmissions Database
CONCLUSION: Patients with AMI and SLE had higher inpatient mortality during the index hospitalization and higher 30-day hospital readmissions compared to AMI patients without SLE. There were no significant differences in most of the other major inpatient outcomes between the two cohorts.PMID:34936910 | DOI:10.1016/j.cpcardiol.2021.101086
Source: Atherosclerosis - December 22, 2021 Category: Cardiology Authors: Shazib Sagheer Pallav Deka Dola Pathak Umair Khan Syeda Humna Zaidi Anum Akhlaq James Blankenship Ann Annis Source Type: research

Prevalence, clinical determinants and prognostic implications of coronary procedural complications of percutaneous coronary intervention in non-ST-segment elevation myocardial infarction: Insights from the contemporary multinational TAO trial.
CONCLUSIONS: In a contemporary NSTE ACS population, procedural complications with PCI remain frequent, are difficult to predict based on clinical characteristics, and are associated with worse ischaemic and haemorrhagic outcomes. PMID: 33518473 [PubMed - as supplied by publisher]
Source: Archives of Cardiovascular Diseases - January 28, 2021 Category: Cardiology Authors: Abtan J, Wiviott SD, Sorbets E, Popovic B, Elbez Y, Mehta SR, Sabatine MS, Bode C, Pollack CV, Cohen M, Moccetti T, Laanmets P, Faxon D, Okreglicki A, Ducrocq G, Steg PG, TAO investigators Tags: Arch Cardiovasc Dis Source Type: research

Protamine sulfate use during tibial bypass does not appear to increase thrombotic events or affect short-term graft patency.
CONCLUSIONS: Heparin reversal with protamine sulfate after tibial or peroneal bypass grafting is not associated with higher cardiovascular morbidity, bypass thrombosis, amputation, or mortality. Additionally, there was no statistically significant difference in post-operative bleeding or thrombosis complications for patients who did not receive protamine, although the findings are suggestive of a potential difference in a more adequately powered study. Our results suggest that protamine sulfate is safe for intraoperative use without increased risk of thrombotic complications or early tibial bypass graft failure. PMID:...
Source: Vascular - May 10, 2020 Category: Surgery Authors: Phair J, Futchko J, Trestman EB, Carnevale M, Friedmann P, Shukla H, Garg K, Koleilat I Tags: Vascular Source Type: research

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI): a phase 3, placebo-controlled, randomised trial
Publication date: Available online 1 September 2019Source: The LancetAuthor(s): Deepak L Bhatt, Philippe Gabriel Steg, Shamir R Mehta, Lawrence A Leiter, Tabassome Simon, Kim Fox, Claes Held, Marielle Andersson, Anders Himmelmann, Wilhelm Ridderstråle, Jersey Chen, Yang Song, Rafael Diaz, Shinya Goto, Stefan K James, Kausik K Ray, Alexander N Parkhomenko, Mikhail N Kosiborod, Darren K McGuire, Robert A HarringtonSummaryBackgroundPatients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. T...
Source: The Lancet - September 2, 2019 Category: General Medicine Source Type: research

Impact of Complications on Resource Utilization During 90-Day Coronary Artery Bypass Graft Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries who have adverse events during their index CABG hospitalization will significantly affect that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and manage the services consumed by Medicare beneficiaries having adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - April 21, 2019 Category: Cardiovascular & Thoracic Surgery Source Type: research

A New Approach to Detect Nonconvulsive Seizures in Patients in a Cardiac Surgery Intensive Care Unit by Monitoring Heart Rate Variability
CORONARY ARTERY BYPASS GRAFTING (CABG) surgery has been associated with different neurologic complications such as intracerebral hemorrhage, seizures, delirium, cognitive impairment, and peripheral neuropathy.1,2 Specifically, the incidence of seizures after cardiac surgery varies between 0.5% and 7.6%.3 Seizures are due mainly to thromboembolic ischemic stroke, cerebral air embolism, or specific drugs.4 When seizures occur, recurrence rates range between 40% and 66%, and an association with an abnormal outcome has been reported.
Source: Journal of Cardiothoracic and Vascular Anesthesia - March 27, 2019 Category: Anesthesiology Authors: Alessandro Forti, Marika Falla, Tommaso Scquizzato, Giacomo Strapazzon Tags: Case Report Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries
ConclusionsMedicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital’s financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care.
Source: The Annals of Thoracic Surgery - December 14, 2018 Category: Cardiovascular & Thoracic Surgery Source Type: research

Impact of Complications on Resource Utilization during 90-day CABG Bundle for Medicare Beneficiaries.
CONCLUSIONS: Medicare beneficiaries that experience adverse events during their index CABG hospitalization will significantly impact that hospital's financial risk. The challenge under the voluntary CABG bundled payment program will be to monitor and reduce adverse events and managing the services consumed by Medicare beneficiaries experiencing adverse events delivered at all the venues of care. PMID: 30553739 [PubMed - as supplied by publisher]
Source: The Annals of Thoracic Surgery - December 13, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Culler SD, Brown PP, Kugelmass AD, Cohen DJ, Reynolds MR, Katz MR, Schlosser ML, Simon AW Tags: Ann Thorac Surg Source Type: research

79-Year-Old Man With Shortness of Breath and Fevers
A 79-year old man with a history of myocardial infarction and coronary artery bypass grafting in 2000, biventricular systolic heart failure with an ejection fraction of 27%, hypertension, persistent atrial fibrillation for which he was taking high-dose aspirin given a previous history of hemorrhagic stroke, stage 3 chronic kidney disease, left cerebellar ischemic stroke, and implantable cardioverter-defibrillator (ICD) placement 5 years previously presented to his local medical facility with a 2-day history of breathlessness, fevers, and chills.
Source: Mayo Clinic Proceedings - November 7, 2018 Category: Internal Medicine Authors: Jaskanwal D. Sara, Megha Prasad, Suraj Kapa Tags: Residents' clinic Source Type: research

Radial versus femoral access and bivalirudin versus unfractionated heparin in invasively managed patients with acute coronary syndrome (MATRIX): final 1-year results of a multicentre, randomised controlled trial
Publication date: Available online 25 August 2018Source: The LancetAuthor(s): Marco Valgimigli, Enrico Frigoli, Sergio Leonardi, Pascal Vranckx, Martina Rothenbühler, Matteo Tebaldi, Ferdinando Varbella, Paolo Calabrò, Stefano Garducci, Paolo Rubartelli, Carlo Briguori, Giuseppe Andó, Maurizio Ferrario, Ugo Limbruno, Roberto Garbo, Paolo Sganzerla, Filippo Russo, Marco Nazzaro, Alessandro Lupi, Bernardo CorteseSummaryBackgroundThe Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (MATRIX) programme was designed to assess the comparative safety and effectiveness of ra...
Source: The Lancet - August 25, 2018 Category: General Medicine Source Type: research

Synchronous or Staged Carotid Endarterectomy and Coronary Artery Bypass Grafting? Propensity score matched study.
CONCLUSION: In this experience combined with the data given in literature, our findings suggest a possible superiority of the staged CABG/CEA approach. Large, randomized studies are required to verify our findings and to establish applicable guidelines. PMID: 30311885 [PubMed - in process]
Source: The Heart Surgery Forum - August 17, 2018 Category: Cardiovascular & Thoracic Surgery Authors: Hempe S, Moza A, Goetzenich A, Tewarie L, Bleilevens C, Autschbach R, Schnoering H, Zayat R Tags: Heart Surg Forum Source Type: research

Carotid artery stenosis at the time of coronary artery bypass grafting is a risk factor but not a cause for peri-operative stroke
Narayan et al. evaluated whether or not carotid artery screening at the time of coronary artery bypass grafting (CABG) influences neurological outcomes [1]. Two of the four strokes in the group with moderate/severe carotid stenosis occurred on the ipsilateral side of the carotid artery lesion, while two were in areas not related to the side of the carotid artery stenosis. In the group with no significant carotid artery stenosis, 18 patients had a stroke of which 16 were ischemic and 2 were hemorrhagic [1].
Source: International Journal of Cardiology - April 3, 2018 Category: Cardiology Authors: Kosmas I. Paraskevas, A. Ross Naylor Tags: Letter to the Editor Source Type: research

Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial
Publication date: Available online 1 November 2017 Source:The Lancet Author(s): Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve Background Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The ai...
Source: The Lancet - November 2, 2017 Category: General Medicine Source Type: research

Angioinvasive Aspergillus-associated Stroke in an Immunocompetent Host Following Cardiac Surgery and ECMO
Conclusions: Ischemic infarcts in the setting of CABG or ECMO are often presumed to be thromboembolic from the heart or device, related to underlying hemodynamic instability, or due to a clinically apparent systemic infection such as endocarditis. This report suggests that invasive cerebral aspergillosis should be considered in seemingly immunocompetent patients following CABG or ECMO. The mechanism is unclear, but may be related to systemic inflammatory dysregulation resulting in increased susceptibility to uncommon pathogens.
Source: The Neurologist - May 1, 2017 Category: Neurology Tags: Case Report/Case Series Source Type: research

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