Tag: acute coronary syndromes

1. In this meta-analysis of randomized clinical trials, coronary computed tomography angiography (CCTA) compared to functional stress testing was associated with no difference in mortality or cardiac hospitalization compared to functional stress testing. 2. Patients undergoing CCTA were more likely to undergo invasive coronary angiography, revascularization, initiate statin and aspirin...
1. Patients undergoing percutaneous coronary intervention (PCI) mainly via radial approach receiving either bivalirudin or heparin, in addition to P2Y12 inhibitors, following myocardial infarction experienced similar rates of death from any cause, myocardial infarction, or major bleeding. 2. Patients who had ST-segment elevation myocardial infarction (STEMI) or non-STEMI myocardial infarctions...
1. In addition to significantly lowering levels of low density lipoprotein cholesterol (LDL-C), evolocumab reduced the composite risk of cardiovascular events in atherosclerotic patients on optimal statin therapy without a significant increase in adverse effects. 2. As individual endpoints, evolocumab did not significantly reduce the rate of either cardiovascular or...
1. Routine invasive coronary angiography was associated with a reduction in 12-month mortality in patients with unstable angina. 2. The survival benefit of invasive coronary angiography management persisted when angiography was delayed up to 2 months after the first episode of unstable angina. Evidence Rating Level: 2 (Good) Study Rundown: Acute coronary...
1. The findings of this cluster randomized trial suggest that it is safe to use the HEART score during initial assessment of chest pain patients in the emergency department (ED). 2. Using the HEART score did not result in statistically significant differences in early discharge, readmissions, or recurrent ED visits. Evidence...
Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services With recent advances in stroke prevention and treatment, failure to recognize the signs of acute ischemic stroke in the emergency department leads to missed opportunities in improving outcomes. The purpose of this retrospective chart review was...
1. The risk of mortality is 4 times higher in women with previous myocardial infarction and 2 times higher in those with history of ischemic stroke. 2. The risk of total fatal and nonfatal cardiovascular events was 13 times higher in women with previous ischemic stroke. Evidence Rating Level: 2 (Good) Study Rundown: Surviving...
1. In this systematic review and meta-analysis, radial percutaneous access during invasive management of acute coronary syndrome was associated with decreased mortality, major adverse coronary events, and major bleeding when compared to femoral access. 2. However, radial artery access was associated with higher cross-over to femoral access. Evidence Rating Level: 1...
1. From a cohort study of Danish patients presenting with acute coronary syndrome, early invasive revascularization interventions were associated with reduced cardiac mortality when compared to conservative invasive strategies. 2. Early intervention was also associated with decreased all-cause mortality and re-hospitalization within 60 days compared to conservative intervention. Evidence Rating Level:...
Acetaminophen for Fever in Critically Ill Patients with Suspected Infection Acetaminophen is a commonly used anti-pyretic in patients admitted to the hospital, including those admitted to an intensive care unit (ICU) with potential infection/sepsis.  The benefits and potential risks of treatment of fever in ICU patients have been debated for...