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MyocardialInfarction

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Prognostic capabilities of coronary computed tomographic angiography before non-cardiac surgery: prospective cohort study

Objectives To determine if coronary computed tomographic angiography enhances prediction of perioperative risk in patients before non-cardiac surgery and to assess the preoperative coronary anatomy in patients who experience a myocardial infarction after non-cardiac surgery.  
feeds.bmj.com
almost 5 years ago
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7

Type 2 myocardial infarction in clinical practice

Stream Type 2 myocardial infarction in clinical practice by BMJ talk medicine from desktop or your mobile device  
feeds.bmj.com
almost 5 years ago
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4

COPD and mortality after acute myocardial infarction

Stream COPD and mortality after acute myocardial infarction by BMJ talk medicine from desktop or your mobile device  
feeds.bmj.com
almost 5 years ago
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7

Good times part 1: DIDO-30 for STEMI - St.Emlyn's

DIDO time for STEMI is the door in, door out time relating to the Emergency Department care of patients with ST elevation myocardial infarction.  
stemlynsblog.org
almost 5 years ago
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A Case of Identity Part Two - EM Nerd

Our standards for acceptable benefit of antiplatelet agents in the management of ACS have become deplorably low. When ISIS-2 was first published we defined success only by aspirin’s ability to affect mortality. The number commonly cited, 2.4%, only describes aspirin’s absolute benefit to decrease death (1). In the one trial that examined its properties to prevent further infarction, published in the NEJM in 1988, aspirin demonstrated additional capabilities to decrease myocardial infarction as well as save lives (2). If in ISIS-2, aspirin had performed as poorly as clopidogrel did in its efficacy defining study, the CURE trial, it may have never gained the stature it currently holds in the management of ACS (3). To date aspirin has been the only antiplatelet agent that has demonstrated a consistent and clinically relevant mortality benefit. Despite the obvious benefits, it was not long before we turned towards other agents in an attempt to supplement aspirin’s antiplatelet properties. The concept of dual antiplatelet therapy so appealing, its theoretical basis so believable, it soon became a perfunctory part of our management strategy for patients presenting to the Emergency Department with ACS.  
emnerd.com
almost 5 years ago
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9

Good times part 1: DIDO-30 for STEMI - St.Emlyn's

DIDO time for STEMI is the door in, door out time relating to the Emergency Department care of patients with ST elevation myocardial infarction.  
feedproxy.google.com
almost 5 years ago
Static.www.bmj
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7

Optimal duration of dual antiplatelet therapy after drug eluting stent remains unclear

Longer duration of dual antiplatelet therapy after implantation of a drug eluting stent is associated with fewer myocardial infarctions but more major bleeding than a shorter duration, a systematic review has found.  
feeds.bmj.com
over 4 years ago
Www.bmj
0
2

Lipid lowering for primary prevention of stroke in older adults?

Vascular events of the heart (myocardial infarction) and brain (stroke) are the world’s leading cause of death and disability. Most events occur in older people without previous symptomatic vascular disease. Although this group has a lower relative risk of vascular events than people with a previous history, they are substantially more prevalent and so account for a greater absolute number of events.1  
feeds.bmj.com
over 4 years ago
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12

Cardiogenic Shock - R.E.B.E.L. EM - Emergency Medicine Blog

Cariogenic Shock is defined as tissue hypoperfusion that is primarily attributable to damage to the heart.  
rebelem.com
over 4 years ago
Www.bmj
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11

Perioperative blood transfusions

The debate regarding the impact of blood transfusions on outcomes spans decades, but many questions, especially concerning any associated cardiovascular risks, remain unanswered. Despite several high profile studies suggesting that a restrictive transfusion strategy might be superior to more liberal approaches,1 2 3 firm consensus is far from established. For example, the most recent meta-analysis published on this topic, with 31 trials and 9813 patients, found no difference in overall morbidity and mortality between liberal and restrictive strategies.4 Importantly, the statistical model in that study was unable to reach the “required information size” for the analysis of mortality and myocardial infarction, a consistent limitation of rare event research, even when data are pooled from a relatively large number of clinical trials.  
feeds.bmj.com
over 4 years ago
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4

Harms associated with single unit perioperative transfusion: retrospective population based analysis

Objective To determine whether perioperative transfusion of as little as one unit of packed red blood cells in the operating room or the day after surgery is associated with measurably increased odds for perioperative ischemic stroke and myocardial infarction.  
feeds.bmj.com
over 4 years ago
Www.bmj
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People taking proton pump inhibitors may have increased risk of myocardial infarction, study shows

People taking proton pump inhibitors have a 16% higher risk of myocardial infarction than people who don’t, a large US data mining study indicates.1  
feeds.bmj.com
over 4 years ago
Www.bmj
0
10

Perioperative blood transfusions

The debate regarding the impact of blood transfusions on outcomes spans decades, but many questions, especially concerning any associated cardiovascular risks, remain unanswered. Despite several high profile studies suggesting that a restrictive transfusion strategy might be superior to more liberal approaches,1 2 3 firm consensus is far from established. For example, the most recent meta-analysis published on this topic, with 31 trials and 9813 patients, found no difference in overall morbidity and mortality between liberal and restrictive strategies.4 Importantly, the statistical model in that study was unable to reach the “required information size” for the analysis of mortality and myocardial infarction, a consistent limitation of rare event research, even when data are pooled from a relatively large number of clinical trials.  
feeds.bmj.com
over 4 years ago
Preview
0
4

Harms associated with single unit perioperative transfusion: retrospective population based analysis

Objective To determine whether perioperative transfusion of as little as one unit of packed red blood cells in the operating room or the day after surgery is associated with measurably increased odds for perioperative ischemic stroke and myocardial infarction.  
feeds.bmj.com
over 4 years ago
Www.bmj
0
10

People taking proton pump inhibitors may have increased risk of myocardial infarction, study shows

People taking proton pump inhibitors have a 16% higher risk of myocardial infarction than people who don’t, a large US data mining study indicates.1  
feeds.bmj.com
over 4 years ago
Preview
0
7

Harms associated with single unit perioperative transfusion: retrospective population based analysis

Objective To determine whether perioperative transfusion of as little as one unit of packed red blood cells in the operating room or the day after surgery is associated with measurably increased odds for perioperative ischemic stroke and myocardial infarction.  
feeds.bmj.com
over 4 years ago
Www.bmj
0
9

Perioperative blood transfusions

The debate regarding the impact of blood transfusions on outcomes spans decades, but many questions, especially concerning any associated cardiovascular risks, remain unanswered. Despite several high profile studies suggesting that a restrictive transfusion strategy might be superior to more liberal approaches,1 2 3 firm consensus is far from established. For example, the most recent meta-analysis published on this topic, with 31 trials and 9813 patients, found no difference in overall morbidity and mortality between liberal and restrictive strategies.4 Importantly, the statistical model in that study was unable to reach the “required information size” for the analysis of mortality and myocardial infarction, a consistent limitation of rare event research, even when data are pooled from a relatively large number of clinical trials.  
feeds.bmj.com
over 4 years ago
Preview
3
47

Atherosclerotic Cardiovascular Disease Mnemonics | IMnotebook.com

> Myocardial infarct, complications ABCDE x2 Arrhythmias / AneurysmBradycardia / ↓BPCardiac failure / cardiac tamponadeDresslers / Death!Embolism / Extra (VSD, pap muscle rupture)   
imnotebook.com
over 4 years ago
Static.www.bmj
0
11

Delivering thrombectomy for acute stroke using cardiology services

Evidence is mounting for the supplementary benefit over thrombolysis of endovascular therapy in selected patients with acute stroke. Mechanical percutaneous removal of intracerebral clot using an aspiration catheter ensures that the artery is recanalised. Like thrombolysis, the benefits are greater with early treatment, and we need to think about how to achieve this. Evidence on the benefits of rapid primary percutaneous coronary intervention in patients presenting with ST segment elevation myocardial infarction (STEMI) led to a network being set up in the United Kingdom to provide 24 hour care.1 Teams staffing these networks, skilled in opening arteries quickly, could also provide endovascular therapy to selected patients with acute stroke.  
feeds.bmj.com
over 4 years ago
Www.bmj
0
14

What is the most effective operation for adults with severe and complex obesity?

Accessing, undergoing, and achieving a successful outcome from surgery for “severe and complex obesity” is difficult and requires determination and effort. Here, we consider “severe and complex obesity” to mean that an individual’s health is compromised by his or her weight to the extent that surgery can be considered to be an appropriate option.1 Surgery may be offered to adults with a body mass index (BMI) of ≥40, or a BMI of ≥35 with an obesity related disease, and it can be very successful. An average 50% of excess weight may be lost in the first few years after surgery, and if this is sustained it is associated with long term reduction in overall mortality and decreased incidences of diabetes, myocardial infarction, stroke and cancer.1 2 This treatment, however, requires careful consideration and serious commitment, with the need to demonstrate full engagement in a structured weight loss programme, to have tried all appropriate non-invasive measures of weight loss, and persevered for referral to a specialist surgical team.1 Once surgery is approved it is necessary to choose which operation to undergo.  
feeds.bmj.com
over 4 years ago