Clinical Cardiology Alert – July 1, 2011
July 1, 2011
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Avoid NSAIDs after Myocardial Infarction
The authors conclude that even short-term treatment with most NSAIDs was associated with increased risk of death and recurrent MI in patients with prior MI. Neither short- nor long-term treatment with NSAIDs is advised in this population, and any NSAID use should be limited from a cardiovascular safety point of view. -
Use of Optimal Medical Therapy in PCI Patients
The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) study showed that in patients with stable coronary artery disease (CAD) put on optimal medical therapy (OMT) that randomization to a percutaneous coronary intervention did not improve survival or prevent myocardial infarction. -
Diagnosis of Thoracic Aorta Dissection
Thoracic aortic dissection is notoriously difficult to diagnose. Since the presenting symptoms are protean, it is not feasible to image everyone with symptoms that could be due to dissection. -
Radial vs Femoral Arterial Access for Coronary Angiography and Intervention in Acute Coronary Syndromes
Several studies have shown lower rates of arterial access site complications when performing cardiac catheterization via the radial artery compared to the femoral artery, but these have largely been retrospective studies or registries. -
Intermediate Dose Dabigatran for Atrial Fibrillation
RE-LY randomized 18,113 patients to one of its three arms. In the entire study group, dabigatran 110 mg twice per day compared with warfarin was associated with lower risks of major bleeding (2.87% vs 3.57 %), intracranial bleeding (0.23% vs 0.76%), and life-threatening bleeding (1.24% vs 1.85%). -
Risks of ICD Implantation
In this paper, Haines and his coauthors propose a scoring system to predict risks associated with implantable cardioverterdefibrillator (ICD) implant procedures. -
Clinical Briefs in Primary Care Supplement
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Pharmacology Watch
Two new drugs for treatment of hepatitis C; NSAIDs and myocardial infarction risk; AIM-HIGH clinical trial stopped; and FDA actions.