Cardiology
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Vasopressin as a Single Vasopressor Agent in Patients with Septic Shock
SYNOPSIS: The use of vasopressin as a vasopressor for septic shock produced similar outcomes as the use of norepinephrine.
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What Influences ICU Admission?
SYNOPSIS: There is widespread variability between hospitals in rates of ICU admission. High ICU utilization hospitals were more likely to use invasive procedures and incurred higher costs than low ICU utilization hospitals with no difference in mortality.
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Reported Beta-lactam Allergy Is Associated with More Adverse Events Among Inpatients
SYNOPSIS: A prospective cohort study from three hospitals determined that patients who did not receive a preferred beta-lactam antibiotic were at greater risk for an adverse event (adjusted odds ratio, 3.1; 95% confidence interval, 1.28-7.89) compared to controls without a beta-lactam allergy.
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Outcomes in Patients Treated with Therapeutic Hypothermia After In-hospital Cardiac Arrest
SYNOPSIS: Current guidelines recommend the use of therapeutic hypothermia in patients with in-hospital cardiac arrest, even though its efficacy has been demonstrated only in randomized trials after out-of-hospital cardiac arrest. This non-randomized, observational cohort study based on a large national registry found that the use of therapeutic hypothermia was associated with lower likelihood of survival and less favorable neurological outcome in patients successfully resuscitated after an in-hospital cardiac arrest.
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Recently Diagnosed Idiopathic Dilated Cardiomyopathy Patients Are at Risk for Major Arrhythmic Events
Patients with recently diagnosed idiopathic dilated cardiomyopathy are at marked risk of major arrhythmia events that are neither well-predicted by traditional methods nor protected against by defibrillator implantation more than three months after diagnosis.
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Diastolic Blood Pressure Goals
An analysis of the community-based ARIC study showed that low diastolic blood pressures were associated with higher baseline and subsequent troponin T levels and adverse cardiac events, but not stroke.
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MitraClip Experience in Functional Mitral Regurgitation
A post-regulatory approval, observational study of patients with symptomatic functional mitral regurgitation stratified by baseline left ventricular ejection fraction (LVEF) showed that these patients received substantial benefit at low rates of hospital mortality and other adverse events, regardless of baseline LVEF.
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Left Main Confusion: Two Randomized Trials Reach Seemingly Opposite Conclusions
The NOBLE and EXCEL trials randomized patients presenting with left main disease to treatment with percutaneous coronary intervention or coronary artery bypass graft.
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Spironolactone Improves Exercise Capacity in Diastolic Heart Failure
In a small randomized, controlled trial of patients presenting with heart failure with preserved ejection fraction, treatment with spironolactone was associated with improved exercise capacity and less exercise-induced increase in left ventricular filling pressures.
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High-flow Nasal Cannula vs. Noninvasive Ventilation in Postextubation Failure: Does It Matter?
In this multicenter, randomized, clinical trial of critically ill adults at high risk for reintubation, high-flow conditioned oxygen therapy was not inferior to noninvasive mechanical ventilation with regard to preventing reintubation and postextubation respiratory failure within 72 hours of extubation.