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It remains debatable as to whether individuals who present with a non-ST-segment elevation MI (NSTEMI) or acute coronary syndrome (ACS) should be managed with a selective or elective invasive strategy vs an approach performing angiography in all patients.
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Anticoagulation with vitamin k antagonists is the standard recommendation for patients with nonvalvular atrial fibrillation and risk factors for stroke. The benefits of warfarin in such patients have been well shown in many clinical trials. Therapy with warfarin, however, is often complicated by the dietary and drug interactions, so that even with frequent monitoring, precise control of the anticoagulation level is difficult.
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The differentiation of constrictive pericarditis from restrictive cardiomyopathy can be difficult, but the treatment implications are great.
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Patients with a positive CT scan for coronary calcium often have a stress test. Askew and colleagues from the Mayo Clinic asked whether such patients should undergo repeat stress testing if the first one is negative or low risk?
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Rosiglitazone (Avandia) implicated in yet another study; Prilosec and Nexium not associated with cardiac events; Anastrozole (Arimidex) shown more effective than tamoxifen for treatment of early-stage breast cancer; antibiotics show no effect on sinusitis; FDA actions.
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Patent Foramen Ovale (PFO) has been associated with cryptogenic stroke in young individuals, but the association is less clear in older individuals where other causes of stroke predominate.
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The appropriate treatment of infective endocarditis (IE), to avoid embolic stroke, is unclear. Thus, Dickerman and colleagues explored the International Collaboration on Endocarditis Prospective Cohort Study (ICE-CPS) database to define the temporal occurrence of stroke in relation to antibiotic therapy.
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Doyle and colleagues performed a retrospective study of a large cohort of patients undergoing PCI at the Mayo Clinic from 1994 to 2000, to determine the long-term outcomes of BMS, with a focus on stent thrombosis and ISR.
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An early invasive approach is preferred for higher risk non-ST elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of cardiac catheterization is not clear.