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Aspirin dose and cardioprotection; uncovering modafinil's abuse potential; proton-pump inhibitors and clopidogrel; FDA actions.
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This report from the implantable cardioverter defibrillator (ICD) portion of the National Cardiovascular Data Registry focuses on the relationships of gender to in-hospital, ICD-associated adverse events.
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Dual anti-platelet therapy with aspirin and clopidogrel reduces cardiac events in patients who have acute coronary syndromes (ACS) and in patients who have percutaneous coronary intervention (PCI). Recently, the phenomenon of "clopidogrel resistance" has received much attention because of the clinical problems of stent thrombosis and recurrent ACS. However, a precise definition of this clinical entity is lacking.
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The introduction of drug-eluting stents (DES) was met with enthusiasm from the interventional cardiology community because of the dramatic reduction in rates of in-stent restenosis (ISR). However, it came to be recognized that this clinical benefit, due to reduced proliferation of smooth muscle cells, came at a price.
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Dr. George Dourgas presented the results of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS AMI) analysis of predictors of stent thrombosis in more than 3,600 patients, and showed that higher doses of clopidogrel (600 mg) pharmacologic therapy, lesion characteristics, and the length of stents were predictors of early-stent thrombosis.
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In this issue: Aspirin dose and cardioprotection; uncovering modafinil's abuse potential; proton-pump inhibitors and clopidogrel; FDA actions.
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Much is being written about the transmission of MRSA between animals and humans. These investigators explored this problem from another angle, examining colonization of pet therapy dogs with MRSA, VRE, and C. difficile during visits to acute and long-term care facilities.
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Extended spectrum β-lactamase (ESBL)-producing Escherichia coli has emerged as an increasingly common cause of community-acquired urinary tract infections (UTIs).