Multivessel CAD in ACS patients: Four important implications
September 29th 2008The article by Schwartzman and Brener (page 33) has 4 important implications for the treatment of acute coronary syndrome (ACS) patients who are found to have multivessel coronary artery disease (CAD) during diagnostic coronary angiography.
Rivaroxaban: A potential replacement for warfarin?
September 29th 2008Millions of people in the United States require chronic anticoagulation to prevent thromboembolism secondary to chronic atrial fibrillation (AF), pulmonary hypertension, mechanical valve replacements, and other prothrombotic conditions.
Fluoroscopy-guided closure of patent foramen ovale for secondary prevention of paradoxical embolism
September 26th 2008Percutaneous closure of the patent foramen ovale (PFO) can be accomplished within 15 minutes using only fl uoroscopy for guidance. Local anesthesia and femoral vein puncture in the groin with a 9 French catheter can achieve about a 90% complete closure rate when the Amplatzer® PFO Occluder is used. Complications are extremely rare and physical restrictions are unnecessary starting a couple of hours after the intervention. Aspirin and clopidogrel (Plavix) are typically prescribed for a few months after the procedure, and the therapy concludes with transesophageal echocardiography at follow-up approximately 6 months later.
Sex-related differences in treatment and outcome in patients with ACS
September 26th 2008The AMIS (Acute Myocardial Infarction in Switzerland) Plus prospective cohort study compared treatment and in-hospital outcomes between men and women with acute coronary syndrome (N = 26,452) admitted to Swiss hospitals between 1997 and 2007. The study reached several important conclusions: women had different baseline characteristics than men at admission, were treated with different drug regimens, and were significantly less likely to undergo percutaneous coronary intervention. After adjusting for these differences, researchers found no significant difference in the rates of in-hospital mortality between men and women, except for women aged 51 to 60 years, who were more likely to die in-hospital.
Management of multivessel CAD in ACS patients: Do not leave for later what you can finish today
September 26th 2008Although multivessel coronary artery disease (CAD) is commonly encountered in patients with acute coronary syndrome (ACS), no randomized controlled trials have evaluated the effi cacy of singlevessel percutaneous coronary intervention (PCI) versus multivessel PCI.