Pearls from Dr. Sahil Parikh

91 y/o with unstable angina with LHC complicated by perforation

2017-01-31

  • Mechanical Valves:

    Posted 01/31/17 02:01:12 PM by Adam Faye

  • TIMI risk Score:

    A higher TIMI risk score correlated significantly with increased numbers of events (all-cause mortality, new or recurrent MI, or severe recurrent ischemia requiring revascularization) at 14 days 

    ●Score of 0/1 – 4.7 percent
    ●Score of 2 – 8.3 percent
    ●Score of 3 – 13.2 percent
    ●Score of 4 – 19.9 percent
    ●Score of 5 – 26.2 percent
    ●Score of 6/7 – 40.9 percent

    Posted 01/31/17 02:06:19 PM by Adam Faye

  • Anti-platelet Agents:

    Prasugrel
    13,608 pts with mod-high risk ACS scheduled for PCI; Prasugrel vs. Clopidogrel
    •Primary Endpoint- Death from CV cause
    •12.1% clopidogrel vs. 9.9% prasugrel
    •Reduced in-stent thrombosis
    •Major Bleeding: 2.4% prasugrel vs. 1.8% clopidogrel

    Ticagrelor
    18,624 pts admitted with ACS; Ticagrelor vs. Clopidogrel
    •Primary Endpoint- Prevention of CV events
    •11.7% clopidogrel vs. 9.8% ticagrelor
    •No sig. diff in major bleeding – but did have higher risk in fatal intracranial bleeding

    Cangrelor
    11,145 pts admitted undergoing PCI: Cangrelor vs. Clopidogrel
    •Primary Endpoint- Death, MI, stent thrombosis at 48hrs
    •Death: 5.9% clopidogrel vs. 4.7% cangrelor
    •Stent Thrombosis: 0.8% cangrelor vs. 1.4% clopidogrel
    •Transient dyspnea more common with Cangrelor

    Posted 01/31/17 02:28:46 PM by Adam Faye

  • IABP:
    600pts. With cardiogenic shock complicating MI planned for PCI – IABP vs. no IABP
    •Primary Outcome – 30-day all-cause mortality
    •39.7% IABP vs. 41.3% no IABP
    •No diff in primary or secondary outcomes

    Posted 01/31/17 02:30:09 PM by Adam Faye

  • 49yo M with HTN p/w epigastric pain found to be extensive Type A aortic dissection

    2017-10-10

  • For further reading...


    Randomized Comparison of Strategies for Type B Aortic Dissection
    The INvestigation of STEnt Grafts in Aortic Dissection (INSTEAD) Trial
    Circulation. 2009;120:2519-2528


    Posted 10/10/17 10:51:41 AM by Kaylan Christianer

  • For further reading...


    Endovascular Repair of Type B Aortic Dissection
    Long-term Results of the Randomized Investigation of Stent Grafts in Aortic Dissection Trial
    Circulation: Cardiovascular Interventions. 2013;6:407-416

     

    Posted 10/10/17 10:52:16 AM by Kaylan Christianer

  • 72YO p/w HTN emergency found to have bilateral RAS

    2017-11-27


    Created by Christopher Kelly
    Book be65e564ffbc09cd3ee32372501a5ece813f14b576dc711ff66870a4906e7f62
    Know a hypochondriac? Get them the best-selling book 'AM I DYING?!: A Complete Guide to Your Symptoms, and What to Do Next'
    The information on the website does not constitute official guidelines except where explicitly stated.
    It is not meant to replace the advice of a health professional.