Pearls from Dr. Sahil Parikh

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


  • 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:

    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

    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

    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


  • 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


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