Clinical Cardiology Alert – December 1, 2008
December 1, 2008
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Diabetes — A Benefit from Targeted Therapy with Prasugrel in ACS
Prasugrel, a novel third-generation oral thienopyridine (following ticlopidine and clopidogrel), has recently been shown to provide clinically important platelet inhibition in acute coronary syndromes (ACS), with decreased ischemic events compared to clopidogrel in the TRITON-TIMI 38 trial of almost 14,000 ACS patients undergoing PCI. -
BMS vs LIMA for Proximal LAD Lesions: 10-Year Follow-up of the SIMS Trial
Coronary artery stenoses involving the proximal left anterior descending coronary artery (LAD) have caused significant concern for clinicians over the years. If these lesions give rise to a myocardial infarction, this is often termed the "widow maker" because of the large area of myocardium subtended by the LAD and the high mortality associated with proximal LAD occlusion. -
Lower Mortality with Drug-Eluting Stents than Bare-Metal Stents
The dramatic reduction in in-stent restenosis (ISR) afforded by drug-eluting stents (DES) led to their widespread use throughout the world. Subsequently, more patients and lesions could be treated percutaneously with less thought about ISR. With the advent of a more widespread adoption of percutaneous coronary intervention, registry data began suggesting an increased risk of late and very late stent thrombosis with DES compared to bare-metal stents (BMS). -
Bridging Anticoagulant Therapy for Mechanical Valve Patients
Unfractionated Heparin (UFH) is the standard bridging therapy for patients with mechanical heart valves who need to temporarily stop oral anticoagulants. Small case series have suggested that low molecular weight heparin (LMWH) may be useful for this purpose. -
Effect of N-33 Polyunsaturated Fatty Acids in Heart Failure
The Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico (GISSI)-Prevenzione trial demonstrated a lower mortality rate in post myocardial infarction patients treated with n-3 polyunsaturated fatty acids (PUFA) vs controls, which was mainly due to a reduction in sudden death. -
Sudden Death After Myocardial Infarction
In this paper, Adabag et al from the Mayo Clinic analyzed the risk of sudden death after an acute myocardial infarction over a 28-year period in patients residing in Olmsted County, MN. -
Clinical Briefs in Primary Care Supplement
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Pharmacology Watch
5-α reductase inhibitors and hip fracture in men; the effects of drug-reimbursement policy on outcomes; new guidelines for type 2 diabetes; beta-blocker-associated brady-cardia is linked to CVD events; FDA Updates.