Daily Archive: November 4, 2011

Nov 04

LEFT MAIN STENOSIS : NEED TO RESTART THE DEBATE IN 2011

By A. B. Mehta, Nihar Mehta In the modern era of Drug eluting stents (DES), percutaneous coronary intervention (PCI) has emerged as a suitable option to coronary artery bypass graft surgery (CABG) in the majority of patients of left main stenosis (LMS). PCI with DES is a better choice in patients with ostial and mid …

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Nov 04

Stress Echocardiography in Valvular Stenotic Heart Disease

Conclusions Stress echocardiography is emerging as an important tool in evaluation of valvular stenosis. It aids in clinical decision making. It provides significant non invasive information on dynamic changes in valve function, left ventricular function, hemodynamic response to exercise. Exercise gives important information on exercise capacity and symptomatic responses. It has the advantage of easy …

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Nov 04

Per operative MI

Patients with atherosclerotic cardiovascular disease, or those with risk factors, are at increased risk for perioperative MI. The largest published experience of the risk of perioperative MI in the troponin era comes from over 8000 patients in the randomized POISE trial of perioperative beta-blocker therapy. The incidence of MI in POISE was 5 percent at …

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Nov 04

Atrial fibrillation after myocardial infarction

Atrial fibrillation is common in acute myocardial infarction  and is associated with poorer outcomes. The long-term incidence and prognosis of AF after discharge for MI was evaluated in a study of 271 patients with reduced left ventricular systolic function and no history of AF. 40 percent of individuals developed AF by two years, and many …

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Nov 04

Apixaban in atrial fibrillation

In AF most on patients warfarin are unable to continue due to difficulty with regular monitoring. Dabigatran is an approved alternative anticoagulant for these patients. In addition, apixaban, a factor Xa inhibitor is being tested. In the AVERROES trial, 5599 AF patients were randomly assigned to either apixaban or aspirin. The study was stopped prematurely …

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