Added On : 12th May 2012Five specific organizational practices significantly associated with lower risk-standardized mortality rates
In-hospital mortality after acute myocardial infarction (AMI) has decreased significantly over the past several decades but varies considerably among U.S. hospitals. In a quantitative analysis building on previous qualitative research (JW Cardiol Mar 30 2011), these investigators sought to identify specific strategies associated with low 30-day risk-standardized mortality rates (RSMRs) after AMI.
Added On : 26th May 2012A new point-of-care genetic test could rapidly identify CYP2C19*2 carriers who might benefit from nonclopidogrel antiplatelet therapy.
The CYP2C19*2 allele is a common variant associated with high platelet reactivity and increased rates of adverse events after percutaneous coronary intervention (PCI) in patients taking clopidogrel. So far, the inability to perform bedside genetic testing has prevented prospective patient assessment for this allele. Now, a simple point-of-care genetic test (validated by conventional genetic testing) has emerged that identifies CYP2C19*2 carrier status within 60 minutes of activation. Results classify individuals as homozygous for the wild-type allele (*1/*1), heterozygous (*1/*2), or homozygous for the *2 allele (*2/*2).
Added On : 8th June 2012Accept No Substitute: Progression of Carotid Intima–Media Thickness and Cardiovascular Risk
A patient-level meta-analysis suggests no association between change in cIMT and risk for cardiovascular events.
Although increased carotid intima–media thickness (cIMT) is an independent predictor of cardiovascular events, it is uncertain whether a change in cIMT is associated with a change in risk. To assess such an association, investigators pooled patient-level data from 16 longitudinal studies including 36,984 participants with a mean follow-up of 7 years.
HAS-BLED for Assessing Bleeding Risk with Anticoagulation: Best of the Mediocre
Notwithstanding a lackluster performance, HAS-BLED beat two other scoring systems in a comparative analysis of trial data.
Bleeding continues to be the Achilles heel of systemic anticoagulation, whether the agent used is warfarin or any of the new anticoagulants entering the market. Predictive models for bleeding include the following:
HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol)