CABG Surgery following STEMI
|
|
- Clifford Carter
- 5 years ago
- Views:
Transcription
1 CABG Surgery following STEMI Susana Harrington, MS,APRN-NP Cardio-Thoracic Surgery Nebraska Methodist Hospital February 15, ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force Practice Guidelines Class I CABG in Patients with STEMI: Urgent CABG in patients whose coronary anatomy not amenable to PCI and who have ongoing or recurrent ischemia, cardiogenic shock, severe HF, or other highrisk features. CABG is recommended in patients with STEMI at time of operative repair of mechanical defects. CABG in Patients with STEMI Class IIa Use of mechanical circulatory support is reasonable in pts with STEMI who are hemodynamically unstable and require urgent CABG. CABG in Patients with STEMI Class IIb Emergency CABG within 6 hrs of symptom onset may be considered in patients with STEMI who do not have cardiogenic shock and are not candidates for PCI or fibrinolytic therapy. 1
2 Timing of Urgent CABG In Relation to use of antiplatelet Agents Class I ASA should not be withheld before urgent CABG Clopidogrel or Ticagrelor should be discontinued at least 24hrs before urgent on-pump CABG, if possible. Short-acting intravenous GP IIb/IIIa receptor antagonists (Eptifibatide, Tirofiban) should be discontinued at least 2-4hrs before urgent CABG. Abciximab should be discontinued at least 12 hrs before urgent CABG. Class IIb Urgent off-pump CABG within 24hrs of Clopidogrel or Ticagrelor administration might be considered, especially if the benefits of prompt revascularization outweigh the risks of bleeding. Urgent CABG within 5 days of Clodipogrel or Ticagrelor administration or within 7 days or Prasugrel administration might be considered, especially if the benefits of prompt revascularization outweigh the risks of bleeding. Brilanta Time is Muscle Black box warning: Specifically states not to start Brilinta in patients who may undergo urgent CABG. Patient will need to wait 5-7 days post administration due to high risks of bleeding/coagulopathy. Timing of CABG in stable patients after acute MI Mortality is higher in the early stages post- MI and progressively decreases with time post-mi Case Study Situation: RB is a 60 yo gentleman, with hx of CAD (3 stents to RCA). He experienced approximate one-hour of substernal chest pain. He did take 3 SLN and ASA at home. Had syncopal episode and sudden cardiac arrest. OFD was called and pt was found in Vtach and was defibrillated x2. He was brought to the ED and was found to be experiencing a STEMI. Pt was taken to cath lab and was found to have 3VCAD. Background Pt has History of : COPD, HTN, Dyslipidemia, OSA, Tobacco Abuse, GERD, Gout, Depression Pt initiated on Nitro gtt and Amiodarone gtt after cardiac cath Troponin Level
3 Findings Emergent Cardiac Cath: CX: Complex ulcerated plaque in the mid 2 nd OM branch (50-75%) RCA: 100% occluded proximally. LAD: Calcified. Mid-LAD: 75%, Distal 50-75%. EF = 35% Unsuccessful attempt made to do a PCI to the RCA Operative Procedure 1. Endoscopic vein harvest from left leg using greater saphenous vein. 2. Coronary bypass grafting x3: left internal mammary artery to distal left anterior descending artery reverse saphenous vein aorta to obtuse marginal artery reverse saphenous vein aorta to right posterior descending artery Recovery ECHO revealed EF of 45% Right ventricular hypokinesia secondary to right ventricular infarction. Liver enzymes were elevated (Amiodarone and Atorvastatin were discontinued --?secondary to hepatic congestion). Discharged to home 5 days post-operatively. Follow-up with cardiac rehab. Miscellaneous ECHO (2/8/17): Technically difficult study due to poor acoustic windows, even with contrast agent enhancement. The left ventricle is not well visualized. Qualitatively, the left ventricular ejection fraction is 30-35%. Echocardiographic images are suboptimal, unable to quantitatively evaluate right ventricular systolic function. There is no pericardial effusion. There is no comparison study available. ECHO: (2/13/17) The left ventricular diastolic diameter is normal ( ) cm. Qualitatively, the left ventricular ejection fraction is 35-40%. The left ventricular wall thickness is mildly increased ( ) cm. There is moderate global hypokinesis of the left ventricle. Abnormal septal motion. Qualitatively, the right ventricle is severely dilated. Qualitatively the right ventricular systolic function is severely decreased. Qualitatively, the right atrium is severely dilated. February 8 th 1:59 am February 8 th 6:25 am 3
4 February 9 th 5:53 am Question Which Anti-platelet should NOT be taken if a patient with ACS is a possible candidate for CABG? Question What EKG leads would indicate the patient has an inferior myocardial infarction? Question: Blockage in what artery would most likely result in a patient having cardiac surgery? Questions Which of the following situations does NOT require an urgent CABG in a STEMI patient? References O Gara, Patrick T., Kushner, Fredrick G., Ascheim, Deborah D., et al ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation Nichols, Elizabeth L., McCullough, Jock N., Ross, Cathy S., et al. Optimal Timing From Myocardial Infarction to Coronary Artery Bypass Grafting on Hospital Mortality. Annals of Thoracic Surgery 2017; 103: Raghavan, Ramya, Benzaquen, Bruno S., Rudski, Lawrence. Timing of bypass surgery in stable patients after acute myocardial infarction. The Canadian Journal of Cardiology Oct; 23 (12):
5 5
A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines
A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction 1
More informationAcute Myocardial Infarction
Acute Myocardial Infarction Hafeza Shaikh, DO, FACC, RPVI Lourdes Cardiology Services Asst.Program Director, Cardiology Fellowship Associate Professor, ROWAN-SOM Acute Myocardial Infarction Definition:
More informationTiming of Surgery After Percutaneous Coronary Intervention
Timing of Surgery After Percutaneous Coronary Intervention Deepak Talreja, MD, FACC Bayview/EVMS/Sentara Outline/Highlights Timing of elective surgery What to do with medications Stopping anti-platelet
More informationSTEMI ST Elevation Myocardial Infarction
STEMI ST Elevation Myocardial Infarction Breakout Session One Moderators: Quinn Capers IV, MD and Scott M. Lilly, MD, PhD Cases Presented by: Umair S. Ahmad, MD 1 Outline 1. Multivessel Revascularization
More informationAcute Myocardial Infarction. Willis E. Godin D.O., FACC
Acute Myocardial Infarction Willis E. Godin D.O., FACC Acute Myocardial Infarction Definition: Decreased delivery of oxygen and nutrients to the myocardium Myocardial tissue necrosis causing irreparable
More informationCardiovascular Health Nova Scotia Update to Antiplatelet Sections of the Nova Scotia Guidelines for Acute Coronary Syndromes, 2008.
Cardiovascular Health Nova Scotia Update to Antiplatelet Sections of the Nova Scotia Guidelines for Acute Coronary Syndromes, 2008. ST Elevation Myocardial Infarction (STEMI)-Acute Coronary Syndrome Guidelines:
More informationLearning Objectives. Epidemiology of Acute Coronary Syndrome
Cardiovascular Update: Antiplatelet therapy in acute coronary syndromes PHILLIP WEEKS, PHARM.D., BCPS-AQ CARDIOLOGY Learning Objectives Interpret guidelines as they relate to constructing an antiplatelet
More informationAcute Coronary Syndrome. Cindy Baker, MD FACC Director Peripheral Vascular Interventions Division of Cardiovascular Medicine
Acute Coronary Syndrome Cindy Baker, MD FACC Director Peripheral Vascular Interventions Division of Cardiovascular Medicine Topics Timing is everything So many drugs to choose from What s a MINOCA? 2 Acute
More informationNova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Antiplatelet Section of the Guidelines)
Cardiovascular Health Nova Scotia Guideline Update Nova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Antiplatelet Section of the Guidelines) Authors: Dr. M. Love, Dr. I. Bata, K. Harrigan
More informationA walk through a STEMI
A walk through a STEMI M.M. s Story Kim Robison Ashley Corcoran Situation M.M. is an 82 year old male brought in by private vehicle on 10/22/17 to the Emergency Department Pt. c/o left arm numbness, pain
More informationAcute Coronary Syndromes
Overview Acute Coronary Syndromes Rabeea Aboufakher, MD, FACC, FSCAI Section Chief of Cardiology Altru Health System Grand Forks, ND Epidemiology Pathophysiology Clinical features and diagnosis STEMI management
More information10/22/16. Lay of the land. Definition of ACS. Why do we worry about ST elevations?
Lay of the land Update on Acute Coronary Syndrome: Five Things Hospitalists Must Know Dhruv S. Kazi, MD, MSc, MS Assistant Professor Department of Medicine (Cardiology), Department of Epidemiology and
More informationNon ST Elevation-ACS. Michael W. Cammarata, MD
Non ST Elevation-ACS Michael W. Cammarata, MD Case Presentation 65 year old man PMH: CAD s/p stent in 2008 HTN HLD Presents with chest pressure, substernally and radiating to the left arm and jaw, similar
More informationNova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Antiplatelet Section of the Guidelines)
Cardiovascular Health Nova Scotia Guideline Update Nova Scotia Guidelines for Acute Coronary Syndromes (Updating the 2008 Antiplatelet Section of the Guidelines) Authors: Dr. M. Love, Dr. I. Bata, K. Harrigan
More informationSafety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD
Safety of Single- Versus Multi-vessel Angioplasty for Patients with AMI and Multi-vessel CAD Mun K. Hong, MD Associate Professor of Medicine Director, Cardiovascular Intervention and Research Weill Cornell
More informationEmergency surgery in acute coronary syndrome
Emergency surgery in acute coronary syndrome Teerawoot Jantarawan Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
More informationWhat oral antiplatelet therapy would you choose? a) ASA alone b) ASA + Clopidogrel c) ASA + Prasugrel d) ASA + Ticagrelor
76 year old female Prior Hypertension, Hyperlipidemia, Smoking On Hydrochlorothiazide, Atorvastatin New onset chest discomfort; 2 episodes in past 24 hours Heart rate 122/min; BP 170/92 mm Hg, Killip Class
More informationQuinn Capers, IV, MD
Heart Attacks Mended Hearts Presentation, January, 2017 Quinn Capers, IV, MD Associate Professor of Medicine (Cardiovascular Medicine) Director, Transradial Coronary Interventions Division of Cardiovascular
More informationControversies in Cardiac Pharmacology
Controversies in Cardiac Pharmacology Thomas D. Conley, MD FACC FSCAI Disclosures I have no relevant relationships with commercial interests to disclose. 1 Doc, do I really need to take all these medicines?
More informationGuideline for STEMI. Reperfusion at a PCI-Capable Hospital
MANSOURA. 2015 Guideline for STEMI Reperfusion at a PCI-Capable Hospital Mahmoud Yossof MANSOURA 2015 Reperfusion Therapy for Patients with STEMI *Patients with cardiogenic shock or severe heart failure
More informationCindy Stephens, MSN, ANP Kelly Walker, MS, ACNP Peter Cohn, MD, FACC
Cindy Stephens, MSN, ANP Kelly Walker, MS, ACNP Peter Cohn, MD, FACC Define Acute Coronary syndromes Explain the Cause Assessment, diagnosis and therapy Reperfusion for STEMI Complications to look for
More informationSTEMI update. Vijay Krishnamoorthy M.D. Interventional Cardiology
STEMI update Vijay Krishnamoorthy M.D. Interventional Cardiology OVERVIEW Current Standard of Care in Management of STEMI Update in management of STEMI Pre-Cath Lab In the ED/Office/EMS. Cath Lab Post
More informationSTEMI Presentation and Case Discussion. Case #1
STEMI Presentation and Case Discussion Scott M Lilly MD PhD, Interventional Cardiology The Ohio State University Contemporary Multidisciplinary Cardiovascular Conference Orlando, Florida September 17 th,
More informationEchocardiographic Cardiovascular Risk Stratification: Beyond Ejection Fraction
Echocardiographic Cardiovascular Risk Stratification: Beyond Ejection Fraction October 4, 2014 James S. Lee, M.D., F.A.C.C. Associates in Cardiology, P.A. Silver Spring, M.D. Disclosures Financial none
More informationM/39 CC D. => peak CKMB (12 hr later) ng/ml T.chol/TG/HDL/LDL 180/150/48/102 mg/dl #
Acute Coronary Syndrome - Case Review - Young-Guk Ko, MD Yonsei Cardiovascular Center Yonsei University College of Medicine Case 1 M/39 #4306212 CC D : Severe squeezing chest pain : 4 hours, aggravated
More informationMid-term results from real-world REPARA registry. Felipe Hernandez, on behalf of the REPARA investigators
Mid-term results from real-world REPARA registry Felipe Hernandez, on behalf of the REPARA investigators Potential conflicts of interest Speaker's name: Felipe Hernandez I have the following potential
More information4. Which survey program does your facility use to get your program designated by the state?
STEMI SURVEY Please complete one survey for each TCD designation you have in your facility. There would be a maximum of three surveys completed if your facility was designated as a trauma, stroke and STEMI
More informationAcute Coronary Syndrome
Acute Coronary Syndrome Vik Gongidi, DO FACOI, FACC Indian River Medical Center Vero Beach, FL Slides adapted from Robert Bender, DO, FACOI, FACC Definition: Acute Myocardial Ischemia Unstable Angina Non-ST-Elevation
More informationBeta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes
Beta-blockers in Patients with Mid-range Left Ventricular Ejection Fraction after AMI Improved Clinical Outcomes Seung-Jae Joo and other KAMIR-NIH investigators Department of Cardiology, Jeju National
More information2018 Acute Coronary Syndrome. Robert Bender, DO, FACOI, FACC Central Maine Heart and Vascular Institute
2018 Acute Coronary Syndrome Robert Bender, DO, FACOI, FACC Central Maine Heart and Vascular Institute Definitions: Acute Myocardial Ischemia Unstable Angina Non-ST-Elevation MI (NSTEMI) }2/3 ST-Elevation
More informationCommon Codes for ICD-10
Common Codes for ICD-10 Specialty: Cardiology *Always utilize more specific codes first. ABNORMALITIES OF HEART RHYTHM ICD-9-CM Codes: 427.81, 427.89, 785.0, 785.1, 785.3 R00.0 Tachycardia, unspecified
More informationRole of echocardiography in the assessment of ischemic heart disease 분당서울대학교병원윤연이
Role of echocardiography in the assessment of ischemic heart disease 분당서울대학교병원윤연이 Outline Evaluation of Chest pain Evaluation of MI complications Prediction of Outcomes Evaluation of Chest pain Evaluation
More informationST Elevation Myocardial Infarction
ST Elevation Myocardial Infarction Scott M. Lilly, MD, PhD Assistant Professor Clinical Department of Cardiovascular Medicine The Ohio State University Wexner Medical Center Outline Case Presentation STEMI
More informationST Elevation Myocardial Infarction
ST Elevation Myocardial Infarction Scott M. Lilly, MD, PhD Assistant Professor Clinical Department of Cardiovascular Medicine The Ohio State University Wexner Medical Center Case Presentation 46 year old
More informationAcute Coronary Syndrome. Sonny Achtchi, DO
Acute Coronary Syndrome Sonny Achtchi, DO Objectives Understand evidence based and practice based treatments for stabilization and initial management of ACS Become familiar with ACS risk stratification
More informationRationale for Prophylactic Support During Percutaneous Coronary Intervention
Rationale for Prophylactic Support During Percutaneous Coronary Intervention Navin K. Kapur, MD, FACC, FSCAI Assistant Director, Interventional Cardiology Director, Interventional Research Laboratories
More informationSupplementary Table S1: Proportion of missing values presents in the original dataset
Supplementary Table S1: Proportion of missing values presents in the original dataset Variable Included (%) Missing (%) Age 89067 (100.0) 0 (0.0) Gender 89067 (100.0) 0 (0.0) Smoking status 80706 (90.6)
More informationDISCUSSION QUESTION - 1
CASE PRESENTATION 87 year old male No past history of diabetes, HTN, dyslipidemia or smoking Very active Medications: omeprazole for heart burn Admitted because of increasing retrosternal chest pressure
More informationAntonio Colombo. Centro Cuore Columbus and S. Raffaele Scientific Institute, Milan, Italy. Miracor Symposium. Speaker: 15. Parigi: May 16-19, 2017
Parigi: May 16-19, 2017 Miracor Symposium Speaker: 15 Antonio Colombo Centro Cuore Columbus and S. Raffaele Scientific Institute, Milan, Italy Nothing to disclose PiCSO Impulse System Elective high risk
More informationUse of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users
Use of Nuclear Cardiology in Myocardial Viability Assessment and Introduction to PET and PET/CT for Advanced Users February 1 5, 2011 University of Santo Tomas Hospital Angelo King A-V Auditorium Manila,
More informationAPPENDIX F: CASE REPORT FORM
APPENDIX F: CASE REPORT FORM Instruction: Complete this form to notify all ACS admissions at your centre to National Cardiovascular Disease Registry. Where check boxes are provided, check ( ) one or more
More information2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease
2016 ACC/AHA Guideline Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease Developed in Collaboration with American Association for Thoracic Surgery, American
More informationISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions
Julinda Mehilli, MD Deutsches Herzzentrum Technische Universität Munich Germany ISAR-LEFT MAIN: A Randomized Clinical Trial on Drug-Eluting Stents for Unprotected Left Main Lesions Background Left main
More informationOUTPATIENT ANTITHROMBOTIC MANAGEMENT POST NON-ST ELEVATION ACUTE CORONARY SYNDROME. TARGET AUDIENCE: All Canadian health care professionals.
OUTPATIENT ANTITHROMBOTIC MANAGEMENT POST NON-ST ELEVATION ACUTE CORONARY SYNDROME TARGET AUDIENCE: All Canadian health care professionals. OBJECTIVE: To review the use of antiplatelet agents and oral
More informationUPMCJAM XCCU CCU 10 PORTERFIELD, CAROL R COLEMAN MD, SILVIA E General
UPMCJAM XCCU CCU 10 PORTERFIELD, CAROL R 784945341 COLEMAN MD, SILVIA E General Medicine 72 years 10/2/1945 Female 0210384908200 AROMATORIO Patient is admitted with acute anterior MI, DES stent LAD. Ejection
More information2017 Cardiology Survival Guide
2017 Cardiology Survival Guide Chapter 4: Cardiac Catheterization/Percutaneous Coronary Intervention A cardiac catheterization involves a physician inserting a thin plastic tube (catheter) into an artery
More informationIndications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014
Indications of Coronary Angiography Dr. Shaheer K. George, M.D Faculty of Medicine, Mansoura University 2014 Indications for cardiac catheterization Before a decision to perform an invasive procedure such
More information2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction
2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction Developed in Collaboration with American College of Emergency Physicians and Society for Cardiovascular Angiography and
More informationJ. Schwitter, MD, FESC Section of Cardiology
J. Schwitter, MD, FESC Section of Cardiology CMR Center of the CHUV University Hospital Lausanne - CHUV Switzerland Centre de RM Cardiaque J. Schwitter, MD, FESC Section of Cardiology CMR Center of the
More informationCangrelor: Is it the new CHAMPION for PCI? Robert Barcelona, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Intensive Care Unit November 13, 2015
Cangrelor: Is it the new CHAMPION for PCI? Robert Barcelona, PharmD, BCPS Clinical Pharmacy Specialist, Cardiac Intensive Care Unit November 13, 2015 Objectives Review the pharmacology and pharmacokinetic
More informationEAE Teaching Course. Magnetic Resonance Imaging. Competitive or Complementary? Sofia, Bulgaria, 5-7 April F.E. Rademakers
EAE Teaching Course Magnetic Resonance Imaging Competitive or Complementary? Sofia, Bulgaria, 5-7 April 2012 F.E. Rademakers Complementary? Of Course N Engl J Med 2012;366:54-63 Clinical relevance Treatment
More information2/26/2013. NCDR.13 Case Scenario Presentation Cath PCI Registry. Disclosures. Objectives. Dashboard Implications of Some Major Metrics
NCDR.13 Case Scenario Presentation Cath PCI Registry Dashboard Implications of Some Major Metrics Disclosures Tony Hermann has nothing to disclose Mark Hutcheson has nothing to disclose Cornelia Anderson
More informationAppendix: ACC/AHA and ESC practice guidelines
Appendix: ACC/AHA and ESC practice guidelines Definitions for guideline recommendations and level of evidence Recommendation Class I Class IIa Class IIb Class III Level of evidence Level A Level B Level
More informationFastTest. You ve read the book now test yourself
FastTest You ve read the book...... now test yourself To ensure you have learned the key points that will improve your patient care, read the authors questions below. The answers will refer you back to
More informationPercutaneous coronary intervention of RIMA. The real challenge!
Percutaneous coronary intervention of RIMA The real challenge! Speaker's name: I do not have any potential conflict of interest Clinical Case 76-year old woman Previous History Actual Disease Diabetes
More informationSession 7: Cardiology I and II Answer Explanations
Session 7: Cardiology I and II Answer Explanations Cardiology I 1. Answer A: Intravenous heparin 4000-unit intravenous bolus, followed by a 1000-unit/hour continuous infusion. The NSTE-ACS guidelines recommend
More informationSurgical vs. Percutaneous Revascularization in Patients with Diabetes and Acute Coronary Syndrome
Surgical vs. Percutaneous Revascularization in Patients with Diabetes and Acute Coronary Syndrome Chris C. Cook, MD Associate Professor of Surgery Director, CT Residency Program, WVU ACOI 10/17/18 No Disclosures
More informationIschaemic heart disease. IInd Chair and Clinic of Cardiology
Ischaemic heart disease IInd Chair and Clinic of Cardiology Definition Syndrome due to chronic insufficient oxygen supply to myocardial cells Nomenclature: ischaemic heart disease (IHD), coronary artery
More informationEarly discharge in selected patients after an acute coronary syndrome can it be safe?
Early discharge in selected patients after an acute coronary syndrome can it be safe? Glória Abreu, Pedro Azevedo, Carina Arantes, Catarina Quina-Rodrigues, Sara Fonseca, Juliana Martins, Catarina Vieira,
More informationCCS/CAIC/CSCS Position Statement on Revascularization Multi-vessel CAD. Teo et al, Canadian Journal of Cardiology 2014;30:
CCS/CAIC/CSCS Position Statement on Revascularization Multi-vessel CAD Teo et al, Canadian Journal of Cardiology 2014;30: 1482-1491 Parallel Paper: Canadian Cardiovascular Society Guidelines for the Diagnosis
More informationDeclaration of conflict of interest NONE
Declaration of conflict of interest NONE Claudio Muneretto MD, PhD Director of Division of Cardiac Surgery University of Brescia Medical School Italy Hybrid Chymera Different features and potential advantages
More informationDisclosures. Inpatient Management of Non-ST Elevation Acute Coronary Syndromes. Edward McNulty MD, FACC. None
Inpatient Management of Non-ST Elevation Acute Coronary Syndromes Edward McNulty MD, FACC Assistant Clinical Professor UCSF Director, SF VAMC Cardiac Catheterization Laboratory Disclosures None New Guidelines
More information3/23/2017. Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate Europace Oct;14(10): Epub 2012 Aug 24.
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
More informationWhat is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation?
What is the Optimal Triple Anti-platelet Therapy Duration in Patients with Acute Myocardial Infarction Undergoing Drug-eluting Stents Implantation? Keun-Ho Park, Myung Ho Jeong, Min Goo Lee, Jum Suk Ko,
More information6/1/18 LEARNING OBJECTIVES PATIENT POPULATION PRESENTATIONS
PREVENTING HOSPITAL READMISSIONS IN CARDIOVASCULAR PATIENTS Christina Cortez Perry, MSN, FNP-C, CCCC Cardiology Coordinator- Corpus Christi Medical Center 1 2 LEARNING OBJECTIVES Identify the target patient
More informationBelinda Green, Cardiologist, SDHB, 2016
Acute Coronary syndromes All STEMI ALL Non STEMI Unstable angina Belinda Green, Cardiologist, SDHB, 2016 Thrombus in proximal LAD Underlying pathophysiology Be very afraid for your patient Wellens
More informationMedicine Dr. Omed Lecture 2 Stable and Unstable Angina
Medicine Dr. Omed Lecture 2 Stable and Unstable Angina Risk stratification in stable angina. High Risk; *post infarct angina, *poor effort tolerance, *ischemia at low workload, *left main or three vessel
More informationSanford Chest Pain Network: Improving Rural STEMI Outcomes
Sanford Chest Pain Network: Improving Rural STEMI Outcomes Naveen Rajpurohit, MD Cardiovascular Fellow Sanford Cardiovascular Institute Sanford Heart Hospital The University of South Dakota Sioux Falls,
More informationAngelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017
Angelika Cyganska, PharmD Austin T. Wilson, MS, PharmD Candidate 2017 Explain the efficacy and safety of triple therapy, in regards to thromboembolic and bleeding risk Summarize the guideline recommendations
More informationCHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand
CHRONIC HEART FAILURE : WHAT ELSE COULD WE OFFER TO OUR PATIENTS? Cardiac Rehabilitation Society of Thailand ENHANCED EXTERNAL COUNTER PULSATION Piyanuj Ruckpanich, MD. Cardiac Rehabilitation Center Perfect
More informationAlex versus Xience Registry Preliminary report
Interventional Cardiology Network Alex versus Xience Preliminary report Mariusz Gąsior 1,2, Marek Gierlotka 1, Lech Poloński 1,2 1 3rd Department of Cardiology, Medical University of Silesia Centre tor
More informationCardiogenic Shock in Acute MI
Cardiogenic Shock in Acute MI Mark Sheldon, MD UNMH Interventional Cardiology Objectives Overview Treatment Definition Shock profiles Causes Medical Mechanical Illustrative case Questions? Revascularization
More informationSupplementary material 1. Definitions of study endpoints (extracted from the Endpoint Validation Committee Charter) 1.
Rationale, design, and baseline characteristics of the SIGNIFY trial: a randomized, double-blind, placebo-controlled trial of ivabradine in patients with stable coronary artery disease without clinical
More informationΔιάρκεια διπλής αντιαιμοπεταλιακής αγωγής. Νικόλαος Γ.Πατσουράκος Καρδιολόγος, Επιμελητής Α ΕΣΥ Τζάνειο Γενικό Νοσοκομείο Πειραιά
Διάρκεια διπλής αντιαιμοπεταλιακής αγωγής Νικόλαος Γ.Πατσουράκος Καρδιολόγος, Επιμελητής Α ΕΣΥ Τζάνειο Γενικό Νοσοκομείο Πειραιά International ACS guidelines: Recommendations on duration of dual
More informationFrans Van de Werf, MD, PhD Leuven, Belgium
STEMI Cases and the ESC STEMI Guidelines Frans Van de Werf, MD, PhD Leuven, Belgium The Easy Case 2/21/2011 History and Risk Factors 50-year old male patient Past medical history: Teratoma right testis
More informationAcute Coronary Syndrome (ACS) Initial Evaluation and Management
Acute Coronary Syndrome (ACS) Initial Evaluation and Management Symptoms of Possible ACS Chest discomfort with or without radiation to the arm(s), jaw, or epigastrium Short of breath Weakness Diaphoresis
More informationClopidogrel and ASA after CABG for NSTEMI
Clopidogrel and ASA after CABG for NSTEMI May 17, 2007 Justin Lee Pharmacy Resident University Health Network Objectives At the end of this session, you should be able to: Explain the rationale for antiplatelet
More informationNew Concepts in Acute Coronary Syndromes Beyond 2000 (XX) Interactive Case Presentations
New Concepts in Acute Coronary Syndromes Beyond 2000 (XX) Interactive Case Presentations Dr. Richard Bon Surrey Memorial Hospital, Surrey, BC Canadian Cardiovascular Congress 2014 October 26, 2014 Conflicts
More informationTSDA ACGME Milestones
TSDA ACGME Milestones Short MW and Edwards JA. Assessing resident milestones using a CASPE March 2012 Short MW and Edwards JA. Assessing resident milestones using a CASPE March 2012 Short
More informationACUTE CORONARY SYNDROME
12 LEAD ECG INTERPRETATION in ACUTE CORONARY SYNDROME WAYNE W RUPPERT, CVT, CCCC, NREMT-P Cardiovascular Clinical Coordinator Bayfront Health Seven Rivers Crystal River, FL Education Specialist St. Joseph
More informationCOAGULATION, BLEEDING, AND TRANSFUSION IN URGENT AND EMERGENCY CORONARY SURGERY
COAGULATION, BLEEDING, AND TRANSFUSION IN URGENT AND EMERGENCY CORONARY SURGERY VALTER CASATI, M.D. DIVISION OF CARDIOVASCULAR ANESTHESIA AND INTENSIVE CARE CLINICA S. GAUDENZIO NOVARA (ITALY) ANTIPLATELET
More informationAcute Coronary syndrome
Acute Coronary syndrome 7th Annual Pharmacotherapy Conference ACS Pathophysiology rupture or erosion of a vulnerable, lipidladen, atherosclerotic coronary plaque, resulting in exposure of circulating blood
More informationAdults With Diagnosed Diabetes
Adults With Diagnosed Diabetes 1990 No data available Less than 4% 4%-6% Above 6% Mokdad AH, et al. Diabetes Care. 2000;23(9):1278-1283. Adults With Diagnosed Diabetes 2000 4%-6% Above 6% Mokdad AH, et
More informationAn update on the management of UA / NSTEMI. Michael H. Crawford, MD
An update on the management of UA / NSTEMI Michael H. Crawford, MD New ACC/AHA Guidelines 2007 What s s new in the last 5 years CT imaging advances Ascendancy of troponin and BNP Clarification of ACEI/ARB
More informationΑντιαιμοπεταλιακη αγωγη (ποια, πο τε και για πο σο)
Αντιαιμοπεταλιακη αγωγη (ποια, πο τε και για πο σο) Dimitrios Alexopoulos, MD, FESC, FACC Cardiology Department, Patras University Hospital, Patras, Rio, Greece. Patras University Hospital I, Dimitrios
More informationPreoperative Cardiac Risk Assessment: Approach & Guidelines
Preoperative Cardiac Risk Assessment: Approach & Guidelines By, Liam Morris, MD., FACC (02/03/18) CPG : Clinical Practice Guidelines GDMT : Guidelines Directed Medical Therapy GWC : Guideline Writing Committee
More informationTCTAP Upendra Kaul MD,DM,FACC,FSCAI,FAMS,FCSI
Indian TUXEDO Trial In Medically Treated Diabetics Upendra Kaul MD,DM,FACC,FSCAI,FAMS,FCSI Executive Director and Dean Escorts Heart Institute & Medical Research Center and Fortis Hospitals, New Delhi
More information2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non ST-Elevation Myocardial Infarction
2017 AHA/ACC Clinical Performance and Quality Measures for Adults With ST-Elevation and Non ST-Elevation Myocardial Infarction Ramzi Khalil MD FACC Assistant Professor Allegheny Gen.Hospital AHN Speakers
More informationDavid A. Orsinelli, MD, FACC, FASE Professor, Internal Medicine The Ohio State University Division of Cardiovascular Medicine Columbus, Ohio
1 STABLE ISCHEMIC HEART DISEASE: A NON-INVASIVE CARDIOLOGIST S PERSECTIVE 2018 Cardiovascular Course for Trainees and Early Career Physicians APRIL 20, 2018 David A. Orsinelli, MD, FACC, FASE Professor,
More informationBalancing Efficacy and Safety of P2Y12 Inhibitors for ACS Patients
SYP.CLO-A.16.07.01 Balancing Efficacy and Safety of P2Y12 Inhibitors for ACS Patients dr. Hariadi Hariawan, Sp.PD, Sp.JP (K) TOPICS Efficacy Safety Consideration from Currently Available Antiplatelet Agents
More informationMedical Management of Acute Coronary Syndrome: The roles of a noncardiologist. Norbert Lingling D. Uy, MD Professor of Medicine UERMMMCI
Medical Management of Acute Coronary Syndrome: The roles of a noncardiologist physician Norbert Lingling D. Uy, MD Professor of Medicine UERMMMCI Outcome objectives of the discussion: At the end of the
More informationCardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition
Cardiovascular Nursing Practice: A Comprehensive Resource Manual and Study Guide for Clinical Nurses 2 nd Edition Table of Contents Volume 1 Chapter 1: Cardiovascular Anatomy and Physiology Basic Cardiac
More informationKnow the Quality of our Care at Every Step. Kansas City ACS Summit BI-State Cardiovascular Education Consortium
Know the Quality of our Care at Every Step Kansas City ACS Summit BI-State Cardiovascular Education Consortium Welcome to the Kansas City ACS Summit Objectives: Follow the flow and care of an ACS patient
More informationCase Report Simultaneous Two-Vessel Subacute Stent Thrombosis Caused by Clopidogrel Resistance from CYP2C19 Polymorphism
Case Reports in Medicine Volume 2016, Article ID 2312078, 4 pages http://dx.doi.org/10.1155/2016/2312078 Case Report Simultaneous Two-Vessel Subacute Stent Thrombosis Caused by Clopidogrel Resistance from
More informationUPDATES FROM THE 2018 ANTIPLATELET GUIDELINES
UPDATES FROM THE 2018 ANTIPLATELET GUIDELINES Claudia Bucci BScPhm, PharmD Clinical Coordinator, Cardiovascular Diseases Sunnybrook Health Sciences Centre 21st Annual Contemporary Therapeutic Issues in
More informationAnatomy of the Heart and the. ICD-10 Codes
Anatomy of the Heart and the Diseases ICD-10 Codes Sharon J. Oliver CPC, CPMA, CPC-I All Rights Reserved 1 Anatomy of the Heart Pulmonary Tricuspid (AV) Valve Mitral Aortic Semilunar Valve Chordae Tendineae
More informationTailoring adjunctive antithrombotic therapy to reperfusion strategy in STEMI
Tailoring adjunctive antithrombotic therapy to reperfusion strategy in STEMI Adel El-Etriby; MD Professor of Cardiology Ain Shams University President of the Egyptian Working Group of Interventional Cardiology
More informationDifficult Data Definitions and Scenario s
Difficult Data Definitions and Scenario s Presenter Disclosure Information Cornelia Anderson BSN, RN To following relationships exist related to this presentation: No Disclosures Objectives Discuss key
More informationDO NOT SUBMIT OR FAX THIS PAGE TO COR F M L DD MM YY
DO NOT SUBMIT OR FAX THIS PAGE TO COR Patient # Patient Initials of Birth Medical Record Number F M L DD MM YY Patient Name Address Telephone (home) Telephone (work) Expected 6-month Follow-up Family Physician
More informationAcute Coronary Syndromes. Disclosures
Acute Coronary Syndromes Disclosures I work for Virginia Garcia Memorial Health Center, Beaverton, OR. Jon Tardiff, BS, PA-C OHSU Clinical Assistant Professor And I am a medical editor for Jones & Bartlett
More information