Интересные ссылки

[dmblok]

Сообщение от Gilarov

Оптимальный возраст для начала первичной профилактики аспирином у мужчин - 47 лет, у женщин - 58 лет.
Увы, нет полного текста.
Age threshold for vascular prophylaxis by aspirin in patients without diabetes
Heart 2008;94:1429-1432

По моему субъективному мнению - эта статья какое-то статистическое извращение.

[Ссылки доступны только зарегистрированным пользователям ]

[Abugov]

Сообщение от dmblok

По моему субъективному мнению - эта статья какое-то статистическое извращение.

Ну, по поводу статистических извращений - моё любимое:
Аспирин убивает больных ИМ, рождённых под знаками Близнецы и Весы. Количество больных - огромное, достоверность - огромная, тест межгруппового взаимодействия - достоверен с огромной силой.

[dmblok]

Сергей, может мы чего не понимаем...
Надо дождаться специалистов - статистических магов.

[vitti]

Уважаемый дмблок!
Если Вас не затруднит, выложите пожалуйста следующую статью:
«J Am Coll Cardiol Intv, 2008; 1:351-357, doi:10.1016/j.jcin.2008.06.003
The "Crush" Technique for Coronary Artery Bifurcation Stenting: Insights From Micro-Computed Tomographic Imaging of Bench Deployments»

[LupusDoc]

Сообщение от dmblok

По моему субъективному мнению - эта статья какое-то статистическое извращение.

А мне понравилось. Краткостью результатов :

RESULTS
Table 1 shows the baseline characteristics of the patients. Mean
age was 49.8 years; 49.7 (men) and 49.9 (women). The mean 10-
year CHD risk for the total population was 9.0% (11.1% and
7.2% for men and women, respectively).
For both men and women, the estimated baseline CHD risk
increased with age (fig 1). Using the quadratic equations (line of
best fit for our data): y=29.225+0.211(age)+0.004(age2) for
men; and y=24.688+0.085(age)+0.003(age2) for women; the
transition from low to moderate/high baseline risk of developing
CHD occurred at about age 47.8 for men and 57.3 for
women. If a higher threshold was used (.15% 10-year CHD
risk), the age transition from low/moderate to high baseline risk
of developing CHD took place at ages 55.8 for men and 68.1 for
women (table 2).

[Abugov]

Вроде ничего особо нового, но кажется полезным:

Emergency Pretreatment Feasible

“The most important finding of this study is that contrast-allergic patients with STEMI who receive emergency pretreatment and then undergo direct PCI for STEMI may not have adverse effects,” the study authors write. “Although this finding may be surprising to cardiologists, a large body of radiology literature suggests that repeat administration of contrast to contrast-allergic patients is rarely dangerous.”

Based on their experience, the investigators offer 6 recommendations:

* Clinicians should weigh the potential benefits of PCI against the risks of repeat contrast reaction, “recognizing that reactions range from minimal to severe or even life-threatening. For patients in whom contrast has caused cardiovascular or respiratory collapse, contrast-requiring emergency procedures should be undertaken only if the potential benefits are considerable.”
* During emergency PCI, it is “reasonable to give intravenous steroids, knowing that they will not prevent immediate reactions but might prevent or mitigate sustained or delayed reactions.”
* Nonionic contrast agents should be used.
* Intravenous H1 and H2 blockers are also reasonable, even though their value is unproved. However, H2 blockers cannot be given alone, because “unopposed H1 histamine receptor stimulation may result in . . . vasoconstriction of the coronary arteries.”
* While the value of montelukast has not been studied in relation to contrast allergy, “[a]naphylaxis is thought to be at least partly regulated by leukotrienes and might be inhibited by a leukotriene inhibitor.”
* Operators should know, or have on-hand, the protocol for immediate treatment for acute reactions including cardiovascular or respiratory collapse. Resuscitation equipment should also be available.

[Abugov]

Хижина дяди Тома:

Black Medicare patients are less likely to be admitted to specialty cardiac hospitals for revascularization than white patients, although the disparity largely disappears when black patients live near such centers, according to a study published online November 5, 2008, ahead of print in Circulation: Cardiovascular Quality and Outcomes.

[Chevychelov]

Попоследнему ESC2007 гайду по АГ аспирин у пациентов с АГ (без других показаний к аспирину) назначается с 50 лет ((47+58) : 2=52,5), почти точно.

[Gilarov]

Meeting Report ESC Forum on Drug Eluting Stents
European Heart House, Nice,
27–28 September 2007
[Ссылки доступны только зарегистрированным пользователям ]
Если не откроется
[Ссылки доступны только зарегистрированным пользователям ]

[Yariko]

Lower-than-expected bleeding in CABG patients taking clopidogrel within five days preop
[Ссылки доступны только зарегистрированным пользователям ]

[Yariko]

Sex Differences in Medical Care and Early Death After Acute Myocardial Infarction [Ссылки доступны только зарегистрированным пользователям ]
Hani Jneid, MD; Gregg C. Fonarow, MD; Christopher P. Cannon, MD et al.
Background—Women receive less evidence-based medical care than men and have higher rates of death after acute myocardial infarction (AMI). It is unclear whether efforts undertaken to improve AMI care have mitigated these sex disparities in the current era.
Methods and Results—Using the Get With the Guidelines–Coronary Artery Disease database, we examined sex differences in care processes and in-hospital death among 78 254 patients with AMI in 420 US hospitals from 2001 to 2006. Women were older, had more comorbidities, less often presented with ST-elevation myocardial infarction (STEMI), and had higher unadjusted in-hospital death (8.2% versus 5.7%; P<0.0001) than men. After multivariable adjustment, sex differences in in-hospital mortality rates were no longer observed in the overall AMI cohort (adjusted odds ratio [OR]=1.04; 95% CI, 0.99 to 1.10) but persisted among STEMI patients (10.2% versus 5.5%; P<0.0001; adjusted OR=1.12; 95% CI, 1.02 to 1.23). Compared with men, women were less likely to receive early aspirin treatment (adjusted OR=0.86; 95% CI, 0.81 to 0.90), early beta-blocker treatment (adjusted OR=0.9; 95% CI, 0.86 to 0.93), reperfusion therapy (adjusted OR=0.75; 95% CI, 0.70 to 0.80), or timely reperfusion (door-to-needle time <30 minutes: adjusted OR=0.78; 95% CI, 0.65 to 0.92; door-to-balloon time <90 minutes: adjusted OR=0.87; 95% CI, 0.79 to 0.95). Women also experienced lower use of cardiac catheterization and revascularization procedures after AMI.
Conclusions—Overall, no sex differences in in-hospital mortality rates after AMI were observed after multivariable adjustment. However, women with STEMI had higher adjusted mortality rates than men. The underuse of evidence-based treatments and delayed reperfusion among women represent potential opportunities for reducing sex disparities in care and outcome after AMI. (Circulation. 2008;118:000-000.)

[dmblok]

Сообщение от Khomitskaya

Sex Differences in Medical Care and Early Death After Acute Myocardial Infarction

[Ссылки доступны только зарегистрированным пользователям ]

[Abugov]

update

[dmblok]

ST-Segment Recovery and Outcome After Primary Percutaneous Coronary Intervention
[Ссылки доступны только зарегистрированным пользователям ]

[rsp]

то ли у них хирурги плохие, то ли очень хорошие рентгенхирурги, либо это действительно правда: 4-х летние результаты стентирования ствола ЛКА "дезами"...
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и через 4 года....
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источник - tctmd