Cardiovascular Disease

May 092011
 

Parra et al diagnosed OSA in 140 patients hospitalized for stroke in Spain and randomized them to nasal auto-titrating CPAP or no therapy. The CPAP-treated patients had better Rankin and Canadian stroke outcome scores at all follow-up visits. They had the same rate of subsequent cardiovascular events, but events occurred at a median 15 months [… read more]

May 052011
 

Rubboli et al summarize the (weak) evidence and current guidelines. General avoidance of drug-eluting stents in those with need of long-term warfarin is still the party-line recommendation, with triple therapy (warfarin, aspirin, clopidogrel) for those who receive a DES due to a strong indication. While TT is clearly superior for high risk patients (e.g., mechanical valve), the [… read more]

Apr 182011
 

Trouillet et al randomized patients requiring mechanical ventilation 4 days after cardiac surgery to either immediate perc-trach, or delayed percutaneous tracheostomy at 15 days. There were no differences in ventilator-free days at 60 days, nor in survival at 28, 60, or 90 days, nor in rates of VAP; however, the early-trach group had a lower [… read more]

Mar 212011
 

The EMShockNet team previously claimed in JAMA that hyperoxia (paO2>300) after cardiac arrest could be deadly (63% in-hospital mortality vs 45% in normoxic patients). After looking at 12,108 database records in Australia/New Zealand, Bellomo et al beg to differ. By applying severity of illness/propensity models, they found no increased risk of death in those with [… read more]

Mar 082011
 

Warfarin is the best drug for stroke prevention in atrial fibrillation. In people with a-fib for whom warfarin was unsuitable (unstable INR, unlikely adherence, etc, but excluding those with prior bleeding on warfarin), twice daily oral direct Xa inhibitor apixaban had a hazard ratio of 0.45 over aspirin for the primary outcome of stroke (absolute [… read more]

Feb 272011
 

Using Medicare records from more than 30,000 beneficiaries with congestive heart failure, Javaheri et al suggest in this observational epidemiologic study that sleep apnea may be woefully overlooked and undertreated in people with CHF. The 2% of the cohort who were tested and treated for sleep apnea had one-third the 2-year mortality of their risk-matched [… read more]