Podcasts about antiplatelet

N Engl J Med 2013;368:1379-1387Background In 2013, it had been established that primary PCI for STEMI was the preferred strategy. Yet many patients did not have prompt access to primary-PCI capable hospitals and transfer delays could impact outcomes. The vast majority of patients with STEMI who present to non-PCI facilities do not subsequently get primary PCI within recommended times.Cardiology Trial's Substack is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.Delays led to the development of prehospital care, such as ECGs in the ambulance, and pre-hospital delivery of fibrinolysis. The Strategic Reperfusion Early after Myocardial Infarction (STREAM) study evaluated whether a fibrinolytic-therapy approach consisting of prehospital or early fibrinolysis with contemporary antiplatelet and anticoagulant therapy, coupled with timely coronary angiography, provides a clinical outcome similar to that with primary PCI in patients with STEMI who present early after symptom onset.Patients Eligible patients had a) STEMI within three hours, b) could not have primary PCI within one hour of first medical contact. No formal exclusion criteria were listed in the main manuscript.Baseline Characteristics A total of 1892 patients underwent randomization in 1:1 fashion. The mean age of patients was 59 years. Less than 15% of both groups were older than 75 years. Females were 20%. More than 90% of patients were Killip class 1. Less than 10% of enrolled patients had had prior CHF, MI, or PCI.Procedures Patients were randomized in a 1:1 ratio to fibrinolysis followed by timely coronary angiography or primary PCI. All patients were transferred to a PCI-capable hospital; for all non-PCI community hospitals participating in the study, a well-developed hub-and-spoke relationship with a PCI-capable site was required.The fibrinolytic strategy included early use of concomitant antiplatelet and anticoagulant medications, as well as additional discretionary glycoprotein IIb/IIIa antagonists. Tenecteplase was administered in a weight-based dose and was combined with low-molecular-weight enoxaparin, weight and age adjusted.Antiplatelet therapy consisted of clopidogrel in a 300-mg loading dose (omitted for patients ≥75 years of age) followed by 75 mg daily and aspirin (150 to 325 mg) immediately followed by 75 to 325 mg daily. Urgent coronary angiography in the fibrinolysis group was permitted at any time in the presence of hemodynamic or electrical instability, worsening ischemia, or progressive or sustained ST-segment elevation requiring immediate coronary intervention, according to the investigator's judgment.Endpoints The primary end point of the trial was a 30-day composite of death from any cause, shock, congestive heart failure, or reinfarction. Single efficacy end points as well as safety end points consisting of ischemic stroke, intracranial hemorrhage, nonintracranial bleeding, and other serious clinical events were recorded.The statistical analysis plan was complicated. A sample size of 1000 patients per study group was planned, and the rate of the primary end point in the primary PCI group was projected to be 15.0%. After one-fifth of patients had been enrolled, trialists amended the protocol to reduce the dose of tenecteplase by 50% in patients older than 75 years because of excess ICH. ECG criteria for inferior MI was also changed to require at least 3 mm (up from 2) of ST elevation in two contiguous leads.This trial was designed as a proof-of-concept study. All statistical tests were of an exploratory nature.Results The median time delay from the onset of symptoms to first medical contact and randomization was similar in the two groups ( 61-62 minutes). The median times between symptom onset and start of reperfusion therapy (bolus tenecteplase or arterial sheath insertion) were 100 minutes and 178 minutes, respectively (P

This episode covers: Cardiology This Week: A concise summary of recent studies Dual antiplatelet therapy in 2025 Optimal communication with patients Snapshots Host: Emer Joyce  Guests: Carlos Aguiar, Michelle Kittleson, Gilles Montalescot Want to watch that episode? Go to: https://esc365.escardio.org/event/1798   Disclaimer ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC.   Declarations of interests Stephan Achenbach, Emer Joyce, Michelle Kittleson and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Gilles Montalescot has declared to have potential conflicts of interest to report: research funds for Action Groupe or honoraria from Abbott, Amgen, AstraZeneca, Bayer, BMS, Boehringer-Ingelheim, Celecor, CSL Behring, Hexacath, Idorsia, Lilly, Novo Nordisk, Pfizer, SMT, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

Host: Emer Joyce Guest: Gilles Montalescot Want to watch that extended interview? Go to: https://esc365.escardio.org/event/1798?resource=interview   Disclaimer ESC TV Today is supported by Bristol Myers Squibb. This scientific content and opinions expressed in the programme have not been influenced in any way by its sponsor. This programme is intended for health care professionals only and is to be used for educational purposes. The European Society of Cardiology (ESC) does not aim to promote medicinal products nor devices. Any views or opinions expressed are the presenters' own and do not reflect the views of the ESC. Declarations of interests Stephan Achenbach, Emer Joyce and Nicolle Kraenkel have declared to have no potential conflicts of interest to report. Carlos Aguiar has declared to have potential conflicts of interest to report: personal fees for consultancy and/or speaker fees from Abbott, AbbVie, Alnylam, Amgen, AstraZeneca, Bayer, BiAL, Boehringer-Ingelheim, Daiichi-Sankyo, Ferrer, Gilead, GSK, Lilly, Novartis, Pfizer, Sanofi, Servier, Takeda, Tecnimede. Davide Capodanno has declared to have potential conflicts of interest to report: Bristol Myers Squibb, Daiichi Sankyo, Sanofi Aventis, Novo Nordisk, Terumo. Gilles Montalescot has declared to have potential conflicts of interest to report: research funds for Action Groupe or honoraria from Abbott, Amgen, AstraZeneca, Bayer, BMS, Boehringer-Ingelheim, Celecor, CSL Behring, Hexacath, Idorsia, Lilly, Novo Nordisk, Pfizer, SMT, Terumo. Steffen Petersen has declared to have potential conflicts of interest to report: consultancy for Circle Cardiovascular Imaging Inc. Calgary, Alberta, Canada. Emma Svennberg has declared to have potential conflicts of interest to report: Abbott, Astra Zeneca, Bayer, Bristol-Myers, Squibb-Pfizer, Johnson & Johnson.

In this episode, Dr. Valentin Fuster discusses the ASSURE DES trial, which compared aspirin monotherapy to withholding antiplatelet therapy in stable patients with drug-eluting stents undergoing non-cardiac surgery. The trial found no significant difference in major adverse outcomes between the two strategies, though minor bleeding was more common in the aspirin group, leading to a recommendation to continue aspirin therapy for most patients undergoing low-to-intermediate risk surgery, with exceptions for those at high bleeding risk.

What if the future of dual antiplatelet therapy (DAPT) could be shorter, safer, and more effective? Uncover the latest insights into drug-eluting stents and how they are transforming how we think about dual-antiplatelet therapy. Join us as we examine the game-changing recommendations from top cardiology societies, which suggest that newer-generation stents can significantly reduce the duration of DAPT, particularly for patients with a high bleeding risk. Listen in as we dissect the innovative tools like the PRECISE-DAPT score and ARC-HBR criteria used to determine bleeding risk, ensuring patient safety without compromising on the efficacy of treatment. We delve into pivotal studies, including the Global Leader Study and the STOP-DAPT trial, that back these groundbreaking changes.Our conversation takes an intriguing turn as we explore the intersection of cardiology advancements with anesthesia practices. Discover how these developments are influencing preoperative settings, potentially altering surgical timing and decision-making in anesthesia care. We bring you exclusive insights from contributor, Janak Chandrasoma, featured in the October 2024 APSF newsletter. We urge you to explore further resources, share the knowledge with your peers, and join us in promoting patient safety in perioperative environments. Don't forget to rate, review, and share the episode with colleagues keen on staying at the forefront of anesthesia patient safety advancements.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/229-revolutionizing-anesthesia-care-for-cardiac-patients/© 2024, The Anesthesia Patient Safety Foundation

34th ESC 2024: Ticagrelor monotherapy vs. dual antiplatelet therapy

In this episode of Medmastery's Cardiology Digest, we dive into three groundbreaking studies that are set to reshape our understanding and approach to cardiology. STUDY #1: First, we discuss a landmark piece of research that sheds new light on the benefits of percutaneous coronary intervention for patients with significant coronary artery disease who need a transcatheter aortic valve replacement. This study addresses important questions about patient selection for this intervention.   Lønborg, J, Jabbari, R, Sabbah, M, et al. 2024. PCI in patients undergoing transcatheter aortic-valve implantation. N Engl J Med. Published online. (https://doi.org/10.1056/NEJMoa2401513) STUDY #2: Next, we examine an insightful meta-analysis that evaluates patient-level data to inform the future of dual antiplatelet therapy after percutaneous coronary intervention. Discover the factors influencing the transition to ticagrelor monotherapy post-PCI and why this could change current guideline recommendations.  Valgimigli, M, Hong, S, Gragnano, F, et al. 2024. De-escalation to ticagrelor monotherapy versus 12 months of dual antiplatelet therapy in patients with and without acute coronary syndromes: A systematic review and individual patient-level meta-analysis of randomized trials. Lancet. 10456: 937–948. (https://doi.org/10.1016/S0140-6736(24)01616-7) STUDY #3: Lastly, we take a closer look at the EPIC-CAD study, which aligns with previous findings from the AFIRE trial. Learn why anticoagulant monotherapy is now being considered for the majority of patients with atrial fibrillation who require anticoagulation and have stable coronary artery disease, and what this means for your clinical practice. Cho, MS, Kang, D-Y, Ahn, J-M, et al. 2024. Edoxaban antithrombotic therapy for atrial fibrillation and stable coronary artery disease. N Engl J Med. Published online. (https://doi.org/10.1056/NEJMoa2407362) Tune in to this episode for an engaging in-depth discussion of these studies and stay ahead in the ever-evolving field of cardiology!  Learn more with Medmastery's courses: Percutaneous Coronary Intervention Essentials (6 CME) Percutaneous Coronary Intervention Essentials Workshop (6 CME) Get a Basic or Pro account, or, get a Trial account. Show notes: Visit us at  https://www.medmastery.com/podcasts/cardiology-podcast.

In this episode of JACC, Valentin Fuster examines genotype-guided antiplatelet therapy, emphasizing its potential to tailor treatments based on genetic variants for improved patient outcomes. While promising, the approach faces challenges like testing delays and variable patient responses that need addressing for broader implementation.

Following an emergency c-section due to HELLP syndrome in her first pregnancy, Jolene Brink was determined to have a different birthing experience with her second child. Through the support of a knowledgeable medical team and insights gained from her EBB Childbirth Class, she successfully achieved her goal of an unmedicated VBAC with the birth of her son, Guthrie, in 2022. Jolene's journey towards a VBAC was a transformative process of healing, empowerment, and reclaiming her birthing experience, showcasing the importance of advocacy and informed decision-making in maternal healthcare. Resources: Check out Doulas of Duluth to learn from her instructors Cooper Orth and Dana Morrison, and follow them on Instagram! Learn about Jolene's work here! Read The Preeclampsia Foundation's article on HELLP Syndrome Follow the Preeclampsia Foundation on Instagram van Oostwaard, M. F. et al. (2015). "Recurrence of hypertensive disorders of pregnancy: An individual patient data meta-analysis." Am J Obstet Gynecol 212(5): 624.e1-17. https://pubmed.ncbi.nlm.nih.gov/25582098/ Duley, L., et al. (2019). "Antiplatelet agents for preventing pre-eclampsia and its complications." Cochrane Database Syst Rev. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820858/ Listen to the Evidence on VBAC - EBB 113 EBB Childbirth Class now includes a module all about planning a VBAC! Learn more about the EBB Childbirth class here. For more information about Evidence Based Birth and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram, YouTube, and TikTok! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.

Case Discussion 111 Answer: Antiplatelet therapy before CABG in CCS patients

Case Discussion 109 Answer: GI protection in SAPT

Special guest Dave L. Dixon, PharmD, FACC, FAHA, FCCP, FNLA, BCACP, CDCES, CLS, the Nancy L. and Ronald H. McFarlane Professor of Pharmacy and Chair of the Department of Pharmacotherapy & Outcomes Science at the Virginia Commonwealth University School of Pharmacy, joins us to talk about chronic coronary disease.Listen in as he discusses the management of chronic coronary disease with a focus on the new American College of Cardiology/American Heart Association guidelines.You'll also hear practical advice from panelists on TRC's Editorial Advisory Board:Anthony A. Donato, Jr., MD, MHPE, Associate Program Director, Tower Health System Internal Medicine Residency Program and Professor of Medicine at the Drexel University College of MedicineSteven E. Nissen, MD, MACC, the Chief Academic Officer at the Heart and Vascular Institute and the Lewis and Patricia Dickey Chair in Cardiovascular Medicine Professor of Medicine at the Cleveland Clinic Lerner School of Medicine at Case Western Reserve UniversityCraig D. Williams, PharmD, FNLA, BCPS, Clinical Professor of Pharmacy Practice at the Oregon Health and Science UniversityFor the purposes of disclosure, Dr. Dixon reports a relevant financial relationship [GLP-1 agonists, SGLT2 inhibitors] with Boehringer Ingelheim (grants/research support). Dr. Steven Nissen reports relevant financial relationships [cardiology] with AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Eli Lilly, Esperion, Medtronic, MyoKardia, New Amsterdam Pharma, Novartis, Pfizer, Silence Therapeutics (grants/research support).The other speakers have nothing to disclose. All relevant financial relationships have been mitigated.TRC Healthcare offers CE credit for this podcast. Log in to your Pharmacist's Letter or Prescriber's Letter account and look for the title of this podcast in the list of available CE courses.The clinical resources mentioned during the podcast are part of a subscription to Pharmacist's Letter and Prescriber's Letter: Toolbox: Optimizing Care of Patients with Coronary Artery DiseaseChart:  Dual Antiplatelet Therapy for Coronary Artery DiseaseChart:  Treatment of HypertensionIf you're not yet a Pharmacist's Letter or Prescriber's Letter subscriber, find out more about our product offerings at trchealthcare.com. Follow or subscribe, rate, and review this show in your favorite podcast app. You can also reach out to provide feedback or make suggestions by emailing us at ContactUs@trchealthcare.com.

Welcome back Rounds Table Listeners! In this throwback episode, Mike and John discuss two papers exploring pharmacotherapy-based interventions for agitation experienced by individuals with dementia and when to start or restart antiplatelet therapy after stroke caused by intracerebral hemorrhage. Check it out below! Effects of Antiplatelet Therapy After Stroke Caused by Intracerebral Hemorrhage (0:00 – 7:14). ... The post TBT – Agitation in Dementia and Antiplatelet Therapy after Intracerebral Hemorrhage first appeared on Healthy Debate. The post TBT – Agitation in Dementia and Antiplatelet Therapy after Intracerebral Hemorrhage appeared first on Healthy Debate.

Welcome back Rounds Table Listeners! In this throwback episode, Mike and John discuss two papers exploring pharmacotherapy-based interventions for agitation experienced by individuals with dementia and when to start or restart antiplatelet therapy after stroke caused by intracerebral hemorrhage. Check it out below! Effects of Antiplatelet Therapy After Stroke Caused by Intracerebral Hemorrhage (0:00 – 7:14). ...The post TBT – Agitation in Dementia and Antiplatelet Therapy after Intracerebral Hemorrhage appeared first on Healthy Debate.

Host: Peter Buch, MD, FACG, AGAF, FACP Guest: Naga Chalasani, MD With the increasing incidence and prevalence of cirrhosis in patients, healthcare professionals have to routinely consider giving anticoagulants to these patients. Understanding how we can safely administer these types of medications to cirrhosis patients is important. To learn more, tune in with Dr. Peter Buch as he speaks with Dr. Naga Chalasani, Co-Author of the article, titled “The Safety of Anticoagulants and Antiplatelet Agents in Patients with Cirrhosis,” which was published in Alimentary Pharmacology and Therapeutics in November 2022, and the David W. Crabb Professor of Gastroenterology and Hepatology at Indiana University School of Medicine in Indianapolis.

Commentary by Dr. Valentin Fuster

Applying guidelines-directed therapies for antiplatelets and antithrombotics requires balancing the risks of cardiovascular events and the risk of bleeding. Guest Erin Michos, MD, MHS, FACC, FAHA, FASE, FASCP, describes the use shared decision-making with patients who are at higher risk for thrombotic events, and discusses pharmacotherapies recommended for use with particular patient groups.2019 AHA/ACC Primary Prevention Guidelines: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000678US Preventive Service Task Force 2022 Aspirin Recommendations: https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/aspirin-to-prevent-cardiovascular-disease-preventive-medicationCURE Trial 2022: https://www.ahajournals.org/doi/10.1161/01.cir.0000029926.71825.e2DAPT risk calculator: https://tools.acc.org/daptriskapp/#!/content/calculator/PRECISE-DAPT score: http://www.precisedaptscore.com/predapt/TWILIGHT trial: https://www.nejm.org/doi/full/10.1056/NEJMoa19084192021 AHA/ACC/SCAI guidelines for acute coronary disease: https://www.ahajournals.org/doi/10.1161/CIR.0000000000001038COMPASS trial: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.046048See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

In this episode of the Spine & Nerve podcast, Dr. Jason Kung and Dr. Brian Joves delve into a comprehensive discussion surrounding anticoagulation guidelines and their implications in interventional pain procedures. With over a hundred thousand downloads and over 1,000 YouTube subscribers, we would like to express our sincere gratitude to all the listeners for your engagement and support. Please continue to share and subscribe to help more people discover the podcast. Today's episode focuses on the safety of epidural steroid injections and the critical role of anticoagulation management.Understanding the rationale behind a patient's anticoagulation therapy is vital for interventional pain physicians. This approach empowers clinicians to make informed decisions about whether to continue or withhold anticoagulation medications prior to procedures. There is a delicate balance between patient-specific risks and the benefits of these interventions. One of the things that must be known and emphasized is the remarkable safety profile of epidural steroid injections. Approximately nine million epidural steroid injections are administered annually, resulting in an adverse event rate of about one in 780,000. This reassuring statistic is attributed to the collaborative efforts of medical societies and the implementation of strict anticoagulation guidelines. The hosts emphasize the role of fluoroscopic guidance, non-particulate steroids, and avoidance of deep sedation in enhancing the safety of these procedures. The episode further delves into the nuances of assessing bleeding risks in patients undergoing interventional pain procedures. As always, we must underscore the importance of a comprehensive physical examination, with a specific focus on identifying signs of easy bruising and mucosal bleeding. The hosts discuss the relevance of specific medications, including aspirin and NSAIDs, and their implications for procedural safety. The hosts engage in an insightful exploration of the guidelines for managing anticoagulation medications pre- and post-procedure. They stress the need for pain physicians to consider the anatomical location of the intervention and evaluate the potential risks versus benefits. The doctors conclude the episode by highlighting the crucial role of shared decision-making and patient education. By fostering collaboration between patients and physicians, the hosts emphasize the creation of a safe and informed healthcare environment.In this thought-provoking episode, the doctors try to help you navigate the complexities of anticoagulation management in interventional pain procedures, and offer some insights for practitioners seeking to provide the highest level of care to their patients. References: Anesthesia Quality Institute Closed Claims Database Review 2011 through 2021 for Epidural Steroid Complications. Naeem Haider. Pain Physician 26 (3), E251, 2023 Stephen Endres, MD and others, The Risks of Continuing or Discontinuing Anticoagulants for Patients Undergoing Common Interventional Pain Procedures, Pain Medicine, Volume 18, Issue 3, March 2017, Pages 403–409, https://doi.org/10.1093/pm/pnw108 Narouze S, Benzon HT, Provenzano D, et alInterventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications (Second Edition): Guidelines From the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, the American Academy of Pain Medicine, the International Neuromodulation Society, the North American Neuromodulation Society, and the World Institute of PainRegional Anesthesia & Pain Medicine 2018; 43:225-262. The ASRA App: https://www.asra.com/the-asra-family/asra-app

Thrombolytics are the standard of care for acute stroke yet are not without risk. Join host, Geoff Wall, with guest, Jake Galdo, as they discuss combination aspirin and clopidogrel versus thrombolytics in mild stroke. The GameChangerThrombolytic use in mild stroke is common due to the time factor of administration, but data is mixed. New research has shown DAPT to be non-inferior to TPA. HostGeoff Wall, PharmD, BCPS, FCCP, BCGPProfessor of Pharmacy Practice, Drake UniversityInternal Medicine/Critical Care, UnityPoint HealthJake Galdo, PharmD, MBA, BCPS, BCGPCourse Content and Developer, CEimpactManaging Network Facilitator, CPESN Health EquityCEO, Seguridad ReferenceChen H, Cui Y, Zhou Z, et al. Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial. JAMA. 2023;329(24):2135–2144. doi:10.1001/jama.2023.7827https://jamanetwork.com/journals/jama/article-abstract/2806532 Pharmacist Members, REDEEM YOUR CPE HERE! Not a member? Get a Pharmacist Membership & earn CE for GameChangers Podcast episodes! (30 mins/episode)CPE Information Learning ObjectivesUpon successful completion of this knowledge-based activity, participants should be able to:1. Discuss how the inclusion and exclusion criteria impact the interpretation of the ARIMIS study 2. Describe the potential benefits of DAPT therapy compared to thrombolytic therapy in mild stroke0.05 CEU/0.5 HrUAN: 0107-0000-23-249-H01-PInitial release date: 7/31/2023Expiration date: 7/31/2024Additional CPE details can be found here.Follow CEimpact on Social Media:LinkedInInstagramDownload the CEimpact App for Free Continuing Education + so much more!

Dr. Thanh Nguyen discusses his paper, "Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke". Show references: https://jamanetwork.com/journals/jama/article-abstract/2806532 This episode was sponsored by the ExTINGUISH Trial for NMDAR Encephalitis: Call 844-4BRAIN5 to refer patients.

Dr. Dan Ackerman talks with Dr. Thanh Nguyen about whether dual antiplatelet therapy is noninferior to intravenous thrombolysis among patients with minor nondisabling acute ischemic stroke. Read the related article in JAMA. Visit NPUb.org/Podcast for associated article links. This episode was sponsored by the ExTINGUISH Trial for NMDAR Encephalitis: Call 844-4BRAIN5 to refer patients.

Welcome to Episode 3 of Medmastery's Cardiology Digest, where we bring you expert insights and the latest scientific findings in the field of cardiology. Stay updated with our bite-sized summaries of late-breaking trials. Hit the subscribe button so you never miss an important update again.   In today's episode, we'll discuss four studies that shed light on new developments in cardiology and medicine:   STUDY 1: The final 15-month results of the MASTER-DAPT trial by Landi A et al. show that abbreviated antiplatelet therapy is non-inferior to standard antiplatelet therapy for high bleeding risk patients undergoing percutaneous coronary intervention (PCI). The trial found that abbreviated therapy significantly reduced the risk of bleeding, with no increase in the risk of ischemic events. Landi A et al. Abbreviated or standard antiplatelet therapy in HBR patients: Final 15-month results of the MASTER-DAPT trial. JACC Cardiovasc Interv 2023 Apr 10; 16:798. (https://doi.org/10.1016/j.jcin.2023.01.366)   STUDY 2: The prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players is discussed in a recent study by Bhatia RT et al. The study found that over 20% of the players had de-novo ECG changes, which were associated with myocardial inflammation and fibrosis. The authors recommend routine ECG screening for athletes post-COVID-19 infection. Bhatia RT et al. Prevalence and diagnostic significance of de-novo 12-lead ECG changes after COVID-19 infection in elite soccer players. Heart 2023 Mar 27; [e-pub]. (https://doi.org/10.1136/heartjnl-2022-322211)   STUDY 3: Haupt CE and Marks M discuss the benefits, limits, and risks of AI-generated medical advice in their recent JAMA article. They argue that AI-generated advice has the potential to improve clinical decision-making and reduce errors, but highlight the need for appropriate training, validation, and regulation to ensure patient safety. Haupt CE, Marks M. AI-Generated Medical Advice-GPT and Beyond. JAMA. 2023 Apr 25;329(16):1349-1350. doi: 10.1001/jama.2023.5321. PMID: 36972070.   Study 4: Lee P et al. discuss the benefits, limits, and risks of GPT-4 as an AI chatbot for medicine in their recent NEJM article. They note that while GPT-4 has the potential to improve patient education and communication, it also raises concerns around privacy, liability, and bias. The authors highlight the need for further research and guidelines on the use of AI chatbots in healthcare. Lee P, Bubeck S, Petro J. Benefits, Limits, and Risks of GPT-4 as an AI Chatbot for Medicine. N Engl J Med. 2023 Mar 30;388(13):1233-1239. doi: 10.1056/NEJMsr2214184. PMID: 36988602.   Thanks for listening to Medmastery's Cardiology Digest. Join us next week for more expert insights and scientific updates and visit https://www.medmastery.com/podcasts/cardiology-podcast for more information.  

Host/Editor: Dr. Alla Turshudzhyan, Chief Medical Resident at UCONN. Majority of peripheral disease (PAD) cases are asymptomatic with only about 25% of patients presenting with claudication, rest pain, gangrene, and limb ulcerations. Ankle-brachial index (ABI) is a first-line diagnostic test. ABI of less than 0.9 is consistent with PAD. ABI greater than 1.3 is a sign of noncompressible calcified vessels. If patient's story and exam are highly concerning for PAD, but ABI is normal, consider post-exercise ABI or a toe-brachial index. Use duplex US to help you identify location and severity of PAD. More advanced imaging may be warranted if non-invasive modalities are non-diagnostic or if patient needs an intervention. For symptomatic PAD patients, it is reasonable to consider clopidogrel over aspirin or low-dose rivaroxaban plus aspirin (while keeping in mind that rivaroxaban + ASA carries an increased risk of bleeding when compared to ASA alone). Antiplatelet therapy use in asymptomatic PAD is not routinely recommended. Treat claudication with supervised exercise program, followed by cilostazol or naftidrofuryl. If your patient progressed to the point that their symptoms are constant, disabling, and no longer responsive to lifestyle modification and pharmacotherapy, revascularization may be indicated. There are two options for revascularization – percutaneous and surgical. Most cases can be done percutaneously. Surgery is reserved for patient with long segment stenosis, multifocal stenosis, eccentric, calcified stenosis, or long segment occlusions. We hope you enjoy this episode! Thank you for listening.

In this episode of the PRS Global Open Keynotes Podcast, Dr. Karen Evans and Dr. Christopher Attinger discuss the safety of continuing antiplatelet and anticoagulant medications in patients undergoing split skin graft procedures. This episode discusses the following PRS Global Open article: Neither Antiplatelet nor Anticoagulant Therapy Increases Graft Failure after Split-thickness Skin Grafting by Elliot T. Walters, Kevin G. Kim, Paige K. Dekker, Gregory P. Stimac, Shyamin Mehra, Tammer Elmarsafi, John S. Steinberg, Christopher E. Attinger, Paul J. Kim and Karen K. Evans. Read the articles for free on PRSGlobalOpen.com:https://bit.ly/AntiplateletnorAnticoagulant Drs. Evans and Attinger are both Professors in the Department of Plastic and Reconstructive Surgery at Medstar Georgetown University Hospital in Washington, DC. Your host, Dr. Damian Marucci, is a board-certified plastic surgeon and Associate Professor of Surgery at the University of Sydney in Australia. #PRSGlobalOpen #KeynotesPodcast #PlasticSurgery

Commentary by Dr. Valentin Fuster

This week, Rob and Zach will be talking about Anticoagulants, Thrombolytics, and Antiplatelet AgentsWe will be discussing the following topics within this episode on Anticoagulants, Thrombolytics, and Antiplatelet Agents!Hemostasis: Coagulation Cascade, Extrinsic + Intrinsic PathwayAnticoagulants:HeparinUFHLMWHFondaparinux Direct Factor InhibitorsXa Inhibitors:RivaroxabanApixabanEdoxabanThrombin Inhibitors:DabigatranArgatrobanBivalirudinVitamin K Antagonists:Warfarin (Coumadin)Thrombolytics (tPA):AlteplaseReteplaseTenecteplaseStreptokinaseUrokinaseAntiplatelets:AspirinP2y12 Receptor Blockers:ClopidogrelTicagrelorPrasugrelTiclopidineGP2b/3a Inhibitors:AbciximabEptifibatideTirofibanPDE-3 Inhibitors:CilostazolAnticoagulants, Thrombolytics, Antiplatelet Agents MOATherapeutic IndicationsAdverse Drug Reactions (ADR's)Drug ComplicationsTo follow along with Notes & Illustrations for our podcasts please become a member on our website! https://www.ninjanerd.org/podcast/anticoagulants-thrombolytics-and-antiplatelet-agentsFollow us on:YouTube: https://www.youtube.com/ninjanerdscienceInstagram: https://www.instagram.com/ninjanerdlecturesFacebook: https://www.facebook.com/NinjaNerdLecturesTwitter: https://twitter.com/ninjanerdsciDiscord: https://discord.com/invite/3srTG4dngWTikTok: https://www.tiktok.com/@ninjanerdlecturesThe Foundation of Daily Health, AG1 by Athletic GreensUnlock Your Free One Year Supply of Vitamin D3+K2 and 5 free Travel Packs Support the show

Dual antiplatelet Tx. with Ticagrelor and graft failure after CABG

This subgroup analysis from the MASTER-DAPT trial demonstrates that in high-bleeding risk patients with acute or recent myocardial infarction it is safe to stop DAPT 1 month after stenting and that this strategy provides a reduction in bleeding risk. In this interview, Pieter C. Smits MD, PhD, FESC and Sidney C. Smith Jr. MD, MACC, with Jeffrey Hsu MD, PhD, discuss a recent piece from JACC: Abbreviated Antiplatelet Therapy after Coronary Stenting in Patients with Myocardial Infarction at High Bleeding Risk.   Subscribe on Apple Podcasts | Subscribe on Google Play | Subscribe to ACCEL

Kyle A. Hess, PharmD (Twitter: @KyleHessPharmD ) describes current guideline recommendations for duration of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention, compares and contrasts strategies for antiplatelet regimens for reduced duration DAPT and selects an appropriate duration of therapy when utilizing shortened DAPT. For more pharmacy content, follow Mayo Clinic Pharmacy Residency Programs @MayoPharmRes or the host, Garrett E. Schramm, Pharm.D., @garrett_schramm on Twitter! You can also connect with the Mayo Clinic's School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd. 

Commentary by Dr. Valentin Fuster

Commentary by Dr. Valentin Fuster

An Update on Antiplatelet Therapy

Dear friends, in this episode we summarized recent data on potent antiplatelet therapy. You can also download the slides via this link:http://ecardiocast.com/wp-content/uploads/2022/06/antiplatelet-therapy.pdf

Dear friends, in this episode we summarized recent data on potent antiplatelet therapy and Kimiara company provided us the data on Brelor. You can also download the slides via this link:http://ecardiocast.com/wp-content/uploads/2022/06/antiplatelet-therapy.pdf

Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our second oncologic emergency: new brain mets. Brain mets:Strongly consider steroids, particularly with the presence of vasogenic edema associated with brain mets Stereotactic radiosurgery (SRS): use of high dose radiation delivered in a single treatment (“fraction”) that is delivered focally to the area of disease seen on imaging (typically MRI); great option for brain mets; can be performed by radiation oncology What to do to expedite Rad Onc planning: Thin-cut MRIStart patient on steroids Interpreting MRI imaging: T1 post-contrast sequence: to look for brain massT2 sequence: looking for vasogenic edema surrounding brain massMidline shift is an issue more so when it is acute; this is very different than slow changes over timeWho to operate on? Functional status prior to surgery; not in an area that can cause other harm; no other good alternative treatment optionsWhat to tell your NSGY colleague during a consult: A quick neuro exam (consciousness, strength, sensation, focal neurologic issues)Brief cancer historyUnderlying organ dysfunction Antiplatelet/anticoagulants A HUGE thank you to our special guests:Ryan Miller, MD, MS: PGY5 in Radiation Oncology at Thomas Jefferson University Hospital, Philadelphia, PAJoshua Lowenstein, MD, MBA: Neurosurgery Attending, REX Neurosurgery and Spine Specialists, Raleigh, NC Please visit our website (TheFellowOnCall.com) for more information Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Go online to PeerView.com/SPE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The latest stroke statistics estimate that about 800,000 individuals in the United States experience a stroke each year. Furthermore, about 20% of all strokes are recurrent, and many of these patients previously experienced a minor stroke or transient ischemic attack (TIA). Recurrence is greatest within the first 24 to 48 hours, but the risk remains elevated for months, even years, after the initial event. The American Heart Association (AHA) and American Stroke Association (ASA) recently updated their guidelines for stroke prevention to include expanded and detailed recommendations for the use of dual antiplatelet therapy (DAPT), the combination of aspirin and clopidogrel or ticagrelor, to further reduce the risk of stroke. These guidelines also include specific recommendations for individuals with minor acute ischemic stroke (AIS) or a TIA. In this activity based on a recent satellite symposium in New Orleans, leading experts on stroke management highlight the current guideline recommendations and discuss the latest perspectives on DAPT before transitioning to patient case scenarios where each expert demonstrates how these advances can be translated into clinical practice to improve outcomes and reduce the risk of recurrent stroke, while accounting for bleeding risks, antiplatelet resistance, and patient adherence. Upon completion of this CE activity, participants will be able to: Identify individuals with AIS or TIA who are appropriate candidates for treatment with antiplatelet therapy to reduce the risk of recurrent stroke, Assess the benefits and risks of using P2Y12 inhibitors with aspirin as DAPT for the prevention of recurrent stroke, Apply DAPT with P2Y12 inhibitors in appropriate patients following symptom onset to reduce the risk of recurrent stroke, Employ patient-centered communication strategies to facilitate adherence to DAPT with P2Y12 inhibitors in appropriate patients with AIS or TIA to reduce the risk of recurrent stroke.

Go online to PeerView.com/SPE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The latest stroke statistics estimate that about 800,000 individuals in the United States experience a stroke each year. Furthermore, about 20% of all strokes are recurrent, and many of these patients previously experienced a minor stroke or transient ischemic attack (TIA). Recurrence is greatest within the first 24 to 48 hours, but the risk remains elevated for months, even years, after the initial event. The American Heart Association (AHA) and American Stroke Association (ASA) recently updated their guidelines for stroke prevention to include expanded and detailed recommendations for the use of dual antiplatelet therapy (DAPT), the combination of aspirin and clopidogrel or ticagrelor, to further reduce the risk of stroke. These guidelines also include specific recommendations for individuals with minor acute ischemic stroke (AIS) or a TIA. In this activity based on a recent satellite symposium in New Orleans, leading experts on stroke management highlight the current guideline recommendations and discuss the latest perspectives on DAPT before transitioning to patient case scenarios where each expert demonstrates how these advances can be translated into clinical practice to improve outcomes and reduce the risk of recurrent stroke, while accounting for bleeding risks, antiplatelet resistance, and patient adherence. Upon completion of this CE activity, participants will be able to: Identify individuals with AIS or TIA who are appropriate candidates for treatment with antiplatelet therapy to reduce the risk of recurrent stroke, Assess the benefits and risks of using P2Y12 inhibitors with aspirin as DAPT for the prevention of recurrent stroke, Apply DAPT with P2Y12 inhibitors in appropriate patients following symptom onset to reduce the risk of recurrent stroke, Employ patient-centered communication strategies to facilitate adherence to DAPT with P2Y12 inhibitors in appropriate patients with AIS or TIA to reduce the risk of recurrent stroke.

Go online to PeerView.com/SPE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The latest stroke statistics estimate that about 800,000 individuals in the United States experience a stroke each year. Furthermore, about 20% of all strokes are recurrent, and many of these patients previously experienced a minor stroke or transient ischemic attack (TIA). Recurrence is greatest within the first 24 to 48 hours, but the risk remains elevated for months, even years, after the initial event. The American Heart Association (AHA) and American Stroke Association (ASA) recently updated their guidelines for stroke prevention to include expanded and detailed recommendations for the use of dual antiplatelet therapy (DAPT), the combination of aspirin and clopidogrel or ticagrelor, to further reduce the risk of stroke. These guidelines also include specific recommendations for individuals with minor acute ischemic stroke (AIS) or a TIA. In this activity based on a recent satellite symposium in New Orleans, leading experts on stroke management highlight the current guideline recommendations and discuss the latest perspectives on DAPT before transitioning to patient case scenarios where each expert demonstrates how these advances can be translated into clinical practice to improve outcomes and reduce the risk of recurrent stroke, while accounting for bleeding risks, antiplatelet resistance, and patient adherence. Upon completion of this CE activity, participants will be able to: Identify individuals with AIS or TIA who are appropriate candidates for treatment with antiplatelet therapy to reduce the risk of recurrent stroke, Assess the benefits and risks of using P2Y12 inhibitors with aspirin as DAPT for the prevention of recurrent stroke, Apply DAPT with P2Y12 inhibitors in appropriate patients following symptom onset to reduce the risk of recurrent stroke, Employ patient-centered communication strategies to facilitate adherence to DAPT with P2Y12 inhibitors in appropriate patients with AIS or TIA to reduce the risk of recurrent stroke.

Go online to PeerView.com/SPE860 to view the activity, download slides and practice aids, and complete the post-test to earn credit. The latest stroke statistics estimate that about 800,000 individuals in the United States experience a stroke each year. Furthermore, about 20% of all strokes are recurrent, and many of these patients previously experienced a minor stroke or transient ischemic attack (TIA). Recurrence is greatest within the first 24 to 48 hours, but the risk remains elevated for months, even years, after the initial event. The American Heart Association (AHA) and American Stroke Association (ASA) recently updated their guidelines for stroke prevention to include expanded and detailed recommendations for the use of dual antiplatelet therapy (DAPT), the combination of aspirin and clopidogrel or ticagrelor, to further reduce the risk of stroke. These guidelines also include specific recommendations for individuals with minor acute ischemic stroke (AIS) or a TIA. In this activity based on a recent satellite symposium in New Orleans, leading experts on stroke management highlight the current guideline recommendations and discuss the latest perspectives on DAPT before transitioning to patient case scenarios where each expert demonstrates how these advances can be translated into clinical practice to improve outcomes and reduce the risk of recurrent stroke, while accounting for bleeding risks, antiplatelet resistance, and patient adherence. Upon completion of this CE activity, participants will be able to: Identify individuals with AIS or TIA who are appropriate candidates for treatment with antiplatelet therapy to reduce the risk of recurrent stroke, Assess the benefits and risks of using P2Y12 inhibitors with aspirin as DAPT for the prevention of recurrent stroke, Apply DAPT with P2Y12 inhibitors in appropriate patients following symptom onset to reduce the risk of recurrent stroke, Employ patient-centered communication strategies to facilitate adherence to DAPT with P2Y12 inhibitors in appropriate patients with AIS or TIA to reduce the risk of recurrent stroke.

With Michelle O'Donoghue & Nicholas Marston - Brigham and Women's Hospital, Boston - USA Link to paper Link to editorial

Welcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Mike and John do a Rapid Fire session to discuss two recent papers exploring pharmacotherapy-based interventions for agitation experienced by individuals with dementia and when to start/restart antiplatelet therapy after stroke caused by intracerebral hemorrhage. Two papers, here ... The post Episode 32 – Agitation in Dementia and Antiplatelet Therapy after Intracerebral Hemorrhage appeared first on Healthy Debate.

Welcome back Rounds Table Listeners! We are back today with our Classic Rapid Fire Podcast! This week, Mike and John do a Rapid Fire session to discuss two recent papers exploring pharmacotherapy-based interventions for agitation experienced by individuals with dementia and when to start/restart antiplatelet therapy after stroke caused by intracerebral hemorrhage. Two papers, here ...The post Episode 32 – Agitation in Dementia and Antiplatelet Therapy after Intracerebral Hemorrhage appeared first on Healthy Debate.

Antiplatelet therapy in patients undergoing CABG

The findings of REASTART Trial

A meta-analysis of RCTs

A review on recent antiplatelet therapy trials

The latest updates on DAPT

How to prevent atherosclerotic cardiovascular events

A brief history of anti-platelet therapy in CAD

This episode centers around acute, lower gastrointestinal bleeding.  Diverticular disease is the most common cause of LGI bleeding.  Most cases of LGI bleeding stop spontaneously.  Risk factors for poor outcome include: hemodynamic instability on presentation, advanced age, coexisting conditions, the use of dual antiplatelet agents,  and fresh blood on digital rectal exam.  We also discuss resuscitation with crystalloid initial therapy.  Transfusion should be limited to specific hemoglobin goals (~7-9 g/dl).  Colonoscopies within 24 hours if patients stabilize.......Watch this presentation at https://www.youtube.com/watch?v=45t5inKsPPsTo learn more, visit https://courses.ccme.org/course/em-prep