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NEJM - Colección Enfermedad Coronaria

Outcomes after Angiography with Sodium Bicarbonate and Acetylcysteine
12/11/2017
ver resumen
Acute kidney injury associated with the administration of contrast material during angiography can result in death, accelerated progression of underlying chronic kidney disease, and the need for dialysis, along with substantial increases in health care costs. The periprocedural administration of…

PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock
30/10/2017
ver resumen
The mortality associated with cardiogenic shock in acute myocardial infarction can be reduced with the use of early revascularization, predominantly percutaneous coronary intervention (PCI), to restore blood flow to the culprit coronary artery. Up to 80% of patients who have cardiogenic shock…

Back to the Future in Cardiogenic Shock — Initial PCI of the Culprit Lesion Only
30/10/2017
ver resumen
Approximately 5 to 10% of cases of acute myocardial infarction are complicated by cardiogenic shock, which is associated with early mortality of 40 to 50%. Nearly two decades ago, the SHOCK (Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock) trial established that…

Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease
5/10/2017
ver resumen
Despite the use of effective secondary prevention strategies, 5 to 10% of patients with cardiovascular disease have recurrent events each year. When used for secondary prevention, aspirin results in a 19% lower risk of major adverse cardiovascular events and a 9% lower risk of cardiovascular death…

An Important Step for Thrombocardiology
5/10/2017
ver resumen
It has been known for more than a century that coronary-artery thrombosis is the most common precipitant of acute myocardial infarction and that atherosclerotic plaques in the coronary arteries are often responsible for angina pectoris. When anticoagulants and antiplatelet agents became available,…

Oxygen Therapy in Suspected Acute Myocardial Infarction
28/9/2017
ver resumen
Myocardial infarction is caused by a mismatch of oxygen and substrate supply and demand in the myocardium that leads to ischemia and ultimately to cell death. Therefore, for more than a century, supplemental oxygen has been used routinely in the treatment of patients with suspected acute myocardial…

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease
28/9/2017
ver resumen
Evidence from large-scale, randomized trials has shown that each reduction of 40 mg per deciliter (1 mmol per liter) in the level of low-density lipoprotein (LDL) cholesterol reduces the risk of coronary events (including coronary death, myocardial infarction, and revascularization procedures) and…

Is Oxygen Therapy Beneficial in Acute Myocardial Infarction? Simple Question, Complicated Mechanism, Simple Answer
28/9/2017
ver resumen
Joseph Priestley first reported his discovery of oxygen in 1775 through observations of a candle burning in "dephlogisticated air." He remarked that the candle burned with great "strength and vivacity" and speculated that this oxygen-enriched air could be used as a medicine; he also expressed…

CETP Inhibitors — A New Inning?
28/9/2017
ver resumen
Former baseball manager Tony La Russa once said, "Even when you have three strikes, you’re still not out. There is always something else you can do." This aphorism could apply to cholesteryl ester transfer protein (CETP) inhibitors, a drug class that was designed to reduce the risk of…

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
21/9/2017
ver resumen
Current pharmaceutical interventions that are designed to slow the progression of atherosclerosis focus almost exclusively on reducing plasma levels of cholesterol. However, clinical and experimental data support an additional critical role for inflammation in atherothrombosis. We previously found…

Bivalirudin versus Heparin Monotherapy in Myocardial Infarction
21/9/2017
ver resumen
Anticoagulation with heparin or bivalirudin, in combination with antiplatelet agents such as aspirin, P2Y12 inhibitors, and glycoprotein IIb/IIIa inhibitors, is routinely used to improve angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) for acute…

Targeting Inflammation in Coronary Artery Disease
21/9/2017
ver resumen
For more than 20 years, our understanding of the biology of atherosclerosis has incorporated the so-called inflammatory hypothesis. Inflammatory cells and signals drive the healing response to vascular injury, allowing the initiation and growth of atherosclerotic plaque. Inflammatory reactions…

Procedural Anticoagulation in Myocardial Infarction
21/9/2017
ver resumen
The prognosis for patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is improved with the use of percutaneous coronary intervention (PCI). Choosing the best procedural anticoagulation regimen to balance the risks of ischemia and bleeding during PCI is essential…

Left Ventricular Free-Wall Rupture
7/9/2017
ver resumen
Figure 1.

Liraglutide and Renal Outcomes in Type 2 Diabetes
31/8/2017
ver resumen
Persons with type 2 diabetes mellitus, particularly those with evidence of cardiovascular disease, are at high risk for chronic kidney disease. In most countries, diabetic kidney disease is reported to be the leading cause of dialysis-dependent chronic kidney disease. Efforts to blunt the global…

A New Chapter for Diabetic Kidney Disease
31/8/2017
ver resumen
Many clinical outcomes have improved over the past two decades for people living with diabetes. However, relatively little progress has been made in the treatment of diabetic kidney disease. Among adults with diabetes in the United States, the prevalence of diabetic kidney disease has remained…

Effect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes
24/8/2017
ver resumen
The Systolic Blood Pressure Intervention Trial (SPRINT) showed that among older adults with hypertension and a high risk of cardiovascular disease, but without prevalent diabetes or a history of stroke, blood-pressure treatment that targeted a systolic blood pressure of less than 120 mm Hg…

Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control
24/8/2017
ver resumen
The most effective blood-pressure goals for treatment with antihypertensive medications are uncertain. Treating hypertension to standard systolic blood-pressure goals is cost-saving or cost-effective among patients at high risk for cardiovascular disease in the United States. However, until…

Venous Congestion in Ischemic Bowel
24/8/2017
ver resumen
Figure 1.

Cognitive Function in a Randomized Trial of Evolocumab
17/8/2017
ver resumen
Statin therapy, ezetimibe, and the proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitor evolocumab have been shown to reduce the rate of cardiovascular events among patients with established cardiovascular disease. These therapies may result in very low levels of low-density lipoprotein…






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