Cardiac Critical Care
Ischemia with nonobstructive coronary artery disease: concept, assessment, and management
19 Apr, 2023 | 13:17h | UTCRelated:
Review: Myocardial infarction with non-obstructive coronary artery disease.
MINOCA from A to Z – American College of Cardiology
Global Survey | Incidence, management and prognosis of esophageal fistula after atrial fibrillation catheter ablation
19 Apr, 2023 | 13:14h | UTCCommentary: Esophageal Fistula Still a Rare but Deadly Complication of AF Ablation: POTTER-AF – TCTMD
Commentary from the author on Twitter
🌎The POTTER-AF study
➡️published #EHJ online
➡️138 oesophageal fistulas
➡️incidence 0,025% overall, 🔥RF 0.038%, ❄️CRYO 0.0015%
☠️Mortality: 90% if treated conservative!
🙏V. Schmidt, @KeelaniAhmad @ChristianHeeger@AGEP_DGK @ESC_Journals #UKSHhttps://t.co/jTmC36wlYQ #EPeeps pic.twitter.com/3lntY6lR6H— Roland Tilz (@RolandTilz) April 16, 2023
Review | Management of cardiogenic shock after acute coronary syndromes
18 Apr, 2023 | 13:27h | UTCManagement of cardiogenic shock after acute coronary syndromes – BJA Education
Position Statement | Neuroprognostication in the post cardiac arrest patient
10 Apr, 2023 | 13:46h | UTC
Review | Cardiogenic shock classification and associated mortality risk
10 Apr, 2023 | 13:42h | UTCCardiogenic Shock Classification and Associated Mortality Risk – Mayo Clinic Proceedings
RCT | Routine invasive approach fails to benefit frail older adults with non–ST-segment elevation acute myocardial infarction
6 Apr, 2023 | 13:23h | UTCEffect of Routine Invasive vs Conservative Strategy in Older Adults With Frailty and Non–ST-Segment Elevation Acute Myocardial Infarction: A Randomized Clinical Trial – JAMA Internal Medicine (link to abstract – $ for full-text)
Commentary on Twitter
A routine invasive strategy did not improve clinical outcomes in frail patients with NSTEMI. Future trials should confirm whether a policy of watchful observation rather than routine invasive management may be effective for these patients. https://t.co/N4hAXg5fid
— JAMA Internal Medicine (@JAMAInternalMed) March 6, 2023
Cohort Study | Maternal cardiac arrest: occurrence, survival, and influencing factors
6 Apr, 2023 | 12:59h | UTCCardiac Arrest During Delivery Hospitalization: A Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentaries:
Cardiac Arrest During Delivery Hospitalization – American College of Cardiology
Cardiac Arrest During Childbirth Is Rare, But Some Women Face Higher Risks – HealthDay
Commentary on Twitter
https://twitter.com/AnnalsofIM/status/1636095275545632768
Cohort Study | Multimodal prediction of favorable outcome after cardiac arrest
6 Apr, 2023 | 13:01h | UTC
M-A | Coronary vasospasm in ANOCA patients: Prevalence, clinical features and prognosis
3 Apr, 2023 | 13:21h | UTC
Update | Optimal oxygen and mean arterial blood pressure targets after cardiac arrest
31 Mar, 2023 | 13:41h | UTC
Commentary on Twitter
O2/MAP after CA? NO clear benefit from deviating from
🩸MAP >65-70 mmHg, if impaired 🧠autoregulation as high as 85-90
💨 PaO2 75-97 mmHg; more liberal O2 may be best if reliable monitoring difficult (ie transport or in ED)
More evidence needed (coming)
🖇️ https://t.co/ujsz09tDSJ pic.twitter.com/fft8Q1turt— Intensive Care Medicine (@yourICM) March 21, 2023
Acute heart failure: diagnostic–therapeutic pathways and preventive strategies — a real-world clinician’s guide
28 Mar, 2023 | 14:45h | UTC
Guidelines for neuroprognostication in comatose adult survivors of cardiac arrest
27 Mar, 2023 | 12:54h | UTC
Review | Improving vasopressor use in cardiac arrest
16 Mar, 2023 | 13:08h | UTCImproving vasopressor use in cardiac arrest – Critical Care
ESC Consensus Statement | Inotropic therapy in patients with advanced heart failure
15 Mar, 2023 | 15:14h | UTC
RCT | Immediate complete revascularization non-inferior to staged approach in ACS patients with multivessel disease
13 Mar, 2023 | 15:10h | UTCSummary: Patients with an acute coronary syndrome and multivessel disease not presenting with cardiogenic shock usually benefit from complete revascularization by percutaneous coronary intervention (PCI). Complete revascularization involves treating all significant blockages in the coronary arteries, including those not causing symptoms (non-culprit lesions).
The BIOVASC randomized non-inferiority trial investigated whether patients with acute coronary syndrome and multivessel coronary disease should undergo immediate complete revascularization during the index procedure or undergo a staged approach with PCI of the culprit lesion only during the index procedure followed by another procedure within 6 weeks of all non-culprit lesions deemed to be clinically significant. The exclusion criteria were:
- Previous coronary artery bypass surgery.
- Cardiogenic shock.
- Single-vessel coronary disease.
- The presence of a chronic coronary total occlusion.
A total of 1525 patients with acute coronary syndrome and multivessel coronary disease were randomly assigned to either an immediate complete revascularization group (764 patients) or a staged complete revascularization group (761 patients). The primary outcome was a composite of all-cause mortality, myocardial infarction, unplanned ischemia-driven revascularization, or cerebrovascular events at 1 year after the index procedure. The study found that immediate complete revascularization was non-inferior to staged complete revascularization for the primary outcome.
Article: Immediate versus staged complete revascularisation in patients presenting with acute coronary syndrome and multivessel coronary disease (BIOVASC): a prospective, open-label, non-inferiority, randomised trial – The Lancet (free registration required)
Commentaries:
Revascularisation in acute coronary syndromes: change in practice? – The Lancet (free registration required)
No Downside to Immediate Complete Revascularization in ACS: BIOVASC – TCTMD
Immediate Complete Revascularization Non-Inferior to Staged Procedure in BIOVASC Trial – HCP Live
Related:
One-Year Outcomes after PCI Strategies in Cardiogenic Shock – New England Journal of Medicine
Consensus Paper | Pain management and opioid stewardship in adult cardiac surgery
8 Mar, 2023 | 14:22h | UTC
ESC 0/1-hour algorithm unable to safely exclude 30-day cardiac death or MI in patients with known coronary artery disease, study finds
8 Mar, 2023 | 14:12h | UTCSummary:
The study aimed to determine if the European Society of Cardiology (ESC) 0/1-hour algorithm using high-sensitivity cardiac troponin T (hs-cTnT) could achieve a negative predictive value of 99% or higher for 30-day cardiac death or myocardial infarction (MI) among emergency department patients with chest pain and known coronary artery disease (CAD).
The study included 1430 adults, and the algorithm had a negative predictive value of 96.6% for 30-day cardiac death or MI among patients with known CAD, suggesting that the algorithm may not be able to safely exclude 30-day cardiac death or MI in these patients.
These findings suggest that clinicians should be cautious when using the ESC 0/1-hour hs-cTnT algorithm in patients with known CAD.
Article: Performance of the European Society of Cardiology 0/1-Hour Algorithm With High-Sensitivity Cardiac Troponin T Among Patients With Known Coronary Artery Disease – JAMA Cardiology (link to abstract – $ for full-text)
Related:
Performance of the European Society of Cardiology 0/1-Hour, 0/2-Hour, and 0/3-Hour Algorithms for Rapid Triage of Acute Myocardial Infarction: An International Collaborative Meta-analysis – Annals of Internal Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In this diagnostic study of 1430 adults, the high-sensitivity troponin T (hs-cTnT) ESC 0/1-hour algorithm had a negative predictive value of 96.6% for 30-day cardiac death or MI among patients with known coronary artery disease. https://t.co/FnILIazEnU
— JAMA Cardiology (@JAMACardio) March 1, 2023
M-A | Early vs. delayed coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation
6 Mar, 2023 | 14:12h | UTCSummary:
This systematic review and meta-analysis of randomized controlled trials evaluated the efficacy and safety of early vs. delayed coronary angiography following an out-of-hospital cardiac arrest in patients without ST elevation on the ECG.
The review included six trials with 1,590 patients and found that early angiography probably has no effect on mortality, survival with good neurologic outcomes, and ICU length of stay, indicating that the procedure should not be routinely recommended for these patients.
Related:
Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac Arrest: Results of the Randomized, Multicentric EMERGE Trial – JAMA Cardiology (link to abstract – $ for full-text)
Guideline | Acute mechanical circulatory support
27 Feb, 2023 | 13:04h | UTC
RCT | Rivaroxaban shows promise compared to Enoxaparin in the acute phase of an acute coronary syndrome
16 Feb, 2023 | 15:20h | UTCInvited Commentary: Rivaroxaban for Patients With Acute Coronary Syndromes—Where Do We Stand? – JAMA Network Open
Commentary on Twitter
The H-REPLACE RCT: short-term rivaroxaban (5mg 2x/day) was noninferior to enoxaparin in safety + efficacy during 6-month follow-up among patients with acute coronary syndrome who missed the primary reperfusion window and before selective revascularization. https://t.co/TIHOwGSWjJ
— JAMA Network Open (@JAMANetworkOpen) February 10, 2023
Review | Indications, clinical impact, and complications of critical care transesophageal echocardiography
15 Feb, 2023 | 15:45h | UTC
Retrospective Study | Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome
15 Feb, 2023 | 15:40h | UTCPost-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome – Critical Care
Review | Liberation from mechanical ventilation in the cardiac intensive care unit
8 Feb, 2023 | 12:45h | UTCLiberation From Mechanical Ventilation in the Cardiac Intensive Care Unit – JACC: Advances
Cohort Study | Predictors of acute coronary occlusion in patients with out-of-hospital cardiac arrest without ST-segment elevation
3 Feb, 2023 | 14:20h | UTCAcute Coronary Occlusion in Patients With Non-ST-Segment Elevation Out-of-Hospital Cardiac Arrest – Journal of the American College of Cardiology (link to abstract – $ for full-text)
JACC Podcast: Acute Coronary Occlusion in Patients with Non-ST-segment Elevation Out-of-hospital Cardiac Arrest
Commentary: Coronary Occlusion in Patients With Non-ST Elevation Cardiac Arrest – American College of Cardiology
Related:
Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac Arrest: Results of the Randomized, Multicentric EMERGE Trial – JAMA Cardiology (link to abstract – $ for full-text)
M-A | Cardiovascular and renal effects of SGLT2 inhibitor initiation in acute heart failure
3 Feb, 2023 | 14:23h | UTC