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Cardiac Critical Care

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 | UTC

Summary:
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)

Commentary: Unclear utility of the European Society of Cardiology 0/1h troponin algorithm in diagnosing acute coronary syndrome in patients with known coronary artery disease – Physician’s Weekly

Related:

Safety and efficacy of the European Society of Cardiology 0/1-hour algorithm for diagnosis of myocardial infarction: systematic review and meta-analysis – Heart

Performance of the European Society of Cardiology 0/1-hour algorithm in the diagnosis of myocardial infarction with high-sensitivity cardiac troponin: Systematic review and meta-analysis – European Heart Journal. Acute Cardiovascular Care

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

 


M-A | Early vs. delayed coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation

6 Mar, 2023 | 14:12h | UTC

Summary:

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.

 

Article: Early Versus Delayed Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation—A Systematic Review and Meta-Analysis of Randomized Controlled Trials – Critical Care Explorations

Related:

Cohort Study | Predictors of acute coronary occlusion in patients with out-of-hospital cardiac arrest without ST-segment elevation

#ESCCongress – RCT: Immediate coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation did not improve outcomes compared to delayed/selective angiography – New England Journal of Medicine

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

The International Society for Heart and Lung Transplantation/Heart Failure Society of America Guideline on Acute Mechanical Circulatory Support – The Journal of Heart and Lung Transplantation

Commentary: New guideline on mechanical circulatory support tackles device selection, ethical dilemmas and more – Cardiovascular Business

 


RCT | Rivaroxaban shows promise compared to Enoxaparin in the acute phase of an acute coronary syndrome

16 Feb, 2023 | 15:20h | UTC

Effect of Rivaroxaban vs Enoxaparin on Major Cardiac Adverse Events and Bleeding Risk in the Acute Phase of Acute Coronary Syndrome: The H-REPLACE Randomized Equivalence and Noninferiority Trial – JAMA Network Open

Invited Commentary: Rivaroxaban for Patients With Acute Coronary Syndromes—Where Do We Stand? – JAMA Network Open

 

Commentary on Twitter

 


Review | Indications, clinical impact, and complications of critical care transesophageal echocardiography

15 Feb, 2023 | 15:45h | UTC

Indications, Clinical Impact, and Complications of Critical Care Transesophageal Echocardiography: A Scoping Review – Journal of Intensive Care Medicine

 


Retrospective Study | Post-cardiac surgery fungal mediastinitis: clinical features, pathogens and outcome

15 Feb, 2023 | 15:40h | UTC

Post-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 | UTC

Liberation 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 | UTC

Acute 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:

#ESCCongress – RCT: Immediate coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation did not improve outcomes compared to delayed/selective angiography – New England Journal of Medicine

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

Cardiovascular and renal effects of SGLT2 inhibitor initiation in acute heart failure: a meta-analysis of randomized controlled trials – Clinical Research in Cardiology

 


Transfusion thresholds for acute coronary syndromes — insights from the TRICS‐III trial and meta‐analysis

3 Feb, 2023 | 13:58h | UTC

Transfusion Thresholds for Acute Coronary Syndromes—Insights From the TRICS‐III Randomized Controlled Trial, Systematic Review, and Meta‐Analysis – Journal of the American Heart Association

 


Deconstructing the dogma: meta-analysis of adjunctive gentamicin and rifampin in staphylococcal prosthetic valve endocarditis

2 Feb, 2023 | 15:00h | UTC

Deconstructing the Dogma: Systematic Literature Review and Meta-analysis of Adjunctive Gentamicin and Rifampin in Staphylococcal Prosthetic Valve Endocarditis – Open Forum Infectious Diseases

 

Commentary on Twitter

 


RCT | Nighttime dexmedetomidine for delirium prevention in non-mechanically ventilated patients after cardiac surgery

1 Feb, 2023 | 12:58h | UTC

Nighttime dexmedetomidine for delirium prevention in non-mechanically ventilated patients after cardiac surgery (MINDDS): A single-centre, parallel-arm, randomised, placebo-controlled superiority trial – eClinicalMedicine

Commentary: Short Dose of Intravenous Sedative May Help Prevent Postoperative Delirium After Heart Surgery – Massachusetts General Hospital

 


RCT | Early extracorporeal CPR did not improve outcomes in patients with refractory out-of-hospital cardiac arrest

30 Jan, 2023 | 01:18h | UTC

Early Extracorporeal CPR for Refractory Out-of-Hospital Cardiac Arrest – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Early Extracorporeal CPR for Out-of-Hospital Cardiac Arrest – American College of Cardiology

 

Commentary on Twitter

 


Perspective | Is it time to retire the diagnosis “hypertensive emergency”?

27 Jan, 2023 | 12:26h | UTC

Is it Time to Retire the Diagnosis “Hypertensive Emergency”? – Journal of the American Heart Association

 


M-A | Colchicine for prevention of post-operative atrial fibrillation

27 Jan, 2023 | 12:03h | UTC

Colchicine for prevention of post-operative atrial fibrillation: Meta-analysis of randomized controlled trials – Frontiers in Cardiovascular Medicine

 


Delayed QT prolongation: derivation of a novel risk factor for adverse cardiovascular events from acute drug overdose

26 Jan, 2023 | 12:10h | UTC

Delayed QT Prolongation: Derivation of a Novel Risk Factor for Adverse Cardiovascular Events from Acute Drug Overdose – Journal of Medical Toxicology

Commentary: January 2023 Annals of Emergency Medicine Journal Club

 


Cardiogenic Shock | Emergency department-focused management

25 Jan, 2023 | 11:21h | UTC

Cardiogenic Shock: Emergency Department-Focused Management – emDocs

Related: The medical treatment of cardiogenic shock – Journal of Intensive Medicine

 


AHA Statement | Surgical management and mechanical circulatory support in high-risk pulmonary embolisms

24 Jan, 2023 | 14:40h | UTC

Surgical Management and Mechanical Circulatory Support in High-Risk Pulmonary Embolisms: Historical Context, Current Status, and Future Directions: A Scientific Statement From the American Heart Association – Journal of the American Heart Association

News Release: New statement suggests more patients may benefit from surgery for pulmonary embolism – American Heart Association

 

Commentary from one of the authors on Twitter (thread – click for more)

 


Retrospective Study | Serial troponin-T and long-term outcomes in suspected acute coronary syndrome

24 Jan, 2023 | 14:09h | UTC

Serial troponin-T and long-term outcomes in suspected acute coronary syndrome – European Heart Journal

 

Commentary on Twitter

 


Review | Wellens syndrome: an important consideration in patients with chest pain

23 Jan, 2023 | 13:26h | UTC

Wellens syndrome: An important consideration in patients with chest pain – JAAPA

Commentary: Wellens Syndrome Important to Consider if Chest Pain: Key Points – American College of Cardiology

 


AHA Scientific Statement | Diagnosis, workup, risk reduction of transient ischemic attack in the ED setting

20 Jan, 2023 | 14:56h | UTC

Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association – Stroke

News Release: Stroke symptoms, even if they disappear within an hour, need emergency assessment – American Heart Association

 


Review | Getting ahead of the game: in-hospital initiation of HFrEF therapies

20 Jan, 2023 | 14:24h | UTC

Getting ahead of the game: in-hospital initiation of HFrEF therapies – European Heart Journal Supplements

 


Development and validation of a risk stratification tool for patients with Type 2 Myocardial Infarction

17 Jan, 2023 | 13:23h | UTC

Improving Risk Stratification for Patients With Type 2 Myocardial Infarction – Journal of the American Heart Association

Commentary: Improving Risk Stratification for Patients With Type 2 MI – American College of Cardiology

 

Commentary on Twitter

 


Nonconvulsive status epilepticus following cardiac arrest: overlooked, untreated and misjudged

12 Jan, 2023 | 12:43h | UTC

Nonconvulsive status epilepticus following cardiac arrest: overlooked, untreated and misjudged – Journal of Neurology

 


Ten rules for optimizing ventilatory settings and targets in post-cardiac arrest patients

11 Jan, 2023 | 14:13h | UTC

Ten rules for optimizing ventilatory settings and targets in post-cardiac arrest patients – Critical Care

 


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