Ventilation strategies in cardiac arrest

Long-term survival for adult out-of-hospital cardiac arrest victims remains dismal and is typically less than 10%. Historically, many resuscitation guidelines have had little evidence to support their recommendations but research in this field has been burgeoning, with advanced life support guidelines undergoing substantial recent changes to reflect new findings. One of these changes has been […]

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Dual antiplatelet therapy may be beneficial post-CABG

Perioperative aspirin therapy in CABG improves graft patency, prevents ischemic events, and prolongs survival.  However, Aspirin resistance is common after CABG, particularly in the immediate post-operative period, in part due to cardiopulmonary bypass causing a pro-inflammatory, pro-thrombotic state.  Clopidogrel has revolutionised the practice of interventional cardiology but it remains unknown whether more aggressive antiplatelet treatment […]

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Increased use of antithrombotics increases hospital admissions for bleeding

The safety of multiple antithrombotic drug regimes has not been investigated in clinical trials.  Specifically, guidelines for the management of patients with myocardial infarction who also have an indication for warfarin are currently unclear; some recommend the use of clopidogrel and warfarin in combination following coronary stent implantation.  As bleeding episodes following myocardial infarction are […]

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ACE and ARB in combination give no added benefits

Both angiotensin-converting enzyme (ACE) inhibitors and angiotensin II-receptor blockers (ARBs) have been shown to be of benefit in patients with heart failure, and in patients who have reduced ventricular function following a myocardial infarction.  However, it is less well known whether they provide benefit in patients with ischaemic heart disease (IHD) and preserved ventricular function.  […]

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Paclitaxel Stents Safe in STEMI

The Harmonising Outcomes with Revascularisation and Stents in Acute Myocardial Infarction (HORIZONS-AMI) was a prospective open label, multi-centre controlled trial involving patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). It incorporated two factorial randomised phases to allow a comparison of the direct thrombin inhibitor bivalirudin alone with heparin plus glycoprotein IIb-IIIa […]

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