PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock

PCI Strategies in Patients with Acute Myocardial Infarction and Cardiogenic Shock

In patients who have acute myocardial infarction with cardiogenic shock, early revascularization of the culprit artery by means of percutaneous coronary intervention (PCI) improves outcomes. However, the majority of patients... read more

Effects of Physical Activity on Poststroke Cognitive Function

Effects of Physical Activity on Poststroke Cognitive Function

Despite the social, health, and economic burdens associated with cognitive impairment poststroke, there is considerable uncertainty about the types of interventions that might preserve or restore cognitive abilities. The... read more

Catheter ablation lowers long-term risk of recurrent stroke in atrial fibrillation patients

Catheter ablation lowers long-term risk of recurrent stroke in atrial fibrillation patients

Atrial fibrillation patients with a prior history of stroke who undergo catheter ablation to treat the abnormal heart rhythm lower their long-term risk of a recurrent stroke by 50 percent. The Intermountain study compared... read more

Detecting Undiagnosed Atrial Fibrillation with Cardiac Monitors

Detecting Undiagnosed Atrial Fibrillation with Cardiac Monitors

A group of researchers led by James A. Reiffel, M.D., did a study to determine the incidence of previously undiagnosed atrial fibrillation in high-risk patients with the use of insertable cardiac monitors (ICM). The results... read more

A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation

A multifaceted intervention to improve treatment with oral anticoagulants in atrial fibrillation

Oral anticoagulation is underused in patients with atrial fibrillation. We assessed the impact of a multifaceted educational intervention, versus usual care, on oral anticoagulant use in patients with atrial fibrillation.... read more

Thrombolytics for Stroke: The Evidence

Thrombolytics for Stroke: The Evidence

Thrombolytics for stroke: undoubtedly the biggest controversy in emergency medicine. Also, the topic of this week’s Emergency Medicine Cases Journal Jam podcast. Rory Spiegel, Anton Helman, and I take a deep dive into the... read more

Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

Cluster-Randomized, Crossover Trial of Head Positioning in Acute Stroke

The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. Disability outcomes after... read more

Accuracy of Medical Claims for Identifying Cardiovascular and Bleeding Events After Myocardial Infarction

Accuracy of Medical Claims for Identifying Cardiovascular and Bleeding Events After Myocardial Infarction

In this secondary analysis of a clinical trial of 12 365 patients with acute myocardial infarction, the cumulative 1-year event rates for myocardial infarction, stroke, and bleeding were lower when medical claims were used... read more

Primary Stroke Center Protocol for Suspected Stroke by Large-Vessel Occlusion

Primary Stroke Center Protocol for Suspected Stroke by Large-Vessel Occlusion

In this cohort study, when the PSC protocol was fully executed, the rate of good outcomes was doubled and the time from arrival at the PSC to reperfusion at the CSC was almost 1 hour less than that with only a partial execution... read more

Acute Kidney Injury is not Associated with IV Contrast Use in the ED

Acute Kidney Injury is not Associated with IV Contrast Use in the ED

Intravenous (IV) iodinated contrast media is used routinely to improve the accuracy of computed tomography (CT) in the emergency department (ED).  Prior studies have linked contrast media with the development of acute kidney... read more

Predicting and measuring fluid responsiveness with echocardiography

Predicting and measuring fluid responsiveness with echocardiography

Echocardiography is an essential tool to predict and measure fluid responsiveness, according to a recent article, which provides a practical guide. Ashley Miller and Justin Mandeville outline the physiological basis of fluid... read more

Mechanical Thrombectomy for Acute Ischemic Stroke

Mechanical Thrombectomy for Acute Ischemic Stroke

Coutinho et al have performed a timely post hoc analysis consisting of a patient population from 2 large, prospective, core laboratory–adjudicated trials: Solitaire With the Intention for Thrombectomy (SWIFT) and Solitaire... read more

Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin

Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin

Efficacy and safety of ticagrelor versus aspirin in acute stroke or transient ischaemic attack of atherosclerotic origin: a subgroup analysis of SOCRATES, a randomised, double-blind, controlled trial. In this prespecified... read more

Cerebral Microbleeds as Predictors of Mortality

Cerebral Microbleeds as Predictors of Mortality

Cerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the... read more