Pharmacological thromboembolic prophylaxis for medical patients in a tertiary care, teaching community hospital: room for improvement.

Venous Thrombembolism (VTE) is a potentially lethal complication in hospitalized patients. Studies indicate that pharmacological prophylaxis may reduce the incidence of VTE. However, the use of VTE prophylaxis remains unclear.

Similar success rates with bivalirudin and unfractionated heparin in bare-metal stent implantation.

Background: Unfractionated heparin (UFH) is the traditional agent utilized during percutaneous peripheral interventions (PPIs) despite its well-known limitations. Bivalirudin, a thrombin-specific anticoagulant, overcomes many of the limitations of UFH and has consistently demonstrated comparable efficacy with significantly fewer bleeding complications. The purpose of this study was to compare procedural success in patients undergoing bare-metal stent implantation for atherosclerotic blockage of the renal, iliac, and femoral arteries and receiving either bivalirudin (0.

The quantitative immunoturbidimetric D-dimer method to rule out venous thromboembolism (VTE).

D-dimer measurement is a technique that may improve the diagnostic strategy for venous thrombo-embolism (VTE). To evaluate D-dimer accuracy in the diagnosis of VTE, we identified 116 patients at Charleston Area Medical Center in Charleston, W.Va.

Aspirin under fire: aspirin use in the primary prevention of coronary heart disease.

The issue of aspirin use in the primary prevention of cardiovascular disease is still debated because of conflicting opinions on risks versus benefits. Recently, a United States Food and Drug Administration (FDA) panel rejected the approval of aspirin in the setting of primary prevention in moderate-risk patients. However, the United States Preventive Services Task Force recommends that clinicians discuss aspirin therapy with patients at increased risk for having a future coronary event.

Subendocardial ischemia without coronary artery disease: is elevated left ventricular end diastolic pressure the culprit?

Background: The aim was to investigate the association between elevated left ventricular end diastolic pressure (LVEDP) and subendocardial ischemia.

Methods: A retrospective chart review was performed of 1846 consecutive patients admitted between January and September 2002 who had chest pain, stress testing and coronary angiography.

Results: 1592 patients were excluded due to a positive coronary angiogram for coronary artery disease (CAD), 254 patients had an angiogram compatible with non-significant CAD and an ejection fraction > 45%; of whom 210 (82.