Clinical Practice Patterns for Transradial Coronary Artery Catheterisation in Australian and New Zealand: Mixed-Methods Survey and Interview Study.

Background: While there has been an increase in the use of the transradial approach when performing percutaneous coronary angiography and intervention, there is evidence of variations in international practice. Ensuring that operators' practices are supported by evidence is important to ensure optimal outcomes.

Method: Interventional cardiologists and advanced trainees completed a cross-sectional survey followed by semi-structured interviews to map current practices for transradial coronary artery procedures in Australia and New Zealand and explore factors that influence clinical decision-making around procedural practice.

N-Terminal Pro B-Type Natriuretic Peptide as a Screening Tool for Inpatient Echocardiogram Requirement Among Patients With Suspected Heart Failure: Using NT-proBNP to Reduce Hospital Length of Stay.

Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a cardiac biomarker with diagnostic and prognostic utility in patients with heart failure (HF). Whether NT-proBNP can be used to triage inpatient transthoracic echocardiogram (TTE) requirements, and whether this impacts hospital length of stay (LOS), is not clear.

Methods: Clinical and biochemical data were prospectively recorded on all inpatients at Wollongong Hospital, NSW, Australia, who had a TTE ordered for suspected HF over a 6-month period.

Clinical predictors and management for radial artery spasm: an Australian cross-sectional study.

Introduction: The transradial approach for coronary artery catheterisation has increased in popularity compared to the transfemoral approach for patients undergoing percutaneous coronary interventions. However, radial artery spasm continues to be a major complication of the procedure. Current management strategies vary concerning radial artery spasm and there is limited evidence of practice in the Australian context.

Association of hypertension with mortality in patients hospitalised with COVID-19.

Objective: To assess whether hypertension is an independent risk factor for mortality among patients hospitalised with COVID-19, and to evaluate the impact of ACE inhibitor and angiotensin receptor blocker (ARB) use on mortality in patients with a background of hypertension.

Method: This observational cohort study included all index hospitalisations with laboratory-proven COVID-19 aged ≥18 years across 21 Australian hospitals. Patients with suspected, but not laboratory-proven COVID-19, were excluded.

Cardiac Complications in Patients Hospitalised With COVID-19 in Australia.

Objectives: Describe the incidence of cardiac complications in patients admitted to hospital with COVID-19 in Australia.

Design: Observational cohort study.

Setting: Twenty-one (21) Australian hospitals.

Preprocedural Anxiety in the Transradial Cardiac Catheterization Era.

Background: Transradial cardiac catheterization is increasingly being used for the management of coronary artery disease given the low risk of procedural discomfort and complications with this approach. However, the evidence relating to preprocedural anxiety levels in these patients is scarce.

Objective: The aim of this study was to evaluate the anxiety levels and the predictors of anxiety in patients undergoing transradial cardiac catheterization procedures.

The effect of topical medications on radial artery spasm in patients undergoing transradial coronary procedures: a systematic review.

Objective: The objective of this review was to identify the effectiveness of topical medications on radial artery spasm (RAS) in patients undergoing transradial percutaneous coronary procedures.

Introduction: Percutaneous coronary procedures were traditionally carried out via the femoral artery; however, over the last 20 years there has been a global increase in the number of proceduralists carrying out percutaneous coronary procedures via the transradial approach. Radial artery spasm remains an issue for the transradial approach, potentially leading to procedural failure.

Safety and efficacy of ulnar artery approach for percutaneous cardiac catheterization: Systematic review and meta-analysis.

Background: Trans-radial access has rapidly become the standard for percutaneous coronary procedures in the last decade. As proceduralists overcome the learning curve and become more competent in trans-radial access, alternative safe access sites such as the ulnar artery have been increasingly used for emergent and elective procedures. The aim of this study was to synthesize the best available evidence of the impact on major adverse cardiac events (MACE) of ulnar artery compared to radial artery cardiac catheterization.

Novel Oral Anticoagulants in Direct Current Cardioversion for Atrial Fibrillation.

Background: For some patients with atrial fibrillation, direct current cardioversion (DCCV) is one strategy that can be used to establish sinus rhythm but appropriate anticoagulation is mandatory to prevent thromboembolic events. Historically, patients were anticoagulated with warfarin with bridging with unfractionated or low molecular weight heparin, however, recently novel oral anticoagulants (NOACs), apixaban, dabigatran and rivaroxaban have become more popular. Despite the increase in use, real world data on safety and efficacy is limited.

The effect of vasodilatory medications on radial artery spasm in patients undergoing transradial coronary artery procedures: a systematic review.

Background: The uptake of percutaneous coronary procedures via the radial artery has increased internationally due to the decreased risk of complications and increased patient satisfaction. The increased susceptibility of the radial artery to spasm however presents a potential risk for procedural failure. Although most experts agree on the need for prophylactic medications to reduce radial artery spasm, currently there is inconsistency in literature regarding the most effective vasodilatory medication or combination of medications.

Effects of methods used to achieve hemostasis on radial artery occlusion following percutaneous coronary procedures: a systematic review.

Background: Transradial access to percutaneous coronary procedures is becoming the preferred access route, and it is being increasingly used for emergent and elective procedures. However, radial artery occlusion (RAO) continues to remain an adverse occurrence following sheath removal or in the first 24 hours following sheath removal due to the smaller diameter of the artery.

Objectives: The overall objective of this study was to synthesize the best available research evidence related to the effects of methods used to achieve hemostasis on RAO rates after percutaneous coronary procedures.

Novel ECG changes in acute coronary syndromes. Would improvement in the recognition of 'STEMI-equivalents' affect time until reperfusion?

Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup.

Effects of topical medications on radial artery spasm in patients undergoing transradial coronary procedures: a systematic review protocol.

The objective is to identify the effectiveness of topical medications in reducing radial artery spasm in patients undergoing transradial coronary procedures.

Effects of methods used to achieve hemostasis on radial artery occlusion following percutaneous coronary procedures: a systematic review protocol.

The objective of this systematic review is to synthesize the best available research evidence related to the effects of methods used to achieve hemostasis on radial artery occlusion (RAO) rates, following the radial artery approach for percutaneous coronary procedures.The specific review question is as follows: What is the effect of methods used to achieve hemostasis post sheath removal on RAO rates in adult patients, following the radial artery approach for percutaneous coronary procedures?

Effectiveness of vasodilatory medications on radial artery spasm in patients undergoing transradial coronary artery procedures: a systematic review protocol.

The quantitative objective is to identify the effectiveness of vasodilatory medications on radial artery spasm in patients undergoing transradial coronary artery procedures.

Return to full normal activities including work at two weeks after acute myocardial infarction.

Patients are generally advised to return to full normal activities, including work, 6 to 8 weeks after acute myocardial infarction (AMI). We assessed the outcomes of early return to normal activities, including work at 2 weeks, after AMI in patients who were stratified to be at a low risk for future cardiac events. Patients were considered for randomization before discharge if they had no angina, had left ventricular ejection fraction >40%, a negative result from a symptom-limited exercise stress test for ischemia (<2 mm ST depression) at 1 week, and achieved >7 METs.

Factors affecting diurnal variability of ventricular tachyarrhythmias detected by multiprogrammable implantable cardioverter-defibrillators.

Many cardiovascular events, including ventricular arrhythmias, display diurnal variability with a morning peak, and a less pronounced afternoon peak. Since the advent of multiprogrammable implantable cardioverter-defibrillators (ICDs), it has been possible to analyse ventricular tachyarrhythmic events. This study aims to evaluate the circadian pattern of ventricular tachycardias in patients treated with ICDs and examines whether antiarrhythmic medications affect this pattern.