Rehospitalization of Patients with Advanced Heart Failure Receiving Continuous, Palliative Dobutamine or Milrinone.

This study aims to determine the incidence of all-cause hospitalization in patients with advanced heart failure (AHF) receiving ambulatory continuous, intravenous dobutamine versus milrinone for palliative intent. Despite medical optimization, patients with AHF develop refractory symptoms, resulting in frequent hospitalizations. Previous trials precede modern care standards.

COVID-19 pandemic: Challenges and solutions from the cardiology pharmacist's perspective.

The recent coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) challenges pharmacists worldwide. Alongside other specialized pharmacists, we re-evaluated daily processes and therapies used to treat COVID-19 patients within our institutions from a cardiovascular perspective and share what we have learned. To develop a collaborative approach for cardiology issues and concerns in the care of confirmed or suspected COVID-19 patients by drawing on the experiences of cardiology pharmacists across the country.

Aspirin rechallenge in an adult patient previously diagnosed with Reye syndrome.

Purpose: Aspirin has been the cornerstone of antiplatelet therapy in patients with acute coronary syndromes and is well accepted and recommended by several major healthcare organizations. A combination of aspirin and a P2Y12 inhibitor, commonly known as dual antiplatelet therapy, is recommended in patients with coronary stent implantation to reduce the risk of stent thrombosis and ischemic events.

Summary: We recently cared for an adult male who presented with an acute coronary syndrome who had a history of Reye syndrome during childhood.

Outcomes for Cancer Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

Background/purpose: The incidence of cardiovascular disease in cancer patients is rising. The risk of in-hospital complications for cancer patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) is not well defined.

Methods/materials: A retrospective single-center cohort assessing STEMI patients with a history of cancer (n = 58) and without a history of cancer (n = 551) who underwent primary PCI between January 1, 2012 and June 30, 2017 was conducted.

Comparison of the Safety of Adenosine and Regadenoson in Patients Undergoing Outpatient Cardiac Stress Testing.

Study Objective: To compare the adverse effect profiles of adenosine and regadenoson in patients undergoing outpatient cardiac stress testing.

Design: Single-center retrospective cohort study.

Setting: Two outpatient clinics, both of which are part of a single tertiary academic medical health system; one clinic exclusively used adenosine for cardiac stress testing, and the other clinic exclusively used regadenoson.

Heart failure assessment at the community pharmacy level: a feasibility pilot study.

Background: A key element missing in disease-management programs for heart failure (HF) is participation of the community pharmacist. The purpose of this study is to determine if a simple and efficient clinical tool will allow community pharmacists to identify patients at risk for worsening HF.

Design: The One Minute Clinic for Heart Failure (TOM-C HF) was developed as a simple six-item symptom screening tool to be used during routine patient/customer interactions.

Comparison of the effects of combination diuretic therapy with oral hydrochlorothiazide or intravenous chlorothiazide in patients receiving intravenous furosemide therapy for the treatment of heart failure.

Study Objective: To compare the effects of combination diuretic therapy with oral hydrochlorothiazide or intravenous chlorothiazide added to background intravenous loop diuretic therapy among patients hospitalized with heart failure.

Design: Single-center, retrospective review.

Setting: Cardiovascular hospital within a university-affiliated teaching institution.

Bleeding outcomes associated with coronary artery bypass graft surgery and recent clopidogrel exposure.

Background: Guidelines recommend discontinuing clopidogrel for at least 5 days before elective coronary artery bypass graft surgery (CABG) to limit blood transfusions and for at least 24 hours before urgent CABG to reduce major bleeding complications. Studies have produced conflicting results regarding whether recent exposure to clopidogrel increases bleeding, the need for intraoperative and postoperative blood products, postoperative complications, and hospital length of stay. We evaluated the effect of clopidogrel exposure on major bleeding at our institution within 5 days of CABG.

Clinical and economic implications of new strategies for heart failure management in the managed care setting.

Clinical pharmacists in all settings see a large number of patients with heart failure, many of whom are Medicare recipients. Clinical studies have identified appropriate drug therapy for patients with heart failure, and several professional organizations have compiled excellent guidelines. Regardless, many patients are not benefiting from treatment with drugs proven to help reduce morbidity and mortality.

Elevated defibrillation threshold with venlafaxine therapy.

Depression is a common comorbidity in patients with heart failure or implantable cardioverter-defibrillators (ICDs). A 35-year-old woman with depression, nonischemic cardiomyopathy, and a history of cardiac arrest had an ICD implanted. During initial testing, the device failed to internally defibrillate the patient.

Safety of antidepressant drugs in the patient with cardiac disease: a review of the literature.

Patients with cardiac disease, specifically ischemic heart disease and heart failure, have a higher frequency of major depressive disorder than patients without cardiac disease. The pathophysiologic reason for this is not completely understood. Previous depression, other debilitating illnesses, and type A personality are risk factors for the development of depression in cardiac patients.