Immediate coronary angiography and systematic targeted temperature management are associated with improved outcome in comatose survivors of cardiac arrest.

Rapid and systematic access to coronary angiography (CAG) and target temperature management (TTM) might improve outcome in comatose patients who survive cardiac arrest (CA). However, there is controversy around indicating immediate CAG in the absence of transmural ischemia on the electrocardiogram after return of spontaneous circulation (ROSC). We evaluated the short- and long-term outcome of patients undergoing systematic CAG and TTM, based on whether culprit lesion percutaneous coronary intervention (PCI) was performed.

Switching from clopidogrel to prasugrel to protect early invasive treatment in acute coronary syndromes: Results of the switch over trial.

Background: Clopidogrel is used to pretreat patients with non-ST elevation acute coronary syndromes (NSTE-ACS), but prasugrel provides better platelet inhibition with improved outcome. However, switching from clopidogrel at the time of percutaneous coronary intervention (PCI) remains incompletely defined. Our aim was to compare the pharmacodynamic (PD) effects of 3 prasugrel loading doses (LDs; G1:10mg, G2: 30mg, and G3: 60mg) before PCI.

[Coronary care units: who to admit and how long].

Coronary care units (CCUs) should ensure the best intensive therapy for all critical cardiologic patients and not only for patients with acute coronary heart disease. Such structures apply the Hub & Spoke model, which consists of an integrated network of services allowing a health organization in which different realities interact and collaborate; this organization is composed of referral core centers (Hubs) and smaller structures (Spokes) referring to Hubs that are engaged in selection, channeling of patients in the acute phase, and for follow-up care of patients in the post-acute phase. The CCUs, based on the organizational reality in which they operate, must hospitalize and dismiss complex patients in a brief lapse of time.