Daily cardiac catheterization procedural volume and complications at an academic medical center.

Background: Over 1,000,000 cardiac catheterizations (CC) are performed annually in the United States. There is a small risk of complication that has persisted despite advances in technology. It is unknown whether daily CC procedural volume can influence this risk.

Dual antiplatelet compared to triple antithrombotic therapy in anterior wall acute myocardial infarction complicated by depressed left ventricular ejection fraction.

Current guidelines recommend triple antithrombotic therapy (TT) consisting of warfarin, aspirin, and a P2Y12 inhibitor following an anterior ST elevation myocardial infarction (STEMI) complicated by extensive wall motion abnormalities. This recommendation, however, is based on data collected before percutaneous coronary intervention (PCI) became the standard of care for the treatment of STEMI. We designed a retrospective study of patients who received PCI for anterior STEMI over an 8-year period to compare rates of thromboembolic and bleeding events between patients receiving dual antiplatelet therapy (DAPT) and those receiving TT, including warfarin.

Successful Use of Therapeutic Hypothermia in a Pregnant Patient.

Out-of-hospital cardiac arrest is a leading cause of death in the United States. Pregnant women are not immune to cardiac arrest, and the treatment of such patients can be difficult. Pregnancy is a relative contraindication to the use of therapeutic hypothermia after cardiac arrest.

An unusual case of flecainide-induced QT prolongation leading to cardiac arrest.

Flecainide is recommended as a first-line antiarrhythmic drug to maintain normal sinus rhythm in patients with atrial fibrillation (AF) who have structurally normal hearts or hypertension without left ventricular hypertrophy. Flecainide is a sodium channel blocker with minimal effects expected on ventricular repolarization. We describe the case of a 32-year-old man with a structurally normal heart and persistent AF who was started on diltiazem and flecainide 50 mg twice/day approximately a year prior to presentation.

The Hispanic Diabetes Management Program: Impact of community pharmacists on clinical outcomes.

Objective: To assess the impact of community pharmacists on clinical outcomes in Hispanic patients with type 2 diabetes.

Methods: 126 patients were enrolled in this longitudinal pre/post cohort study that took place in nine community and four workplace pharmacies in San Antonio, TX. Pharmacists provided education, point-of-care testing for glycemic and metabolic parameters, clinical assessment, goal setting, and drug therapy management with physicians.

Dronedarone: a new antiarrhythmic agent.

Dronedarone is an antiarrhythmic agent recently approved by the United States Food and Drug Administration for the reduction of cardiovascular-related hospitalizations in patients with paroxysmal or persistent atrial fibrillation or atrial flutter. The drug is a derivative of amiodarone and has been modified to reduce the organ toxicities frequently encountered with amiodarone. Dronedarone exerts its antiarrhythmic effects through multichannel blockade of the sodium, potassium, and calcium channels and also possesses antiadrenergic activity, thereby exhibiting pharmacologic effects of all four Vaughan Williams classes of antiarrhythmics.

Proton pump inhibitors and clopidogrel: is it a significant drug interaction?

Importance Of The Field: Clopidogrel is indicated as part of a dual antiplatelet therapy (DAT) with aspirin for the prevention of cardiac related events in acute coronary syndromes particularly in patients undergoing percutaneous coronary intervention. Recently, there have been reports of a clinically significant drug interaction between clopidogrel and proton pump inhibitors (PPI), which are frequently co-prescribed to prevent DAT associated gastrointestinal (GI) bleeding.

Areas Covered In This Review: This review evaluates the risk of GI bleeding associated with DAT and the rationale for the use of PPI.