Out of compliance in cardiology when you read a clinical guide. From the list SBMFC sent by Juan Gérvas.
Conflicto de intereses en cardiologia 1Conflicto de intereses en cardiologia 2
Mostrando las entradas con la etiqueta Cardiology. Mostrar todas las entradas
Mostrando las entradas con la etiqueta Cardiology. Mostrar todas las entradas
07 octubre, 2011
28 febrero, 2011
Universal definition,`` measurement of creatine kinase-myocardial band rather than troponin allows more accurate diagnosis of periprocedural necrosis and infarction after coronary intervention
Image via Wikipedia| Lim CC, van Gaal WJ, Testa L, et al. With the ``universal definition,`` measurement of creatine kinase-myocardial band rather than troponin allows more accurate diagnosis of periprocedural necrosis and infarction after coronary intervention. J Am Coll Cardiol. 2011 Feb 8;57(6):653-61. (Original) PMID: 21292125 | ||
| Read Abstract | ||
| DISCIPLINE | RELEVANCE TO PRACTICE | IS THIS NEWS? |
| Surgery - Cardiac |   | |
| Cardiology | * | * |
* Ratings pending – login to http://plus.mcmaster.ca/evidenceupdates in a few days if interested.
| Abstract |
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| OBJECTIVES: We aimed to assess the differential implications of creatine kinase-myocardial band (CK-MB) and troponin measurement with the universal definition of periprocedural injury after percutaneous coronary intervention. BACKGROUND: Differentiation between definitions of periprocedural necrosis and periprocedural infarction has practical, sociological, and research implications. Troponin is the recommended biomarker, but there has been debate about the recommended diagnostic thresholds. METHODS: Thirty-two patients undergoing multivessel percutaneous coronary intervention and late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging in a prospective study had cardiac troponin I, CK-MB, and inflammatory markers (C-reactive protein, serum amyloid A, myeloperoxidase, tumor necrosis factor alpha) measured at baseline, 1 h, 6 h, 12 h, and 24 h after the procedure. Three ``periprocedural injury`` groups were defined with the universal definition: G1: no injury (biomarker <99th percentile); G2: periprocedural necrosis (1 to 3 x 99th percentile); G3: myocardial infarction (MI) type 4a (>3 x 99th percentile). Differences in inflammatory profiles were analyzed. RESULTS: With CK-MB there were 17, 10, and 5 patients in groups 1, 2, and 3, respectively. Patients with CK-MB-defined MI type 4a closely approximated patients with new CMR-LGE injury. Groups defined with CK-MB showed progressively increasing percentage change in C-reactive protein and serum amyloid A, reflecting increasing inflammatory response (p < 0.05). Using cardiac troponin I resulted in 26 patients defined as MI type 4a, but only a small minority had evidence of abnormality on CMR-LGE, and only 3 patients were defined as necrosis. No differences in inflammatory response were evident when groups were defined with troponin. CONCLUSIONS: Measuring CK-MB is more clinically relevant for diagnosing MI type 4a, when applying the universal definition. Current troponin thresholds are oversensitive with the arbitrary limit of 3 x 99th percentile failing to discriminate between periprocedural necrosis and MI type 4a. (Myocardial Injury following Coronary Artery bypass Surgery versus Angioplasty: a randomised controlled trial using biochemical markers and cardiovascular magnetic resonance imaging; ISRCTN25699844). |
26 octubre, 2008
Pocket Consultant Cardiology
Download: http://www.4shared.com/file/67376139/10dec54e/Blackwell_Publishing_Pocket_Consultant_Cardiology_5th.html
Cardiology is a rapidly changing and expanding field. Management protocols change regularly, new categories of treatment options are being discovered, and there is a new focus on the prevention of cardiovascular diseases. Pocket Consultant: Cardiology is a highly practical, user-friendly guide to this expanding field. Now in its fifth edition, this book has been highly praised for its readability, conciseness and clear illustrations, and is an indispensable guide for those dealing with common cardiological problems. The author, the current president of the British Cardiac Society, is internationally known in the field of clinical cardiology. This is an ideal book for the junior doctor who wants a quick, easily understandable guide to cardiology. This title is now available for the PDA, powered by Skyscape.
Más información
Cardiology: Cardiology
Autor R. H. Swanton
Publicado por Blackwell Publishing, 2003
ISBN 1405101970, 9781405101974
464 páginas
More information in Google Books
Pocket Consultant Cardiology
Download: http://www.4shared.com/file/67376139/10dec54e/Blackwell_Publishing_Pocket_Consultant_Cardiology_5th.html
Cardiology is a rapidly changing and expanding field. Management protocols change regularly, new categories of treatment options are being discovered, and there is a new focus on the prevention of cardiovascular diseases. Pocket Consultant: Cardiology is a highly practical, user-friendly guide to this expanding field. Now in its fifth edition, this book has been highly praised for its readability, conciseness and clear illustrations, and is an indispensable guide for those dealing with common cardiological problems. The author, the current president of the British Cardiac Society, is internationally known in the field of clinical cardiology. This is an ideal book for the junior doctor who wants a quick, easily understandable guide to cardiology. This title is now available for the PDA, powered by Skyscape.
Más información
Cardiology: Cardiology
Autor R. H. Swanton
Publicado por Blackwell Publishing, 2003
ISBN 1405101970, 9781405101974
464 páginas
More information in Google Books
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