International journal of cardiology
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Evidence from clinical cohorts indicates an obesity paradox in overweight and obese patients who seem to have a more favorable short-term and long-term prognosis than leaner patients. Although obese cardiac arrest victims are theoretically more difficult to be resuscitated due to difficulties in providing adequate chest compressions, ventilation, and oxygenation, research so far has shown that there is an obesity paradox in cardiac arrest.
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Extracorporeal membrane oxygenation (ECMO) provides excellent support to circulation. However, ECMO capacity to effectively assist the heart, and in particular the left ventricle, is limited. We herein review the modifications of left ventricular dynamics during peripheral ECMO, highlight the importance of left ventricle venting and describe a method for the conversion of a femoro-femoral ECMO into a paracorporeal left ventricular assist device.
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Editorial Comparative Study
Exploring the reduction in myocardial infarctions in the PLATO trial: which patients benefited on ticagrelor vs. clopidogrel?
Ticagrelor showed significant reductions in myocardial infarctions (MIs) compared to clopidogrel in the Platelet Inhibition and Patient Outcomes (PLATO) trial. However, there was no explanation as to whether there was an equal distribution of benefit throughout acute coronary syndrome (ACS) types. ⋯ Ticagrelor significantly reduced MIs compared to clopidogrel only in STEMI patients, with those receiving early PCI having worse outcomes with ticagrelor. Despite, NSTEMI patients showing no significant reduction in MI with ticagrelor vs. clopidogrel, CV mortality was significantly reduced. In summary, we cannot be sure what is driving the STEMI-MI benefit, the NSTEMI-CV mortality benefit, nor the overall mortality benefit for ticagrelor-treated patients compared to clopidogrel treated patients.