Cardiol J
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Randomized Controlled Trial Multicenter Study Comparative Study
Effect of ASA dose doubling versus switching to clopidogrel on plasma inflammatory markers concentration in patients with type 2 diabetes and high platelet reactivity: the AVOCADO study.
The aim of the study was to compare the effects of 2 strategies of antiplatelet treatment (i.e., 150 mg ASA vs. 75 mg clpoidogrel) on plasma level of inflammatory markers in type 2 diabetes mellitus (T2DM) patients with high platelet reactivity (HPR). ⋯ Increasing the dose of ASA from 75 mg to 150 mg daily or switching ASA 75 mg to clopidogrel 75 mg daily may reduce concentrations of some inflammatory markers (in particular hsCRP, IL-6 and CD40L) in T2DM patients with HPR treated previously with 75 mg of ASA.
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Transfusion-related acute lung injury (TRALI) is one of the leading causes of death associated with transfusion of blood and blood components. The understanding of the etiology and pathophysiology of this syndrome has much improved during the last decades, nevertheless numerous issues are still unresolved and symptomatic treatment remains the cornerstone of medical management. ⋯ The awareness of the problem within the medical society is still unsatisfactory which results in a high number of unrecognized cases or of inaccurate diagnoses one of which is cardiogenic pulmonary edema. The aim of this review is to make the TRALI syndrome more familiar to clinicians and to emphasize how significant proper medical management is both for the patients presenting TRALI symptoms as well as for future recipients of blood components.
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Randomized Controlled Trial Comparative Study
Comparison of aspirin plus heparin with heparin alone on asymptomatic perioperative deep vein thrombosis in candidates for elective off-pump coronary artery bypass graft: a randomized clinical trial.
Symptomatic or asymptomatic deep vein thrombosis (DVT) is a common complication following coronary artery bypass graft (CABG), in which less than 1% of these patients suffer from clinically evident pulmonary embolism (PE). DVT and PE can increase other morbidities of coronary revascularization from short to long period, but no clear consensus still exists regarding proper thromboprophylaxis strategy in the literatures. This study was designed to compare the anti-platelet prophylaxis of aspirin plus heparin with heparin alone on asymptomatic perioperative DVT in patients that are candidates for elective off-pump CABG. ⋯ The incidence of DVT decreased more with aspirin plus heparin as compared to heparin alone in patients who underwent elective off-pump CABG. As regards the results obtained in this study, more studies need to be conducted to establish this strategy for prophylaxis of DVT in CABG.
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An increasing proportion of patients present for concomitant aortic valve replacement (AVR) and coronary artery bypass grafting (CABG) with left ventricular (LV) dysfunction. The aim of this study was to evaluate the early outcomes and late survival of patients with different degrees of LV function undergoing concomitant AVR and CABG. ⋯ Patients with severely impaired LVEF experience worse outcomes. However, in the era of modern surgery, this alone should not predicate exclusion, given the established benefits of surgery in this high-risk group.
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Under normal conditions function of the right ventricle (RV) is determined by the heart rhythm, RV filling time, RV systolic synchrony and interdependence between both ventricles. Failure of the left ventricle (LV) can lead to RV failure. Impaired function of the RV significantly worsens the prognosis in patients after myocardial infarction and with LV failure. ⋯ Frequent coexistence of chronic heart failure (CHF) and AF causes overlapping of the arrhythmia and RV dysfunction in the setting of CHF. They may lead to hemodynamic compromise and worsen prognosis in patients with chronic RV failure of various etiologies. RV structure and function can be assessed in 2D, 3D echocardiography, cardiac magnetic resonance imagingand computed tomography.