Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Oct 2020
Mortality in patients after acute myocardial infarction managed by cardiologists and primary care physicians: a systematic review.
Mortality following acute myocardial infarction (AMI) remains high despite of progress in invasive and noninvasive treatments. ⋯ Patients after AMI consulted by both a cardiologist and a GP may be at lower risk of death compared with patients consulted by a GP or a cardiologist only. However, these findings are based on moderate‑quality nonrandomized studies. We found no evidence on the relation between the specialization of the physician and the risk of cardiovascular death, stroke, or myocardial infarction in AMI survivors.
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Pol. Arch. Med. Wewn. · Oct 2020
Long-term survival improvement with acute kidney recovery after successful transcatheter aortic valve replacement.
Chronic kidney disease (CKD) is frequent in patients treated with transcatheter aortic valve replacement. Yet, the procedure can improve kidney function, that is, it can lead to acute kidney recovery (AKR). ⋯ Transcatheter aortic valve replacement led to acute kidney recovery in a substantial number of patients with CKD and an improved 4‑year survival.
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Pol. Arch. Med. Wewn. · Oct 2020
ReviewOral anticoagulation in patients with active cancer and atrial fibrillation: current challenges.
Atrial fibrillation and cancer are common comorbidities. Given an increased risk of arterial thrombosis caused by the former and an increased risk of bleeding in patients with the latter, the management of anticoagulation in patients in whom they coexist is complex. ⋯ For each of these 9 challenges, the evidence available is presented, the author's personal practical advice is given and the most pressing need to move the field forward is stated. I conclude by emphasizing the need for high‑quality evidence and, more practically, by stressing 1) the importance of patient preference and values in the decision on whether and how to anticoagulate, and 2) the need for periodic reassessment of the benefits of anticoagulation with changes in cancer status and treatment plan.