Weekly Guideline Update - 2013 ESC Cardiac Pacing

2013 ESC "Cardiac Pacing and Cardiac Resynchronization Therapy"

http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/cardiac-pacing-and-cardiac-resynchronisation-therapy.aspx

CIRC - Trends in Survival From Out-of-Hospital Cardiac Arrest

 "Recent Trends in Survival From Out-of-Hospital Cardiac Arrest in the United States"

"Conclusions—Data drawn from a large subset of U.S communities suggest that rates of survival from out-of-hospital cardiac arrest have improved among sites participating in a performance improvement registry."

http://circ.ahajournals.org/content/130/21/1876.full

BMJ - Co-trimoxazole and sudden death

 "Co-trimoxazole and sudden death in patients receiving inhibitors of renin-angiotensin system: population based study"

"Conclusions |
In older patients receiving angiotensin converting enzyme inhibitors or angiotensin receptor blockers, co-trimoxazole is associated with an increased risk of sudden death. Unrecognized severe hyperkalemia may underlie this finding. When appropriate, alternative antibiotics should be considered in such patients."

http://www.bmj.com/content/349/bmj.g6196

NEJM - Atenolol versus Losartan in Marfan's

 "Atenolol versus Losartan in Children and Young Adults with Marfan's Syndrome"

"CONCLUSIONS

Among children and young adults with Marfan's syndrome who were randomly assigned to losartan or atenolol, we found no significant difference in the rate of aortic-root dilatation between the two treatment groups over a 3-year period. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov number,NCT00429364.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1404731

JAMA -β-Blockers in Heart Failure and Preserved EF

"Association Between Use of β-Blockers and Outcomes in Patients With Heart Failure and Preserved Ejection Fraction"

"Conclusions and Relevance  In patients with HFPEF, use of β-blockers was associated with lower all-cause mortality but not with combined all-cause mortality or heart failure hospitalization. β-Blockers in HFPEF should be examined in a large randomized clinical trial."

http://jama.jamanetwork.com/article.aspx?articleid=1935124

Weekly Guideline - 2014 ESC Noncardiac Surgery

 "2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management"


http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/perioperative-cardiac-care.aspx

CIRC - Survival in Hospital Cardiac Arrest and Use of AED

"Improved Survival After Out-of-Hospital Cardiac Arrest and Use of Automated External Defibrillators"

"Conclusions—Increased AED use is associated with increased survival in patients with a shockable initial rhythm. We recommend continuous efforts to introduce or extend AED programs."

http://circ.ahajournals.org/content/130/21/1868.abstract 

BMJ - Vitamin D and Mortality

"Genetically low vitamin D concentrations and increased mortality: mendelian randomisation analysis in three large cohorts"

"Conclusions Genetically low 25-hydroxyvitamin D concentrations were associated with increased all cause mortality, cancer mortality, and other mortality but not with increased cardiovascular mortality. These findings are compatible with the notion that genetically low 25-hydroxyvitamin D concentrations may be causally associated with cancer and other mortality but also suggest that the observational association with cardiovascular mortality could be the result of confounding."

http://www.bmj.com/content/349/bmj.g6330

NEJM - Pancreatitis

"Early versus On-Demand Nasoenteric Tube Feeding in Acute Pancreatitis"

"CONCLUSIONS

This trial did not show the superiority of early nasoenteric tube feeding, as compared with an oral diet after 72 hours, in reducing the rate of infection or death in patients with acute pancreatitis at high risk for complications. (Funded by the Netherlands Organization for Health Research and Development and others; PYTHON Current Controlled Trials number, ISRCTN18170985.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1404393?query=featured_home

JAMA - Closure Devices vs Compression for Femoral Artery Puncture

"Comparison of Vascular Closure Devices vs Manual Compression After Femoral Artery Puncture"

"Conclusions and Relevance  In patients undergoing transfemoral coronary angiography, VCDs were noninferior to manual compression in terms of vascular access-site complications and reduced time to hemostasis." 



http://jama.jamanetwork.com/article.aspx?articleid=1935125

Weekly Guideline - 2012/ 2013 IDSA Sepsis

"International  Guidelines for Management of Severe Sepsis  and Septic Shock: 2012"

http://www.idsociety.org/uploadedFiles/IDSA/Guidelines-Patient_Care/IDSA_Practice_Guidelines/Fever_and_Infections/2013%20Sepsis%20Guidelines.pdf

JACC - The QT Interval & Incident Cardiovascular Events

"The QT Interval Is Associated With Incident Cardiovascular Events"

"Conclusions  The QT interval was associated with incident cardiovascular events in middle-aged and older adults without prior CVD." 
http://content.onlinejacc.org/article.aspx?articleID=1934902 

BMJ - Oral Contraceptive and Mortality

"Oral contraceptive use and mortality after 36 years of follow-up in the Nurses’ Health Study: prospective cohort study"

"Conclusions
All cause mortality did not differ significantly between women who had ever used oral contraceptives and never users. Oral contraceptive use was associated with certain causes of death, including increased rates of violent or accidental death and deaths due to breast cancer, whereas deaths due to ovarian cancer were less common among women who used oral contraceptives. These results pertain to earlier oral contraceptive formulations with higher hormone doses rather than the now more commonly used third and fourth generation formulations with lower estrogen doses."

http://www.bmj.com/content/349/bmj.g6356 

NEJM - Cost-Effectiveness of CT Screening for Lung CA

"Cost-Effectiveness of CT Screening in the National Lung Screening Trial"

"CONCLUSIONS

We estimated that screening for lung cancer with low-dose CT would cost $81,000 per QALY gained, but we also determined that modest changes in our assumptions would greatly alter this figure. The determination of whether screening outside the trial will be cost-effective will depend on how screening is implemented. (Funded by the National Cancer Institute; NLST ClinicalTrials.gov number,NCT00047385.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1312547?query=featured_home

JAMA - Nonobstructive CAD and MI Risk

 "Nonobstructive Coronary Artery Disease and Risk of Myocardial Infarction"

"Conclusions and Relevance  In this cohort of patients undergoing elective coronary angiography, nonobstructive CAD, compared with no apparent CAD, was associated with a significantly greater 1-year risk of MI and all-cause mortality. These findings suggest clinical importance of nonobstructive CAD and warrant further investigation of interventions to improve outcomes among these patients."

http://jama.jamanetwork.com/article.aspx?articleid=1920971

Weekly Guideline - 2014 AHA/ASA Prevention of Stroke

"AHA/ASA Guideline Guidelines for the Primary Prevention of Stroke"

http://stroke.ahajournals.org/content/early/2014/10/28/STR.0000000000000046

CIRC - Endocarditis Outcomes

"Long-Term Clinical Outcome of Major Adverse Cardiac Events in Survivors of Infective Endocarditis"

"Conclusion—Despite treatment, the risk of long-term major adverse cardiac events was substantially increased in IE survivors."

http://circ.ahajournals.org/content/130/19/1684.abstract

BMJ - Milk and Fractures in Men & Women

"Milk intake and risk of mortality and fractures in women and men: cohort studies"

"Conclusions High milk intake was associated with higher mortality in one cohort of women and in another cohort of men, and with higher fracture incidence in women. Given the observational study designs with the inherent possibility of residual confounding and reverse causation phenomena, a cautious interpretation of the results is recommended."


http://www.bmj.com/content/349/bmj.g6015

NEJM - Ebola

"Clinical Illness and Outcomes in Patients with Ebola in Sierra Leone"

"CONCLUSIONS

The incubation period and case fatality rate among patients with EVD in Sierra Leone are similar to those observed elsewhere in the 2014 outbreak and in previous outbreaks. Although bleeding was an infrequent finding, diarrhea and other gastrointestinal manifestations were common. (Funded by the National Institutes of Health and others.)"

http://www.nejm.org/doi/full/10.1056/NEJMoa1411680?query=featured_home

JAMA - Dalteparin vs Unfractionated Heparin for the Prevention of VTE

"Cost-effectiveness of Dalteparin vs Unfractionated Heparin for the Prevention of Venous Thromboembolism in Critically Ill Patients"

"Conclusions and Relevance  From a health care payer perspective, the use of the LMWH dalteparin for VTE prophylaxis among critically ill medical-surgical patients was more effective and had similar or lower costs than the use of UFH. These findings were driven by lower rates of pulmonary embolus and heparin-induced thrombocytopenia and corresponding lower overall use of resources with LMWH."

http://jama.jamanetwork.com/article.aspx?articleid=1921813