http://www.theheart.org/web_slides/1186083.do
A randomized study on Acetylcysteine for Contrast-Induced Nephropathy Trial (ACT) with patients undergoing an angiographic procedure.
Lo mejor en cardiopatía isquémica e intervencionismo coronario
Dr. Ignacio Cruz González, Hospital Universitario de Salamanca
@icruzgonzalez
Lo mejor del Congreso AHA Anaheim 2017
16/11/17 14:00
http://aha17.secardiologia.es
#PostAHA17
Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCPP, prepared useful Practice Aids pertaining to anticoagulation reversal for this CME activity titled "Reversal of Action: Addressing the Unmet Need for Universal Antidotes to Factor Xa Anticoagulants." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2LI9xc3. CME credit will be available until June 11, 2019.
Prevention of AKI in infants undergoing CHD surgery - an RCTscanFOAM
A presentation by Elin Tholacius at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Lo mejor en cardiopatía isquémica e intervencionismo coronario
Dr. Ignacio Cruz González, Hospital Universitario de Salamanca
@icruzgonzalez
Lo mejor del Congreso AHA Anaheim 2017
16/11/17 14:00
http://aha17.secardiologia.es
#PostAHA17
Charles V. Pollack, Jr., MA, MD, FACEP, FAAEM, FAHA, FESC, FCPP, prepared useful Practice Aids pertaining to anticoagulation reversal for this CME activity titled "Reversal of Action: Addressing the Unmet Need for Universal Antidotes to Factor Xa Anticoagulants." For the full presentation, monograph, complete CME information, and to apply for credit, please visit us at http://bit.ly/2LI9xc3. CME credit will be available until June 11, 2019.
Prevention of AKI in infants undergoing CHD surgery - an RCTscanFOAM
A presentation by Elin Tholacius at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Free handy references about Adult Suspected Stroke Algorithm from the ACLS Certification Institute.
View all ACLS algorithms at http://www.ACLScertification.com/
FOURIER: estudio de eventos cardiovasculares con evolocumab
30/03/2017 18:30h Casa del Corazón, Madrid
http://evolocumab.secardiologia.es
#evolocumab
Se abordarán los siguientes temas:
Presentación de resultados del estudio FOURIER
Interpretación de los datos en el contexto actual
Traslación clínica y aplicabilidad de los resultados
Coloquio y preguntas del público
mHealth Israel_Irit Hochberg_Rambam Hospital_ Decision Support System for Tre...Levi Shapiro
Presentation for mHealth Israel, June 7, 2017, by Dr. Irit Hochberg, Rambam Health Care Campus, Institute of Diabetes, Endicronology and Metabolism- Decision Support System for Treating Diabetes in Hospitalized Patients
Latest Trials on CAD from 2020 ESC Congress Han Naung Tun
LoDoCo2 Trial: low-dose colchicine reduced the risk of major cardiovascular events in patients with CAD
ATPCI: Trimetazidine in Angina Patients With Recent Successful Percutaneous Coronary Intervention
RAPID CTCA :Early Coronary CT Angiography in Patients With Suspected or Provisionally Diagnosed Acute Coronary Syndrome
OCT and MRI Find an MI Cause in 85% of Women With MINOCA: HARP
General or regional anaesthesia for orthopaedic surgery (THA/TKA)?scanFOAM
A talk by Andreas Harsten at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Ponencia presentada por el Dr. Nicolás Manito Lorite en el directo online ‘Fármacos que mejoran el pronóstico cardiovascular’, realizado en la Casa del Corazón el 5 de junio de 2018
A review of the existing evidence that supports the current practice in perioperative medicine regarding Renin-angiotensin-aldosterone system antagonists, mainly ACE inhibitors and Angiotensin type 1 receptor blockers (ARB's).
Presented as the Cleveland Clinic Hospital Medicine Grand Rounds on April 1, 2009. CME AMA Category 1 - 1 hour.
Free handy references about Adult Suspected Stroke Algorithm from the ACLS Certification Institute.
View all ACLS algorithms at http://www.ACLScertification.com/
FOURIER: estudio de eventos cardiovasculares con evolocumab
30/03/2017 18:30h Casa del Corazón, Madrid
http://evolocumab.secardiologia.es
#evolocumab
Se abordarán los siguientes temas:
Presentación de resultados del estudio FOURIER
Interpretación de los datos en el contexto actual
Traslación clínica y aplicabilidad de los resultados
Coloquio y preguntas del público
mHealth Israel_Irit Hochberg_Rambam Hospital_ Decision Support System for Tre...Levi Shapiro
Presentation for mHealth Israel, June 7, 2017, by Dr. Irit Hochberg, Rambam Health Care Campus, Institute of Diabetes, Endicronology and Metabolism- Decision Support System for Treating Diabetes in Hospitalized Patients
Latest Trials on CAD from 2020 ESC Congress Han Naung Tun
LoDoCo2 Trial: low-dose colchicine reduced the risk of major cardiovascular events in patients with CAD
ATPCI: Trimetazidine in Angina Patients With Recent Successful Percutaneous Coronary Intervention
RAPID CTCA :Early Coronary CT Angiography in Patients With Suspected or Provisionally Diagnosed Acute Coronary Syndrome
OCT and MRI Find an MI Cause in 85% of Women With MINOCA: HARP
General or regional anaesthesia for orthopaedic surgery (THA/TKA)?scanFOAM
A talk by Andreas Harsten at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All available content from SSAI2017: https://scanfoam.org/ssai2017/
Delivered in collaboration between scanFOAM, SSAI & SFAI.
Ponencia presentada por el Dr. Nicolás Manito Lorite en el directo online ‘Fármacos que mejoran el pronóstico cardiovascular’, realizado en la Casa del Corazón el 5 de junio de 2018
A review of the existing evidence that supports the current practice in perioperative medicine regarding Renin-angiotensin-aldosterone system antagonists, mainly ACE inhibitors and Angiotensin type 1 receptor blockers (ARB's).
Presented as the Cleveland Clinic Hospital Medicine Grand Rounds on April 1, 2009. CME AMA Category 1 - 1 hour.
Did you know that the right kind of salt actually HELPS your heart? How about that blood pressure drugs slow down the heart which decreases oxygen to the brain. Does that sound like a good idea to you? Did you also know that cholesterol is critical for hormone production in the body? It's time for some common sense! You are built to be healthy!
Presentations by Tawfiq Choudhury and Rocco Hadland from the second webinar of the Mastering Cholesterol webinar series on Thursday 11 May 2023, focusing on Statins.
JUPITER (Justification for the Use of Statins in Primary Prevention: An Inter...theheart.org
- 4-year, double-blind, placebo-controlled, randomized clinical trial
- Population and treatment:
17 802 patients with normal LDL-C (median 108 mg/dL) and elevated CRP (>2.0 mg/L) randomized to rosuvastatin 20 mg/d or placebo
- Primary outcome:
Composite of nonfatal MI, nonfatal stroke, hospitalization for unstable angina, revascularization, and confirmed death from CV causes
See the article at http://www.theheart.org/article/917181.do
TCT 2012 research highlights: A slideshow presentationtheheart.org
TCT 2012 took place in Miami, FL, on October 22-26. Key trials and presentations at the sessions included: PFO Closure, RESPECT, PC Trial, FAME II, ADVANCE, TAVR, TRILOGY-ACS, Live cases, DESSOLVE I and II, SES PARTNER B, MASTER, Career Achievement Award, ADAPT-DES, STEMI-RADIAL and POST
ESC 2012 research highlights: A slideshow presentationtheheart.org
The European Society of Cardiology (ESC) 2012 Congress took place in Munich, Germany from August 25 through August 29, 2012. Key trials presented at the sessions include: WOEST, ALTITUDE, FAME II, TRILOGY ACS, ACCESS EU,PURE, GARY. IABP SHOCK II, PARAMOUNT and DeFACTO
The American Heart Association (AHA) 2012 Scientific Sessions took place in Los Angeles, CA on November 3-7, 2012. Key trials presented at the sessions include: FREEDOM, TACT, UMPIRE, PHS II, OPERA and FORWARD, ASPIRE, TRILOGY ACS/ARCTIC, MADIT-RIT, RELAX-AHF, POSEIDON / SCIPIO, PCSK9 studies, PCSK9, dal-OUTCOMES andLoDoCo.
AHA 2010 research highlights: A slideshow presentation theheart.org
http://www.theheart.org/editorial-program/1156073.do
The American Heart Association (AHA) 2010 Scientific Sessions took place in Chicago. Key trials presented at the sessions include: ADVANCE,RAFT,QRS EMPHASIS-HF,ASCEND HF,ROCKET AF,CLOSURE I,GRAVITAS,P-OM3,BASKET-PROVE,DEFINE,SYMPLICITY HTN,ASCOT CRP and ACT.
TCT 2010 research highlights: A slideshow presentation theheart.org
http://www.theheart.org/editorial-program/1128553.do
The 22nd annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium took place in Washington. Key trials presented at the meeting include: PARTNER, ZILVER PTX, ISAR-TEST 4,SORT-OUT 4, COMPARE,SPIRIT IV, HORIZONS-AMI, BIOFREEDOM, PROTECT-AF, CAP and Robotically assisted PCI
ONTARGET trial - Summary & Results with Ramipril Global Endpointtheheart.org
A study to test whether an ARB (which blocks the effects of angiotensin II without enhancing bradykinin) was similarly effective to an ACE inhibitor and whether the combination of an ACE inhibitor and an ARB may be superior
OASIS-6 trial - Summary & Results at ACCtheheart.org
http://www.theheart.org/web_slides/1136801.do
A randomized, placebo study using patients with STEMI exposed to fondaparinux or to usual care-placebo. The Sixth Organization to Assess Strategies in Acute Ischemic Syndromes.
http://www.theheart.org/web_slides/1136565.do
A prospective,randomized, open-label, blinded-end-point evaluation trial on incremental decrease in endpoints through aggressive lipid lowering (IDEAL) using patients with a history of acute MI
http://www.theheart.org/web_slides/1283911.do
A survey of 153,996 adults on prospective urban rural epidemiology (PURE) to examine the relationship of societal influences on human lifestyle behaviors, CV risk factors, and incidence of chronic non communicable diseases
http://www.theheart.org/web_slides/1146197.do
A randomized study,on action to control cardiovascular risk in diabetes and blood-pressure-lowering arm (ACCORD BP) in a nonblinded fashion, to intensive BP-lowering
http://www.theheart.org/web_slides/1144191.do
A randomized to prasugrel or clopidogrel study on TRITON-TIMI 38 with patients who have moderate- to high-risk ACS.
http://www.theheart.org/web_slides/1425587.do
A randomized to placebo or ivabradine study on Systolic Heart Failure Treatment with the If Inhibitor Ivabradine (SHIFT) with patients on standard HF medications according to guidelines
http://www.theheart.org/web_slides/1146285.do
A prospective randomized trial on Embolic Protection in Patients with Atrial Fibrillation (PROTECT-AF) comparing closure of the LAA* (with the Watchman occluder) with long-term warfarin therapy
http://www.theheart.org/web_slides/1242353.do
An analysis based on an Italian registry of 308 patients with Brugada syndrome who underwent programmed electrical stimulation (PES) studies according to one consistent protocol (unlike earlier multicenter studies that were based on varying PES protocols)
http://www.theheart.org/web_slides/1242347.do
A trial on ALTITUDE to evaluate mortality after device implantation or after shock therapy in large numbers of patients with implanted devices
http://www.theheart.org/web_slides/1225253.do
A PRECOMBAT trial Premier of randomized comparison of bypass surgery vs angioplasty using sirolimus-eluting stent in patients with left main coronary artery disease
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
2. ACT (Acetylcysteine for Contrast-Induced
Nephropathy Trial)
O Berwanger (Hospital de Coração, São Paulo, Brazil)
American Heart Association 2010 Scientific Sessions
• The antioxidant N-acetylcysteine has been used as adjunctive therapy for about
10 years to reduce kidney injury caused by contrast used in coronary and
vascular angiography. However, evidence for its use remains conflicting
• Population and treatment:
2308 patients undergoing an angiographic procedure
Randomized to 1200 mg of N-acetylcysteine, twice daily, with two doses given
before the procedure and two doses after the procedure, or to placebo
• Outcomes:
Primary end point: contrast-induced nephropathy
Secondary end points: serum creatinine elevations
3. ACT: Results
• No difference was observed in the primary end point:
12.7% in both groups (RR 1.00; 95% CI, 0.81–1.25)
• No difference was observed in the secondary end point:
3.9% for N-acetylcysteine and 3.8% for placebo (serum creatinine elevation
>0.5 mg/dL)
• No difference was observed in the 30-day clinical end points:
Including mortality, the need for dialysis, or CV mortality
• A subgroup analysis revealed no benefit in any patient population:
Including patients stratified by age, the presence of diabetes mellitus, sex,
serum creatinine levels, or type of contrast used prior to angiography
4. ACT: Commentary*
"I would be comfortable saying that this is a definitive trial, and I'd be comfortable
saying that because if you look at the other high-quality trials, we reached exactly
the same result."
- Dr Otavio Berwanger
"I remember being in the cath lab as a cardiology fellow and patients were coming
in with N-acetylcysteine, and I remember thinking, 'What the heck is this drug?' How
quickly it was adopted into practice was remarkable."
- Dr Brahmajee Nallamothu
*All comments from ACT: No benefit of N-acetylcysteine to reduce contrast-induced nephropathy
(http://www.theheart.org/article/1151175.do)
5. Become a member of http://www.theheart.org
Become a fan on Facebook: http://www.facebook.com/theheartorg
Follow us on Twitter: http://www.twitter.com/theheartorg
theheart.org is the leading online source of independent cardiology news.
We are the top provider of news and opinions for over 100 000 physicians.