Most Read Articles
Roshini Claire Anthony, 29 May 2020

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

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Thrombus aspiration ineffective for STEMI patients

08 May 2020

Thrombus aspiration (TA) during primary percutaneous coronary intervention (PPCI) does not seem to improve outcomes in patients with ST-elevation myocardial infarction (STEMI), a recent study has found.

The study included 563 STEMI patients (mean age, 62.3±12.8 years; 79.6 percent male), of whom 291 underwent PPCI alone while the remaining 272 received TA. The primary endpoint was the occurrence of major adverse cardiac events (MACEs), defined as a composite of cardiovascular death, cardiogenic shock, recurrent myocardial infarction or heart failure hospitalization.

At the 5-year follow-up, 42 patients in the PPCI alone group developed MACEs, as opposed to only 26 in the TA group. The corresponding rates were 3.13 percent and 2.02 percent, which did not correspond to a significant risk estimate according to Cox proportional hazards regression (adjusted hazard ratio [HR], 0.70, 95 percent confidence interval [CI], 0.42–1.17; p=0.171).

Analysis by the individual components showed that there was no particular driver of the principal findings. Recurrent myocardial infarction (adjusted HR, 0.79, 97 percent CI, 0.36–1.74; p=0.564), cardiogenic shock (adjusted HR, 0.72, 95 percent CI, 0.32–1.65; p=0.437) and heart failure hospitalization (adjusted HR, 0.57, 95 percent CI, 0.27–1.20; p=0.139) were all similarly likely to occur in the PPCI alone and TA arms.

The same was true for cardiovascular (adjusted HR, 0.91, 95 percent CI, 0.45–1.87; p=0.805) and all-cause (adjusted HR, 1.08, 95 percent CI, 0.61–1.89; p=0.799) deaths.

Moreover, this lack of efficacy was compounded by a significant safety concern. Stroke occurred in 0.70 percent of the TA group, as opposed to only 0.14 percent of the PPCA alone arm. This corresponded to a significant risk estimate (adjusted HR, 7.32, 95 percent CI, 1.33–40.31; p=0.022).

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Most Read Articles
Roshini Claire Anthony, 29 May 2020

For coffee drinkers, drinking filtered coffee may be tied to a lower mortality risk, including cardiovascular disease (CVD)-related mortality, a study from Norway suggested.

3 days ago
Use of metformin is effective in preventing hyperglycaemia in nondiabetic cancer patients exposed to high-dose prednisone-based chemotherapy, results of a randomized study have shown.
6 days ago
Use of corticosteroid is not associated with improved outcomes in idiopathic pulmonary fibrosis (IPF) patients admitted to the hospital with acute exacerbation (AE), reveals a recent study. In addition, corticosteroids may even contribute to reduced overall survival following exacerbation.
Dr. Wong Soon Tee, 28 May 2020
Acne is a common skin problem seen in primary care. Dr Wong Soon Tee of Assurance Skin Clinic at Mt Elizabeth Novena Hospital, Singapore shares his insights with Pearl Toh on how to manage acne in the primary care setting.