Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
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G Ital Cardiol (Rome) · Feb 2014
Review[Role of emergent coronary angiography in post-cardiac arrest care: from literature review to clinical practice].
Out-of-hospital cardiac arrest is a relatively common event. Acute coronary thrombotic events are the main trigger of sudden cardiac arrest. Mortality of patients, in whom return of spontaneous circulation is obtained, is still high, mainly due to anoxic brain injury and progressive cardiac failure. ⋯ Conversely, whether patients without ST-segment elevation on ECG or patients who remain unconscious after return of spontaneous circulation should always undergo emergent coronary angiography is still unclear. Recent observational stud ies have shown that emergent invasive coronary strategies may improve hospital survival also in this patient subset. This suggests that resuscitated cardiac arrest victims without an obvious non-cardiac etiology should always undergo emergent coronary angiography, in association with therapeutic hypothermia if indicated.
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G Ital Cardiol (Rome) · Feb 2014
[Management of thromboembolic risk in patients with atrial fibrillation in Italy: baseline data from the PREFER in AF European Registry].
Atrial fibrillation (AF) is a common heart rhythm disorder associated with an increased risk of stroke, heart failure and death. Although available evidence supports the administration of oral anticoagulants with respect to other treatment options to prevent thromboembolism, the use of oral anticoagulation therapy remains suboptimal. The PREFER in AF registry was conducted to evaluate patterns of prescriptions and patient adherence to guidelines, clinical features, quality of life and treatment satisfaction. ⋯ Among Western European countries included in the registry, Italy has the lowest prescription rate of vitamin K antagonists and the highest rate of INR measurements. Italian patients also report lower levels of satisfaction with treatment and a higher subjective difficulty in managing anticoagulation therapy. The new oral anticoagulants may favor treatment management, thus having the potential of improving medication adherence and persistence as well as quality of life.