The American journal of medicine
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The association of takotsubo syndrome with future risk of cardiovascular and noncardiovascular morbidity and mortality is unclear. We assessed the long-term risk of morbidity and mortality in patients with takotsubo syndrome. ⋯ Takotsubo syndrome is associated with a risk of mortality similar to that of myocardial infarction after 15 years, but a lower risk of cardiovascular rehospitalization. Patients with takotsubo syndrome nonetheless have more in-hospital mortality and cardiovascular morbidity than population controls.
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Empirically, a significant proportion of patients using direct oral anticoagulation (DOAC) take off-label reduced doses. We aimed to investigate the prevalence, indications, dosages, and bleeding complications of oral anticoagulants on admission to the emergency department. ⋯ Vitamin-K antagonists are still the most widely used drug followed by rivaroxaban. A significant proportion of patients are being prescribed off label-doses. While no difference was found for the respective anticoagulants with respect to bleeding, concomitant aspirin use was a significant predictor for bleeding in our collective.
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The Fourth Universal Definition of Myocardial Infarction defines electrocardiographic Q waves as duration ≥30 ms and amplitude ≥1 mm or QS complex in 2 contiguous leads. However, current taskforce criteria may be overly restrictive. Therefore, we investigated the association of isolated, lenient, or strict Q waves with long-term outcome. ⋯ This large contemporary analysis suggests that less-stringent Q-wave criteria carry prognostic value in predicting adverse outcome among primary care patients.