The Canadian journal of cardiology
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Approximately 2% to 4% of patients undergo urgent or emergency coronary artery bypass grafting (CABG) for complications of percutaneous coronary intervention (PCI) after treatment with glycoprotein (GP) IIb/IIIa inhibitors. The pharmacokinetic and pharmacodynamic properties of GP IIb/IIIa inhibitors play a large role in determining the safety of their use in the setting of urgent or emergency CABG procedures. ⋯ Limited data for tirofiban show that bleeding is not increased when compared with acetylsalicylic acid or heparin. Eptifibatide and tirofiban appear to have favourable safety profiles compared with abciximab in the setting of emergency or urgent CABG after failed PCI.
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Comparative Study Clinical Trial
Detection of myocardial injury after internal cardioversion for atrial fibrillation.
Cardiac troponin levels do not rise to marked levels after external cardioversion of atrial fibrillation. Subsequent test discharges during implantation of cardioverter defibrillators may cause an elevation of cardiac troponin levels, but are still controversial. ⋯ Following uncomplicated IC of atrial fibrillation, cardiac biomarkers do not rise to marked levels, which indicates that significant myocardial injury does not occur by shocks in the usual dosage.
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Case Reports
Tricuspid valve disruption and ventricular septal defect secondary to blunt chest trauma.
An unusual case of blunt thoracic injury is presented, highlighting the importance of echocardiography in the assessment of patients with suspected cardiac trauma.
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Practice Guideline Guideline
Secondary prevention after acute myocardial infarction in four Canadian provinces, 1997-2000.
Publication of population-based analyses of medication use after acute myocardial infarction (AMI) could encourage the use of effective secondary prevention medications. ⋯ Although utilization rates for recommended cardiac medications are increasing over time, there remains room for improvement. Overall utilization rates and temporal trends are generally similar in all four provinces, but there are wide regional variations within provinces.
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Practice Guideline Comparative Study Guideline
The 2004 Canadian recommendations for the management of hypertension: Part II--Therapy.
To provide updated, evidence-based recommendations for the management of hypertension in adults. ⋯ All recommendations were graded according to the strength of the evidence and voted on by the Canadian Hypertension Education Program Evidence-Based Recommendations Task Force. Individuals with irreconcilable competing interests (declared by all members, compiled and circulated before the meeting) relative to any specific recommendation were excluded from voting on that recommendation. Only recommendations achieving at least 70% consensus are reported here. These guidelines will continue to be updated annually.