Heart : official journal of the British Cardiac Society
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Many patients undergo non-invasive testing for the detection of coronary artery disease before non-cardiac surgery. This is despite the low predictive value of positive tests in this population and the lack of any evidence of benefit of coronary revascularisation before non-cardiac surgical procedures. ⋯ Therefore, there is a need for a shift in emphasis from risk stratification by non-invasive testing to risk modification by the application of interventions, which prevent perioperative ischaemia--principally, perioperative beta adrenergic blockade and perhaps treatment with statins. Clinical risk stratification tools reliably identify patients at high risk of perioperative ischaemic events and can guide in the appropriate use of perioperative medical treatment.
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Letter Comparative Study
N-terminal brain natriuretic peptide is predictive of death after cardiac transplantation.
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The high mortality rates associated with out of hospital cardiac arrest, particularly those occurring in the home, stress the need for early treatment in the form of publicly accessible external defibrillators.
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Multicenter Study
Circumstances of out of hospital cardiac arrest in patients with ischaemic heart disease.
To discover the circumstances of out of hospital cardiac death irrespective of resuscitation attempts. ⋯ The burden of out of hospital cardiac arrest is mainly in the home but most victims have premonitory symptoms. Public education to seek help urgently for new or prolonged chest pain seems the most promising method to address the problem.