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Pharmacology

October 11, 2019
This timely review examines the use of single and mutiple agents to decrease saphenous graft failure after CABG. These are difficult and expensive studies to perform, requiring repeat imaging after surgery, a procedure patients are often reluctant to undergo.
June 17, 2018
Controversial and revisited topic of dual-antiplatelet therapy (DAPT) (aspirin and clopidogrel) versus low dose warfarin after On-X mechanical aortic valve replacement.  There were two arms to the study: low and high risk for thromboembolism.  The low-risk arm was terminated secondary to higher thromboembolic events in the DAPT group.  For the high-r
May 3, 2018
The latest on portable venovenous ECMO in a cohort in which half of the subjects died after a resource-intensive treatment. The results of the relevant EOLIA trial are keenly awaited.
March 21, 2018
One of the more contentious issues in Enhanced Recovery After Surgery (ERAS) programs is the role of preoperative carbohydrate loading.  This randomized trial demonstrated less need for insulin for treating serum glucose >180 mg/dl in the carbohydrate-loading group compared to the placebo group (2.4% versus 16.0%; RR 0.15; p<0.001) with no chan
January 17, 2018
The new EACTS Guidelines on perioperative medication in adult cardiac surgery address antithrombotic management, atrial fibrillation, renin–angiotensin–aldosterone system inhibitors, beta-blockers, dyslipidaemia, ulcer prevention and steroids, antibiotic prophylaxis, anaesthesia and postoperative analgesia, and blood glucose management.
July 18, 2017
In this study, the Dabigatran reversal-drug Idarucizumab was tested.  503 patients were enrolled, of whom 202 had to undergo an urgent procedure.  Of the patients requiring an urgent procedure, the median time of initiation of the procedure was 1.6 hours, and at that time periprocedural hemostasis was assessed as normal in 93.4% of the patients.
December 22, 2016
This retrospective study compared Celsior (65% of pts) to all-blood continuous myocardial protection (35%) in 631 patients undergoing elective aortic valve replacement.  Troponin T release was lower in Celsior patients, as was the risk of postoperative death (OR 0.33; 0.15 - 0.76).  Other outcomes were similar between the groups.
August 8, 2016
This is a retrospective study comparing outcomes of conventional 1:4 cardioplegia vs 4:1 Del Nido cardioplegia on adult patients undergoing CABG. 249 consecutive patients underwent coronary artery bypass using blood cardioplegia and 159 using del Nido Cardioplegia.
July 14, 2016
In this matched cohort study the authors evaluate the age-associated risk of bleeding and thrombosis in 3313 patients ≥70 years attending a single thrombosis service and treated with vitamin K antagonist (VKA). Patients were matched 1:1:1 by decade (70-79, 80-89, 90-99 years) and duration of treatment.

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