2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention Levine, Glenn N., MD, FACC, FAHA; Bates, Eric R., MD, FACC, FAHA; Blankenship, James C., MD, FACC, FSCAI ...
Journal of the American College of Cardiology,
12/2011, Volume:
58, Issue:
24
Journal Article
Redox‐unstable cuprous hydridotriphenylborate was isolated as an N‐heterocyclic carbene adduct (IPr)Cu(HBPh3) (IPr=1,3‐bis(2,6‐diisopropylphenyl)imidazol‐2‐ylidene) with good thermal stability. ...Although this compound displays a contact ion‐pair structure, CuIH‐like catalytic activity was envisaged in carbonyl hydrosilylation. Sufficient moisture stability allowed the catalysis in aqueous/organic media. Mechanistic study further showed that a phenyl group on the borate anion is ed by (IPr)Cu+ to give the cationic organocopper complex (IPr)2Cu2(μ‐Ph)BPh4.
Monomeric Cu(HBPh3) supported by an N‐heterocyclic carbene is thermally stable and catalyzes the carbonyl hydrosilylation in water as a co‐solvent.
During the past decade, direct oral anticoagulants (DOACs) have advanced and simplified the prevention and treatment of venous thromboembolism (VTE). However, there remains a high incidence of ...bleeds, which calls for agents that have a reduced risk of bleeding. Factor XI (FXI) deficiency is associated with lower rates of venous thrombosis and stroke compared to the general population with a lower risk of bleeding. In conjunction with this, phase 2 studies have demonstrated safety and the potential for reduced thrombotic events with FXI inhibitors as compared to currently available medications. The aim of this review is to summarize key data on the clinical pharmacology of FXI, the latest developments in clinical trials of FXI inhibitors, and to describe the efficacy and safety profiles of FXI inhibitors for the prevention of venous and arterial thromboembolism.
Background: In patients with atrial fibrillation (AF), ventricular rate control with medications has been found to be noninferior in preventing clinical events, compared to a strategy converting ...patients to sinus rhythm and maintaining it with medications. Guidelines have accepted rate control as an acceptable therapeutic option. Most of the prior studies excluded patients without significant left ventricular dysfunction, or permanent AF.
Methods: The authors searched the PubMed, CENTRAL, and EMBASE databases for randomized controlled trials from 1966 to 2011. Trials included were direct head‐to‐head comparisons of rate‐ and rhythm‐control strategy using pharmacological means. The primary outcome assessed was risk of all‐cause mortality. We also assessed other pooled clinical endpoints using a random effects model (Mantel‐Haenszel) between rate and rhythm‐control strategies.
Results: Ten studies (total N = 7,867) met inclusion/exclusion criteria. In‐hospital mortality was not different between groups (P = 0.31). The rates of stroke, systemic embolism, worsening heart failure, myocardial infarction, and bleeding were also similar. However, rates of rehospitalization were much lower with a rate‐control strategy (P = 0.007). An exploratory analysis in patients younger than 65 years revealed a rhythm‐control strategy was superior to rate control in the prevention of all‐cause mortality (P = 0.0007).
Conclusions: This systematic review suggests no difference in clinical outcomes with a rate or rhythm‐control strategy with AF. However, rehospitalization rates appear to be lower with pharmacological rate control for all ages, while finding support for rhythm control in younger patients.
(PACE 2013; 36:122–133)
Abstract
Elderly patients over the age of ≥ 75 years are especially susceptible to coronary artery disease (CAD) as age is an important nonmodifiable risk factors for atherosclerosis and a predictor ...of poorer outcomes. In fact, CAD is a major cause of mortality and morbidity in this population. Due to concerns of functional frailty, comorbidities, and patient preference of conservative to no treatment have played a role in reducing the interest in pursuing prospective studies in this high-risk group. In this review, we provide an overview of the epidemiology, pathophysiology, and management of CAD in older adults.
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