■ Transcatheter aortic valve implantation for severe aortic stenosis
A Garg, S Verna
CMAJ 2019, vol 191 (5): E134
1 – Transcatheter aortic valve implantation is first-line therapy for high-risk patients with severe symptomatic aortic stenosis
2 – The procedure should be performed at a dedicated centre of excellence specializing in treatment of valvular heart disease
3 – There are unique postoperative risk associated with transcatheter aortic valve implantation
4- While thromboprophylaxis is recommended after transcatheter replacement, the choice of therapy is controversial
5 – Routine endocarditis prophylaxis is recommended for patients with na implanted transcatheter aortic valve
https://www.cmaj.ca/content/191/5/E134
■ E-cigarettes
M Allosh, J Johnston, B Harvey
CMAJ 2019, vol 191 (41): E1136
- E-cigarette use is increasing in Canada, especially among youth
2 – E-cigarette use is strongly associated with the initiation and ongoing use of cigarette smoking
3 – E-cigarettes are na additional smoking cessation tool
4 – E-cigarettes are unregulated products with potentially dangerous health effects
5 – Clinicians should ask about e-cigarette use
https://www.cmaj.ca/content/191/41/E1136
■ Proprotein convertase subtilisin-kexin type 9 (PCSK9)
D Leong, P E Wu
CMAJ 2019, vol 191 (32): E894
1 – Protein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are a new class of low-density lipoprotein (LDL-c) lowering medications
2 – PCSK9 inhibitors have been shown to improve cardiovascular outcomes
3 – PCSK9 inhibitors are recommended as add-on therapy in patientes at very high risk
4 – PCSK9 inhibitors are well tolerated, but long-term safety data are lacking
https://www.cmaj.ca/content/191/32/E894
■ The cardiovascular benefits of low-dosage acetylsalicylic acid
P Koipillai, N S Nishtala
CMAJ 2019, vol 191 (43): E1194
1 – Acetysalicylic acid (ASA) has established benefit in the secondary prevention of cardiovascular disease
2 – The benefit of ASA in the primary prevention of cardiovascular disease is offset by potential bleeding risks
3 – Patients with diabetes, despite their increased cardiovascular risk, have questionable benefit from ASA used for primary prevention
4 – Perioperative use of ASA in noncardiac surgery is unlikely to reduce the risk of myocardial infarction or venous thromboembolism
5 – Acetysalicylic acid should be used patients with myocardial injury or ischemia after noncardiac surgery
https://www.cmaj.ca/content/191/43/E1194
■ Direct oral anticoagulante and the bleeding patients
B Wood, M Sholberg, A Ackery
CMAJ 2016, vol 188 (3): 215
1 – Direct oral anticoagulante agentes are now routinely used for the prevention of stroke in nonvalvular atrial fibrillation
2 – Risk of bleeding with direct oral anticoagulantes is lower than with vitamin K antagonists, but varies by site
3 – Direct oral anticoagulants are characterized by rapid onset of action and short half-live
4 – Direct oral antiagulants variably affect standard clot-based assays
5 – Idarucizumab has recently been approved by the US Food and Drug Administraton to reverse the activity of dabigatran
https://www.cmaj.ca/content/188/3/215
■ Postpartum hypertension
K Powles, S Gandhi
CMAJ 2017, vol 189 (27): E913
1 – Blood pressure should be measured three to six day after delivery
2 – Onset of preeclampsia can be postpartum
3 – Treatment is recommended if high blood pressure is presente persistently (systolic > 140 and/or diastolic > 90 mmHg)
4 – Pospartum hypertension may persist for several weeks
5 – Postpartum hypertension can be treated safely during breastfeeding
https://www.cmaj.ca/content/189/27/E913
■ Screening for fetal congenital heart disease
A Pham, M Melchior
CMAJ 2017, vol 189 (12): E468
1 – Congenital heart disease is the most common caue of infant death and morbidity from birth defects
2 – Referral for fetal echocardiography should bem ade in cases where nuchal tanslucency is above the 99th percentile
3 – Most cases of congenital heart disease occur n low-risk populations
4 – Both maternal and fetal factors may prompt referral for fetal echocardiography
5 – Some lesions can be treated antenatally
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367993/
■ Cardiopulmonary resuscitation
F Khan, C Vaillancourt
CMAJ 2017, vol 189 (1): E25
1 – Chest compressions during cardiopulmonar resuscitation should be fast pushes
2 – Perischock pauses should be limited to improve survival
3 Rescuers may adopt an interrrupted or continuous CPR strategy
4 – Vasopressin offers no advantage over epinephrine in cardiac arrest
5 – A target temperature should be maintained in the postcardiac arrest period
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5224950/
■ Dr Paulo Fernando Leite
Cardiologia/Prevenção Cardiovascular
Estratificação de Risco Cardiovascular
Consultório: Rua Padre Rolim 815/sala 601
Tel: 33245518
CRMMG: 7026
Email: pfleite1873@gmail.com
Data: Fev 2020