In the ACUITY trial of over 3400 patients with ACS who underwent stent implantation, the 30 day rate of stent thrombosis was 1.4% (no different with bare metal or drug-eluting stents). The most significant co-morbid factors associated with early stent thrombosis were insulin requiring diabetes, renal insufficiency, and overall burden of atherosclerosis. Lack of pre-procedural, or inconsistent 30 day use of a thienopyridine (such as clopidogrel) was also, not surprisingly, a strong predictor. Although all patients should be counseled as to the importance of post-stent thienopyridine use, the message has to be loud and clear in those with renal insufficiency, diabetes, and high atherosclerotic burden (abstract).
What comes to mind when you think of getting CME? I bet most of you would say sitting in an auditorium, whether that be during your local grand rounds or at our professional society meeting, like Hospital Medicine 16 in sunny San Diego this past March. Hanging out in the Twitterverse? Probably not so much… […]
As a nurse practitioner in hospital medicine I have multiple opportunities to interact with all sorts of physician hospitalist colleagues, hospital medicine group leaders, quality officers etc. Often their interactions with me take on a certain wary curiosity, like I am some exotic monkey or another creature that is unfamiliar to them. If I am […]
By reading the headlines recently, practitioners would not know if they saved or tanked the healthcare system. One day disaster looms, the next we have moderated growth and business can continue as usual (and by business, I mean doing the correct things correctly). A new study, along with some recent data, helps shed some light […]