Use of Direct Thrombin Inhibitors for Treating Non-ST-Segment Elevation Acute Coronary Syndromes In Special Patient Groups: Women, Diabetics, the Elderly, and Chronic Renal Insufficiency

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Use of Direct Thrombin Inhibitors for Treating Non-ST-Segment Elevation Acute Coronary Syndromes In Special Patient Groups: Women, Diabetics, the Elderly, and Chronic Renal Insufficiency

This complimentary newsletter provides a targeted review of the results of the ACUITY trial with particular emphasis on the high risk populations - women, elderly, diabetics, and patients with chronic renal insufficiency. In addition, he describes the findings of ACUITY in relation to therapy "switch", when patients were initially treated with heparins prior to randomization. Emergency physicians are increasingly becoming exposed to a greater variety of therapies for patients with acute coronary syndrome. It is our hope to provide you, the practicing clinician, with the educational tools to continue to give outstanding care to your patients.

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CRUSADE: Contemporary Evaluation and Management Of 200,000 High-Risk NSTE-ACS Patients

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CRUSADE: Contemporary Evaluation and Management Of 200,000 High-Risk NSTE-ACS Patients

After six years and the enrollment of over 200,000 patients, the CRUSADE national quality improvement and educational initiative ended on January 31, 2007. This date brought to a close an invaluable and unprecedented compilation of data on the management of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), as well as important data on a smaller but very contemporary cohort of patients with acute ST-segment elevation myocardial infarction (STEMI).

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Diagnosis and Risk Stratification of Acute Heart Failure Syndromes

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Diagnosis and Risk Stratification of Acute Heart Failure Syndromes

The evaluation and management of emergency department patients with potential acute heart failure syndrome have remained a significant challenge for decades. Dramatically, unlike advances for the assessment and treatment of patients with acute coronary syndrome, the emergency physician’s diagnostic tools for heart failure have remained limited. The complexity and morbidity of this syndrome alone has led to risk aversion and extremely high admission rates. These difficulties, as well as the increasing prevalence and incidence of heart failure due to improved treatment of ACS and our aging population, has placed an enormous burden on healthcare resources worldwide.

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Direct Thrombin Inhibitors in Non-ST-Segment Elevation Acute Coronary Syndromes

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Direct Thrombin Inhibitors in Non-ST-Segment Elevation Acute Coronary Syndromes

For patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) presenting to the emergency department, appropriate anti-thrombotic and anti-platelet therapy is critical to optimize outcome. Unfractionated heparin is often given as an anti-thrombin in this setting, however, if suffers from a number of pharmacologic limitations including non-specific binding, the requirement for frequent monitoring of its anti-coagulant effect, and the formation of antibodies to the heparin/platelet factor 4/platelet complex which can cause heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia thrombosis syndrome (HITTS). Low molecular weight heparins, also an indirect thrombin inhibitor, can be used without monitoring their anti-thrombin effects. Ease of use and effectiveness makes them a popular choice in the emergency setting.

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Advancing the Standard of Care - Cardiovascular and Neurovascular Emergencies (2006)

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Advancing the Standard of Care - Cardiovascular and Neurovascular Emergencies (2006)

EMCREG–International is pleased to present this complimentary 84-page CME monograph covering the proceedings of our satellite symposium at the ACEP Scientific Assembly in New Orleans, Louisiana. A number of important topics are covered in this monograph including management of non-ST-segment elevation and ST-segment elevation acute coronary syndrome (ACS), the CRUSADE Quality Improvement Initiative, decreasing time to treatment for ST-segment elevation myocardial infarction, direct thrombin inhibitors in ACS, acute decompensated heart failure care, the use of lactate as a marker for trauma and sepsis, point-of-care testing for cardiac biomarkers, the management of hypertension in acute neurovascular emergencies and advances in acute stroke care.

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