Mksap 16 Cardio Part 2

Front 1

COURAGE trial

Back 1

contemporary PCI combined with aggressive medical therapy was not superior to aggressive medical therapy alone in reducing death or MI

Front 2

BARI-2D trial

Back 2

randomized type 2 DM with class I or II angina to revascularization (PCI or surgery) vs medical therapy; no difference in all-cause mortality or MI at 5 years

Front 3

coronary angiography and PCI should be reserved for

Back 3

symptomatic despite optimal medical therapy, unable to tolerate medications, high-risk findings on noninvasive imaging

Front 4

Indications for surgical revascularization in CAD

Back 4

left main disease and multivessel disease (2-3 vessels) with involvement of proximal LAD and reduced systolic function

Front 5

What is "hybrid" coronary revascularization?

Back 5

combining minimally invasive surgery and PCI; to reduce operative risk

Front 6

s/p PCI, duration of plavix (CSAP)

Back 6

1 year after DES, 1 month after BMS

Front 7

s/p PCI, duration of plavix (ACS)

Back 7

1 year

Front 8

s/p CABG duration of plavix

Back 8

CSAP not indicated, ACS 1 year

Front 9

elective noncardiac surgery in patients with CAD + stent - how long to delay surgery?

Back 9

at least 6 weeks after BMS; at least 1 year after DES

Front 10

use of TIMI risk score

Back 10

to determine aggressive medical therapy vs early invasive approach (>/=3 vs 0-2)

Front 11

how long should surgical revascularization be delayed after stopping clopidogrel?

Back 11

5-7 days

Front 12

advantages of prasugrel over clopidogrel? "PRESUGREL"

Back 12

recently approved oral thienopyridine that does not require hepatic conversion to its active form and is more potent with a faster onset than clopidogrel

Front 13

MOA of glycoprotein IIb/IIIa inhibitors

Back 13

block the final common pathway of platelet aggregation

Front 14

trade name of prasugrel

Back 14

Effient

Front 15

benefit most from glycoprotein IIb/IIIa inhibitors

Back 15

intermediate or high TIMI risk score and patients who undergo an early invasive approach and receive PCI

Front 16

ACUITY and the EARLY ACS trials

Back 16

increased bleeding events and no benefit for routine early glycoprotein IIb/IIIa inhibitors in ED

Front 17

when is LMWH preferred as anticoagulation ?

Back 17

the absence of kidney disease, in planned surgical revascularization, and in those undergoing an early invasive approach

Front 18

When is UFH preferred as anticoagulation

Back 18

for patients being considered for an early invasive approach, those with increased bleeding risk, and in the setting of kidney disease

Front 19

when is bivaluridin an acceptable alternative to UFH?

Back 19

patients undergoing elective PCI

Front 20

The MIRACL and PROVE IT trials found that

Back 20

high-dose statin therapy initiated soon after an ACS reduced cardiovascular events at 18 months and 2 years, respectively.

Front 21

Code STEMI time goals

Back 21

PCI within 90 mins of first medical contact; if not, thrombolytics within 30 mins

Front 22

target plasma glucose in patients hospitalized with ACS

Back 22

<180

Front 23

High-risk features in patients with STEMI (8)

Back 23

cardiogenic shock, new LBBB, anterior wall MI, HF, extensive ST-segment elevation, SBP <100 mm Hg, HR>100/min, and >75 years

Front 24

therapy for high-risk patient presents to a non–PCI-capable facility

Back 24

thrombolytic therapy and immediate transfer (no waiting to determine if reperfusion has occurred)

Front 25

therapy for patients with cardiogenic shock who present to a non–PCI-capable facility

Back 25

thrombolytic therapy, placement of an intra-aortic balloon pump, and immediate transfer to a PCI facility

Front 26

guideline-suggested door-to-balloon time

Back 26

<90 minutes

Front 27

what is "rescue" PCI?

Back 27

PCI performed in the setting of failed thrombolytic therapy

Front 28

What is "facilitated" PCI?

Back 28

strategy of planned, immediate PCI after full- or half-dose thrombolytic therapy +/- glycoprotein IIb/IIIa inhibitor

Front 29

rescue PCI or facilitated PCI of use?

Back 29

rescue PCI has benefit over conservative therapy or repeat thrombolytics; facilitated PCi should be avoided (increased adverse events)

Front 30

vascular complications of PCI (4)

Back 30

hematoma, arterial pseudoaneurysm, arteriovenous fistula, and retroperitoneal bleeding