Patients treated with aspirin after a first myocardial infarction who also receive a proton pump inhibitor have a higher incidence of cardiovascular events.
Evid Based Med. 2011 Nov 22;
Authors: Juurlink DN
PMID: 22108076 [PubMed - as supplied by publisher]
Link to Article at PubMedTiotropium is superior to salmeterol in reducing frequency of exacerbations: but the effect of adding tiotropium to the combination of inhaled corticosteroid and long-acting ?(2)-agonist remains unclear.
Evid Based Med. 2011 Nov 22;
Authors: Hodder R
PMID: 22108077 [PubMed - as supplied by publisher]
Link to Article at PubMedUsefulness of Adiponectin as a Predictor of All Cause Mortality in Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention.
Am J Cardiol. 2011 Nov 18;
Authors: Lindberg S, Pedersen SH, Møgelvang R, Bjerre M, Frystyk J, Flyvbjerg A, Galatius S, Jensen JS
Abstract
Substantial evidence points to a protective role of adiponectin against atherosclerosis and cardiovascular (CV) disease. However, in the setting of an acute myocardial infarction (AMI), the role of adiponectin has not previously been studied. Consequently, the aim of this study was to investigate the prognostic role of adiponectin after AMI in a large population of patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A total of 735 consecutive patients with ST-segment elevation myocardial infarction admitted to a single high-volume invasive heart center and treated with primary percutaneous coronary intervention from September 2006 to December 2008 were included. Blood samples were drawn immediately before the invasive procedure. Plasma adiponectin was measured using a validated immunoassay. End points were all-cause mortality, CV mortality, and admission for new AMI or heart failure. The median follow-up time was 27 months (interquartile range 22 to 33). Patients with high adiponectin (quartile 4) had increased mortality compared to patients with low adiponectin (quartiles 1 to 3) (log-rank p <0.001). After adjustment for conventional risk factors (age, gender, smoking, hypertension, hypercholesterolemia, diabetes, body mass index, C-reactive protein, peak troponin I, creatinine, estimated glomerular filtration rate, previous AMI, multivessel disease, complex lesions, left anterior descending coronary artery lesion, and symptom-to-balloon time) by Cox regression analysis, high adiponectin remained an independent predictor of all-cause mortality (hazard ratio 2.1, 95% confidence interval 1.3 to 3.2, p = 0.001) and CV mortality (hazard ratio 2.6, 95% confidence interval 1.5 to 4.5, p = 0.001). In conclusion, increased plasma adiponectin independently predicts all-cause and CV mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.
PMID: 22105783 [PubMed - as supplied by publisher]
Link to Article at PubMedDaptomycin for Methicillin-Resistant Staphylococcus aureus Bloodstream Infection and Elevated Vancomycin Minimum Inhibitory Concentrations: Has the Time Come?
Clin Infect Dis. 2011 Nov 21;
Authors: Weston A, Boucher HW
PMID: 22109946 [PubMed - as supplied by publisher]
Link to Article at PubMedDaptomycin Versus Vancomycin for Bloodstream Infections Due to Methicillin-Resistant Staphylococcus aureus With a High Vancomycin Minimum Inhibitory Concentration: A Case-Control Study.
Clin Infect Dis. 2011 Nov 21;
Authors: Moore CL, Osaki-Kiyan P, Haque NZ, Perri MB, Donabedian S, Zervos MJ
Abstract
Background.?Reports have found a link between vancomycin treatment failure in methicillin-resistant Staphyloccocus aureus (MRSA) bloodstream infections (BSIs) and higher vancomycin minimum inhibitory concentrations (MICs), despite MICs being below the susceptibility breakpoint of 2 ?g/mL. Consensus guidelines recommend considering use of alternative agents for infections involving a higher vancomycin MIC, despite few data to support this approach.Methods.?This retrospective case-control study evaluated the effectiveness and safety of vancomycin, compared with that of daptomycin, in the treatment of MRSA BSIs with a high vancomycin MIC (ie, >1 ?g/mL).Results.?A total of 118 vancomycin-treated subjects were compared with 59 daptomycin-treated subjects. Clinical failure, defined compositely as mortality, microbiologic failure, and/or recurrence of infection, was numerically lower in daptomycin-treated subjects (31% vs 17%; P = .084) and was mainly driven by a lower incidence of mortality in the daptomycin group (20% vs 9%; P = .046). Factors independently associated with clinical failure included acute renal failure (odds ratio [OR], 3.91 [95% confidence interval {CI}, 1.05-14.56]) and vancomycin treatment group (OR, 3.13 [95%, CI, 1.00-9.76]). Right-sided endocarditis was independently associated with clinical success (OR, 0.07 [95% CI, .01-.83]). A comparison of 60-day mortality between vancomycin- and daptomycin-treated subjects found a higher probability of survival in the daptomycin-treated group (P = .022).Conclusions.?The results demonstrated that daptomycin was associated with a better outcome compared with vancomycin for the treatment of BSIs due to MRSA with higher vancomycin MICs. These findings support the recommendations of recent guidelines, which suggest consideration of the switch to alternative agents when the isolate has a high vancomycin MIC or when patients are not improving during receipt of therapy.
PMID: 22109947 [PubMed - as supplied by publisher]
Link to Article at PubMedThe Challenge of Identifying Resistant-Organism Pneumonia in the Emergency Department: Still Navigating on the Erie Canal?
Clin Infect Dis. 2011 Nov 21;
Authors: Murri R, De Pascale G
PMID: 22109953 [PubMed - as supplied by publisher]
Link to Article at PubMed