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A Dutch observational registry-based study evaluated the link between PCR-positive influenza and subsequent acute myocardial infarction (MI) risk. It found that the incidence of MI was 6 times higher within one week of influenza diagnosis compared to a control period. The relative incidence was 16.6 in patients without coronary artery disease (CAD) and 1.4 in those with CAD. Antithrombotic use was linked to a lower MI risk (4.1 vs. 13.5). These findings suggest flu vaccination might prevent MI, especially in older adults.

de Boer AR et al. Influenza infection and acute myocardial infarction. NEJM Evid 2024 Jul; 3:EVIDoa2300361. (https://doi.org/10.1056/EVIDoa2300361)

I completed Quiz: ⌛ Timing of Antimicrobial Therapy!

A meta-analysis of randomized trials comparing anticoagulation and antiplatelet therapy for cervical artery dissection found no significant difference in the composite outcome of ischemic stroke, death, or major bleeding at 90 days. Specifically, 3 out of 218 patients in the anticoagulation group and 10 out of 226 in the antiplatelet group experienced primary outcome events. Secondary analysis suggested fewer ischemic strokes but more major bleeding events with anticoagulation. Larger trials are needed to confirm these findings and explore newer treatments.

Atrial fibrillation (AF) is observed to be 15 times more common in patients with cirrhosis compared to the general population. Despite this high incidence, individuals with cirrhosis have been systematically excluded from randomized clinical trials evaluating anticoagulants in AF patients. To address this gap, researchers utilized two extensive U.S. insurance databases comprising nearly 25,000 patients with cirrhosis and new-onset nonvalvular AF. They conducted a propensity score–matched comparison between patients who began treatment with apixaban and those who initiated either rivaroxaban or warfarin.

The findings revealed that patients treated with apixaban had a significantly lower risk of major bleeding compared to those treated with rivaroxaban (5.1% vs. 8.7% annually) or warfarin (5.1% vs. 7.9% annually). There were no observed differences in the rates of ischemic embolic events (such as stroke) or all-cause mortality among the different oral anticoagulant groups.

This retrospective study, which emulates a randomized study design through the use…

Air leak or Air trapping?

RV dilation and TR associated with PE

Oral Sebetralstat for On-Demand Treatment of Hereditary Angioedema Attacks

Population:

• Patients with type 1 or type 2 hereditary angioedema (HAE) aged 12 years or older.

• Total of 136 participants were enrolled, with 110 participants included in the full analysis population.

Intervention:

• Oral administration of sebetralstat at doses of 300 mg or 600 mg.

A central line placed by CRNA!

Can you identify the complication?

Successful placement of a carotid artery central line going through the internal jugular vein!