#cancer patients+ AF🫀on #DOACs often need invasive procedures. #PeriOp DOAC management in PAUSE study ▶️ Joseph R. Shaw et al find active cancer=📈surgical bleeding🩸 Cautious 💊is crucial‼️ #CardioOnc #thrombosis #hemostasis The Ottawa Hospital McMaster University ISTH linkinghub.elsevier.com/retrieve/pii/S…

1/10 ORAL IRON IN IRON DEFICIENCY ANEMIA (IDA) I tweeted a poll asking how you would treat a case of uncomplicated IDA with oral iron. The options and responses are shown below:

Now we’re talking - and this editorial is from an anesthesiologist - not a hospitalist. Couldn’t agree more. Pre-operative withdrawal of renin–angiotensin inhibitors: time to re-visit current guidelines | European Heart Journal | Oxford Academic academic.oup.com/eurheartj/adva…

1/n Hyponatremia in cirrhosis rounds: case 1: ESLD 2/2 ETOH. Admitted at OUH 2/2 abd distension/lethargy w/sNa 133. Kept on spirono + furosem + lactulose. Gradual ⬇️in sNa in 10 days. Transferred 4 ⬆️level of care. Arrives with sNa 125, sCr 0.8. Alert, jaundice, ascites, no edema

Is SGLT2i-DKA mediated by genetic factors? Not sure, but thank you to all of our study sites for recruiting patients. We are approaching 70% recruitment. After that we will do some fancy GWAS!! Text/call/sos/ring my doorbell if you want to learn more! 𝔄fsaneh

Efficacy and Safety of Apixaban according to the CHADS2-VASc score in AHREs - ARTESiA subanalysis by Jeffrey Healey Absolute risk reduction for stroke and systemic embolism only in pts with CHADS2-VASc >4 Manuscript 👉 jacc.org/doi/10.1016/j.… #HRS2024 Heart Rhythm Society

A lot of good advice in this thread- especially re: transfer timing and decisions. I often debrief with trainees when ward resuscitations have been challenging or inefficient- it’s very difficult to care for critically ill patients outside of a critical care environment.

Some good news for preop consults: Major vascular surgery patients assessed by a cardiology or GIM physician prior to surgery have better outcomes than those who are not. pubmed.ncbi.nlm.nih.gov/38709199/

POAF was significantly associated with a higher risk of postop ischemic stroke w/i 1 yr & was mitigated by postop anticoag. A model could assist in identifying high-risk pts before NCS. Role of anticoag in modifying stroke risk assoc with new-onset POAF pubmed.ncbi.nlm.nih.gov/39179854/

It's heeerrree... ACC/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2024 Appropriate Use Criteria for Multimodality Imaging in Cardiovascular Evaluation of Patients Undergoing Nonemergent, Noncardiac Surgery | Journal of the American College of Cardiology jacc.org/doi/10.1016/j.…

Continuation vs Discontinuation of RASIs Before Major Noncardiac Surgery jamanetwork.com/journals/jama/…

1/9 Tweetorial - Part 1 2024 ACC Periop Guidelines: What's New/Different? Algorithm: in general (specifics to follow) -added risk modifiers (see below) -incorporated DASI & biomarkers Please comment, follow me, and repost. #CardioTwitter/#CardioX #HospitalMedicine #spaqi #acp

Fantastic thread highlighting the recent ACC/AHA Perioperative guideline update.

Despite lack of RCTs, use of rhythm control and anticoag for POAF have increased over time. Awaiting results from ASPIRE-AF re:anticoag. Temporal Trends in the Management Practices of Clinically Important Perioperative Atrial Fibrillation After Noncard… pubmed.ncbi.nlm.nih.gov/39582707/

Study incl 2/3 intracranial procedures had 11% covert stroke rate assoc w incr postop delirium & long-term cognitive dysfunction. Rate in non-neurosurg pts only 3% (less than NeuroVISION) pubmed.ncbi.nlm.nih.gov/39723887/

Good summary of current state in periop neurocognitive dysfunction prevention... Best anaesthetic technique for prevention of postoperative cognitive dysfunction in older patients after hip fracture surgery – is the debate over? …-publications.onlinelibrary.wiley.com/doi/full/10.11…

Really important study- getting closer to answering the questions surrounding atrial fibrillation identified during hospitalization.

New Primary Aldosteronism Guidelines - simpler, streamlined, and hopefully more pragmatic. academic.oup.com/jcem/advance-a…

Shorter durations of #antibiotic prophylaxis, including no prophylaxis, appear noninferior to longer durations for preventing mortality in patients with #cirrhosis and upper gastrointestinal bleeding. ja.ma/45k4vvS @bradspellberg Todd C. Lee