Dual antiplatelet therapy – best current clinical practice
Dual antiplatelet therapy (DAPT) refers to the combination of aspirin (ASA) and an oral inhibitor of the platelet P2Y12 receptor for adenosine 5’-diphosphate (ADP), and is primarily indicated after myocardial infarction or coronary intervention for acute coronary syndromes (ACS) and chronic coronary syndromes (CCS). DAPT is one of the most extensively researched treatments in modern medicine, with data from over 35 randomised trials (and the associated meta-analyses) being synthesised into latest practice guidelines.
A common sense approach to the preoperative cardiac assessment of patients undergoing non-cardiac surgery
Cardiac complications after non-cardiac surgery depend on patient-related risk factors, on the type of surgery, and on the circumstances under which it takes place. Surgical factors that influence cardiac risk are related to the urgency, invasiveness, type, and duration of the procedure, as well as blood loss and fluid shifts. The types of surgery to be performed can be categorised into low, intermediate and high risk categories Minimising perioperative major adverse cardiac events (MACE) remains a challenge. Quantifying the risk of an individual patient can be tricky, but a few fundamental principles can help in assessing which patients are at higher risk of MACE.
Renal denervation - a practical approach based on the latest clinical evidence
The purpose of this review is to inform the reader of the scientific progress made over the past seventy years in the treatment of hypertension. Although lifestyle changes and oral antihypertensive therapy remains the backbone of treatment, catheter based renal denervation (RD) has emerged as a valuable additional treatment for patients with uncontrolled hypertension. Although RD lowers blood pressure, it also appears to have other beneficial effects.
Highlights of the 2021 ESC Congress Hot Line sessions
The annual European Society of Cardiology (ESC) congress took place virtually between 27 and 30 August 2021. It is the largest medical conference in Europe and the best attended cardiology congress worldwide. Each year the results of ground breaking trials in cardiovascular medicine are presented at dedicated Hot Line sessions. Highlights from recent years include the PARADIGM-HF trial, the DAPAHF trial and the EMPEROR-Reduced trial. No fewer than eighteen trials were presented this year. It would be beyond the scope of this article to explore all of these trials and the following were selected based on their likelihood to change my current clinical practice.
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