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Dronedarone is a new antiarrhythmic drug with structural similarities to amiodarone. During development of the molecule, the steps included removal of the iodine atoms and making the compound more lipophilic; the latter produces a shorter elimination half-life and reduced tissue accumulation.
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In this study of physician use of clinical information technology in relation to 4 common diagnoses in 41 urban hospitals in Texas, inpatient outcomes were better the more extensive the use of computerized order entry, test results, physician charting, and decision support. Increased use of IT was also associated with significantly lower costs for all hospital admissions.
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Whether oral vitamin K reduces the risk of bleeding related to excessive anticoagulation from warfarin remains unclear.
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Since the risk of gastrointestinal bleeding is increased when clopidogrel is added to aspirin therapy in patients with acute coronary syndromes (ACS), many prescribe proton-pump inhibitors (PPIs) to reduce this risk. However, mechanistic studies suggest that PPIs may reduce the effectiveness of clopidogrel.
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Dr. George Dourgas presented the results of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS AMI) analysis of predictors of stent thrombosis in more than 3,600 patients, and showed that higher doses of clopidogrel (600 mg) pharmacologic therapy, lesion characteristics, and the length of stents were predictors of early-stent thrombosis.
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The introduction of drug-eluting stents (DES) was met with enthusiasm from the interventional cardiology community because of the dramatic reduction in rates of in-stent restenosis (ISR). However, it came to be recognized that this clinical benefit, due to reduced proliferation of smooth muscle cells, came at a price.
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Dual anti-platelet therapy with aspirin and clopidogrel reduces cardiac events in patients who have acute coronary syndromes (ACS) and in patients who have percutaneous coronary intervention (PCI). Recently, the phenomenon of "clopidogrel resistance" has received much attention because of the clinical problems of stent thrombosis and recurrent ACS. However, a precise definition of this clinical entity is lacking.
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This report from the implantable cardioverter defibrillator (ICD) portion of the National Cardiovascular Data Registry focuses on the relationships of gender to in-hospital, ICD-associated adverse events.
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