Cardiac catheterization 3 to 24 hours after thrombolytic completion in STEMI patients.

Cardiac catheterization less than 3 hours after thrombolytic completion in STEMI patients.

ST-segment Elevation Myocardial Infarction (STEMI)

Cardiac catheterization by forearm approach 3 to 24 hours after thrombolytic completion in STEMI patients

Cardiac catheterization standard strategy

Cardiac catheterization by forearm approach within 3 hours after thrombolytic completion in STEMI patients

Cardiac catheterization fast strategy

Sancta Maggiore Hospital

Fast Radial Pharmaco-invasive Strategy In ST Elevation Myocardial Infarction Trial

Comparison Of The Fast Pharmaco-invasive Strategy With The Standard Pharmaco-invasive Strategy In Patients With ST Elevation Myocardial Infarction Stratified By The Forearm Approach: Randomized Clinical Trial

Mean Hemoglobin change 24 hours after the cardiac catheterization

Patients with Final coronary minimum luminal diameter greater than 30% and / or final coronary flow TIMI 0 or 1 after percutaneous coronary intervention

Composite of death from all cause, and major bleeding (BARC 3 or 5) during hospitalization

Number of participants with hemoglobin change over 3 g/dL

Target vessel quantitative flow ratio (QFR) before the percutaneous coronary intervention. This software measures the coronary flow after the procedure.

Target vessel quantitative flow ratio (QFR) after the percutaneous coronary intervention. This software measures the coronary flow after the procedure.

Patients with ischemic or hemorrhagic stroke during hospitalization: loss of neurological function caused by an ischemic or hemorrhagic event with residual symptoms lasting at least 24 hours after onset or leading to death

Patients with overt bleeding plus hemoglobin drop of 3 to < 5 g/dL (provided hemoglobin drop is related to bleed); transfusion with overt bleeding

Patients with overt bleeding plus hemoglobin drop > 5 g/dL (provided hemoglobin drop is related to bleed); cardiac tamponade; bleeding requiring surgical intervention for control; bleeding requiring IV vasoactive agents

Patients with intracranial hemorrhage confirmed by autopsy, imaging, or lumbar puncture; intraocular bleed compromising vision

Definite fatal bleeding (overt or autopsy or imaging confirmation)

New myocardial infarction during hospitalization: following the National Cardiovascular Data Registry (NCDR) criteria

Recurrent angina during hospitalization: new angina after 6 hours of pci until discharge

Number of participants with new or worsening heart failure during hospitalization: unusual dyspnea on light exertion, recurrent dyspnea occurring in the supine position, fluid retention; or the description of rales, jugular venous distension, pulmonary edema on physical exam, or pulmonary edema on chest x-ray

Number of participants with cardiogenic shock during hospitalization: episode of systolic blood pressure <90 mm Hg, and/or cardiac index <2.2 L/min/m2 determined to be secondary to cardiac dysfunction for at least 30 minutes, and/or the requirement for parenteral inotropic or vasopressor agents or mechanical support (e.g., Intra aortic balloon pump (IABP), extracorporeal circulation, ventricular assist devices) to maintain blood pressure and cardiac index above those specified levels.

Number of participants with readmission after 30 days of index event

Number of participants with new revascularization of the target vessel during hospitalization

University of Sao Paulo General Hospital

Comparison of the fast pharmaco-invasive strategy with the standard pharmaco-invasive strategy in patients with ST-elevation myocardial infarction stratified by the forearm approach

After alteplase therapy , 4-6 hour later, activated partial thromboplastin time (APTT) was checked. According to initial SC LMWH use time, fixed dose SC LMWH, enoxaparin, was administered subcutaneous every 12 hours.

After thrombolytic treatment, a bolus of 10 mg of alteplase followed by 90 mg over 2-h infusion, patients either administered a constant heparin infusion (18 U/Kg per hour) adjusted to maintain an activated partial thromboplastin time of 46-70 s.

This Study Will Provide Data Comparing Safety of LMWH Versus UFH in the Treatment of Acute PE Cases Who Require Thrombolytic Treatment.

enoxaparin ,alteplase, unfractionated heparin

Ataturk University Faculty of Medicine Pulmonary Disease Department

Comparison of Low-Molecular-Weight Heparin (LMWH) and Unfractionated Heparin (UFH) in Combination With Thrombolytic Treatment of Acute Massive Pulmonary Thromboembolism

Elif Yilmazel Ucar

Chest physician

Ataturk University

Patients will receive propofol as general anesthetics.

Patients will receive desflurane as general anesthetics.

Patients received propofol or desflurane as general anesthetic for total knee replacement.
Inclusion criteria: Age > 65 years old; BMI > 30 kg/m2; undergoing primary total knee replacement surgery; and ASA classification II-III

Desflurane

Propofol

Total

Sex: Female, Male

Region of Enrollment

The primary end point was the incidence of postoperative delirium as measured by the Confusion Assessment Method (CAM).

Patients received desflurane as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Patients received propofol as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Assessment of Delirium

Patients received desflurane as general anesthetic

Patients received propofol as general anesthetic

- Time to Spontaneous Breathing After Desflurane/Propofol Discontinuation

- Time to Eye Opening After Desflurane/Propofol Discontinuation

Patient received desflurane as a general anesthesia

Patient received propofol as a general anesthesia

- Time to Tracheal Extubation After Desflurane/Propofol Discontinuation

- Time to Following Command After Desflurane/Propofol Discontinuation

Nausea and Vomiting

Recovery Room Time

B-type Natriuretic Peptide

N-terminal proBNP

Patients who had troponin level > 0.2 ng/mL

Troponin I

ProBNP

• The Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised is a test that requires subjects to repeat a series of digits that have been verbally presented to them both forward and, in a later independent test, reverse order. It measures attention and working memory

Patients received desflurane as a general anesthetic

Patients received propofol as a general anesthetic

Recall of Digit Span

• The Digit Symbol Substitution Test (DSST) measures attention, working memory, sustained visual attention and psychomotor speed. Subjects are given a table that pairs digits and symbols, and asked to decipher a code using the table, completing as many as possible in 90 seconds. The DSST has been found to be more sensitive than other tests to changes in high-levels of cognition

Digit Symbol Substitution Test

• Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail A requires the subject to rapidly sequence a straightforward series. The scoring for this test is the time in seconds required for completion of the test

Trail Making Part A

• Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail B is a more difficult cognitive flexibility task requiring the subject to follow a sequential pattern while shifting cognitive sets and reflects executive functioning, although other cognitive abilities, such as psychomotor speed and visual scanning, are necessary for successful completion of the task. The scoring for this test is the time in seconds required for completion of the test

Trail Making Part B

Trail Making Test is an executive measure of sequencing and cognitive flexibility. Trail B is a more difficult cognitive flexibility task requiring the subject to follow a sequential pattern while shifting cognitive sets and reflects executive functioning, although other cognitive abilities, such as psychomotor speed and visual scanning, are necessary for successful completion of the task. The scoring for this test is the time in seconds required for completion of the test

Duration of Surgery

Duration of Anesthesia

Amount of Intraoperative Fentanyl

Patients will receive desflurane as general anesthetic. Desflurane is inhaled agent which will be provided continuously via ETT in concentrations varying from 4-6% according to BIS monitoring.
Desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Desflurane Group

Patients will receive propofol as general anesthetic Propofol is an intravenous agent which will be provided continuously via IV in doses varying from 100 to 200 mcg/kg/min according to BIS monitoring.
Propofol: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Propofol Group

Overall Study

Dr. Pedro Tanaka

Patients will receive desflurane as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Patients will receive propofol as general anesthetic
propofol or desflurane: comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

Obesity

Arthritis

comparison of the incidence in delirium and post-operative cognitive dysfunction from propofol and desflurane in patients under general anesthesia

propofol

Stanford University School of Medicine

Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement

Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement: A Pilot Assessment of Short-term and Long-term Differences in Outcome

consciousness disorders/insult

Fast Radial Pharmaco-invasive Strategy In ST Elevation Myocardial Infarction Trial

Comparison of Low-Molecular-Weight Heparin (LMWH) and Unfractionated Heparin (UFH) in Combination With Thrombolytic Treatment of Acute Massive Pulmonary Thromboembolism

Desflurane or Propofol Anesthesia in Elderly Obese Patients Undergoing Total Knee Replacement

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