NSTEMI part 2. Pharmacotherapy: antiplatelets, anticoagulants, other therapies

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  • Опубликовано: 12 апр 2024
  • 01:10 1-Other therapies
    01:10 β-blocker: acute, long term, low EF, normal EF
    10:14 ACE-I
    13:21 Aldosterone antagonist
    16:01 Entresto and SGLT-2 inhibitors
    20:08 Summary slide
    23:22 2-Antiplatelet therapy
    23:22 Clopidogrel vs prasugrel vs ticagrelor: differences? which one to use? Factors to consider? Should we preload?
    36:58 De-escalation from potent P2Y12 inhibitors DAPT to clopidogrel DAPT at 1 month
    38:18 De-escalate to clopidogrel monotherapy at 1 month? Trials and guidelines
    43:22 What is high ischemic risk? What is high bleeding risk?
    46:50 De-escalate to ticagrelor monotherapy at 1 month? Trials
    49:07 Patients who also require chronic anticoagulation
    51:02 3-Anticoagulant therapy
    52:07 UFH preferred to enoxaparin. Trials, guidelines
    53:21 how to dose enoxaparin during cath and PCI- Disadvantages
    57:54 Dose of UFH in ACS less than PE. Role of fondaparinux (59:35)
    01:52:02 How to manage anticoagulation in ACS pre-cath and during cath in patients who are chronically taking warfarin or NOAC. Radial vs femoral
    01:08:38 4-IV Glycoprotein IIb/III inhibitors (GPI) and IV Cangrelor
    01:10:48 Cangrelor: when to use? It is not a bailout drug and has narrower indications than GPI
    01:13:40 How to switch from cangrelor to oral P2Y12 antagonist

Комментарии • 17

  • @onion8740
    @onion8740 2 месяца назад +11

    I’m an interventional/structural cardiology fellow in the US, set to graduate in 2 months. We have never met, but you’ve nevertheless been one of my greatest teachers over the years. How I would’ve loved to have trained under you Dr Hanna. Keep up your excellent work.

    • @eliashanna8248
      @eliashanna8248  2 месяца назад +2

      That is one of the nicest comments I have read, thank you!! I am very happy to hear that, and hopefully we meet one day.

  • @studentforlife9687
    @studentforlife9687 2 месяца назад +5

    Thank you Dr Hanna for your state of the art lectures, It always makes my day when I get a notification that you posted a new one, you're the best teacher I've ever had and I wish to meet to you one day when I come to the US to thank you face to face.

    • @petarbeslic991
      @petarbeslic991 2 месяца назад +1

      Same in my case!!

    • @eliashanna8248
      @eliashanna8248  2 месяца назад

      Such a kind comment, thank you! I am happy the videos had a positive impact on you. Yes, hopefully we meet one day

  • @dramymagdy
    @dramymagdy Месяц назад

    Thank you Doctor Hanna, very informative and in depth as always.

  • @soi2238
    @soi2238 2 месяца назад +1

    Greatest lecture, Doc. Elias Hanna. Your talent in explanation is at the unreal level, thank you!

  • @Docsammy
    @Docsammy 2 месяца назад

    Your lectures should really be part of curriculum for fellowship program. Thanks for sharing your knowledge

  • @Saleemyousuf1990
    @Saleemyousuf1990 2 месяца назад +1

    Excellent lecture.....no words can explain my gratitude....
    Please elaborate on for how long should we give beta blockers in patient post STEMI with persistently low EF.

    • @eliashanna8248
      @eliashanna8248  2 месяца назад +1

      Thank you! In that case, beta blocker should be kept long term, for as long as tolerated. In fact, even if EF recovers at 1 month, beta blocker should be continued long term based on the available data, especially if the initial EF is

  • @dlawerfarhad798
    @dlawerfarhad798 2 месяца назад

    Thanks alot dear dr. I am very excited to see and watch your very nice talk on cardiology and we get alot of benefit and update, we hope your more success in your life.

  • @user-cf9sm6tx1v
    @user-cf9sm6tx1v 2 месяца назад

    Dr.Hanna thanks alot for very useful lecture, please tell us about PTMC,ASD closure, TAVI...

  • @mirhansyahperdana7113
    @mirhansyahperdana7113 2 месяца назад

    Why is bridging with ufh needed during oral anticoagulation interruption? Thank u for your fantastic lecture dr. Hanna

  • @ctsmith2024
    @ctsmith2024 2 месяца назад

    Hey Dr. Hanna, I’m an IC Fellow in Texas. Your lectures have been a large portion of my knowledge foundation over the last couple years! Question about CMS requirements (usually outdated)… do you typically just explain why you don’t recommend B-Blocker therapy for a particular patient based on this newer data?

    • @eliashanna8248
      @eliashanna8248  2 месяца назад +1

      That is great to hear, thank you! Yes, you could provide an explanation. But keep in mind, as I explained at 09:29, that even if EF normal and the patient is lower risk, I still favor beta-blocker therapy for 30 days after acute MI (starting the 2nd day), as per COMMIT CCS trial and multiple registry data.

    • @lieltalebel4103
      @lieltalebel4103 Час назад

      ​@@eliashanna8248wow what a lecture simple and Cristal clear and Do you have a book you will recommend me to read Dr.?