Eagle's Eye View: Your Weekly CV Update From ACC.org Identifying Myocardial Infarction after PCI; Myocardial Fibrosis & Severe Aortic Valve Stenosis; Anticoagulation & Cancer Diagnoses
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Mar 5, 2025 Discover the optimal threshold for identifying myocardial infarctions after PCI. Unravel the intriguing prognostic features of myocardial fibrosis in patients with severe aortic valve stenosis. Delve into the complex relationship between anticoagulation, bleeding risks, and cancer diagnoses. This discussion highlights how troponin levels and bleeding events can significantly impact patient outcomes. Tune in for cutting-edge insights into these critical cardiovascular topics!
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Key Troponin Threshold After PCI
- A post-PCI troponin increase exceeding 40% from baseline and above five times the 99th percentile indicates significant myocardial injury.
- This threshold predicts a four-fold increase in all-cause mortality and three-fold in major adverse cardiovascular events.
Myocardial Fibrosis Prognostic in Both Sexes
- Myocardial fibrosis and extracellular volume abnormality predict higher mortality after aortic valve replacement in both sexes.
- Women show less replacement fibrosis and wall thickening than men but prognostic impact remains similar.
Investigate Bleeding for Cancer
- Investigate unexplained bleeding after starting anticoagulation for possible underlying cancer.
- Bleeding sites often correspond to cancer locations, necessitating focused evaluation.