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

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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

Опубликовано:

15 окт 2024

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Комментарии : 17

@onion8740 6 месяцев назад

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 6 месяцев назад

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 6 месяцев назад

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 6 месяцев назад

Same in my case!!

@eliashanna8248 6 месяцев назад

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

@soi2238 6 месяцев назад

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

@eliashanna8248 6 месяцев назад

Thank you for your kind words!

@Docsammy 6 месяцев назад

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

@Saleemyousuf1990 6 месяцев назад

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 5 месяцев назад

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

@dramymagdy 4 месяца назад

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

@dlawerfarhad798 6 месяцев 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.

@ctsmith2024 5 месяцев 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 5 месяцев назад

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.