Cardiology Flashcards
LQT1
KVLQT1
Phase 3 K channels (Kr)
LQT2
HERG gene
Under active K channel (Ks)
LQT3
SCN5A
Overactive Na channel on depolarisation (NaL)
Drug with best mortality benefit HFrEF
Beta Blockers
Carvedilol (CAPERNICUS for severe HF)
Metoprolol
Bisoprolol
MRA > ACEi > ARB
Benefit of ACE for HF
Mortality 3.8%
Decreased readmission for heart failure
no difference compared to ARB
Digoxin in HF
Reduce HF hospitalisation for those intolerant to B Blockers or persistent symptoms on B Blockers
Emperor Preserve Trial
Empagliflozin vs placebo
21% RR for CV death and HHF
E/e’ consistent with HFpEF
> 13
Impaired longitudinal strain cut off
Abnormal if >-16
Indication for CMRI
LV Hypertrophy
LA volume index consistent with HFpEF
> 34
Clinically significant MS
Valve area <1cm
Mean gradient >10mmhg
PASP >30mmHg
If symptomatic, recommended for perc MV repair or surgery
PCSK9 Inhibitors
Alirocumab
Evolocumab
COURAGE trial
In stable angina (2000)
Optimal medical therapy vs PCI
Nil reduction in death or MI
ISCHAEMIA trial
No reduced risk of Mortality or MI in invasive vs conservative strategy
SYNTAX study
Cardiac surgery superior to PC in triple vessel or left main disease
> MACE at 1 year
STITCHES trial
At 10 years, mortality benefit of CABG for ischaemic CM
Should be considered in young patients without angina
Non dihydropyridine CCB
Diltiazem
Verapamil
The immediate success rate of cardio version
90%
Falls with duration of AF
risk of early recurrence
Drugs that increase likelihood of successful cardio version
Sotalol
Ibutilide
Dofetilide
Irreversible P2Y12 platelet receptor
Clopidogrel
Reversibly binds to P2Y-12 receptor
Ticagrelor
Poor METS
Good METS
<4
>10
MACE
total death MI stroke hospitalization because of HF revascularization (PCI, ACBG)