PEARLS
Intralesional abciximab and thrombus aspiration may have long-term benefits in patients with anterior STEMI
undergoing primary PCI.

In patients with STEMI complicated by cardiogenic shock, admission blood glucose is an independent predictor
of increased risk of mortality only among patients without diabetes.

Ticagrelor is likely to be cost-effective compared with clopidogrel in preventing downstream morbidity and
mortality associated with ACS.

Patients in North America receive high-dose aspirin more frequently than patients elsewhere in the world.

A high baseline plasma total cortisol level is associated with increased mortality in patients with cardiogenic
shock after acute MI.

Alcohol and Stroke: J-shaped relationship. Low alcohol intake is associated with a reduced risk of stroke
morbidity and mortality, whereas heavy alcohol intake is associated with an increased risk of total stroke. The
association between alcohol intake and stroke morbidity and mortality is J-shaped.

Consumption of
nuts is inversely associated with fatal and nonfatal ischemic heart disease (IHD) and
diabetes, but not stroke.
Legume consumption is inversely associated with total IHD but not stroke or diabetes.

Patent foramen ovale (PFO) closure in patients with prior cryptogenic stroke, TIA or systemic arterial
embolism results in  Increased risk of incident atrial arrhythmias. PFO closure has not been shown to
significantly reduce the risk of recurrent stroke/TIA (RR 0.73, P=0.10); however, an increased risk of incident
atrial arrhythmias has been detected (RR 3.67, P<0.0001).
Udell JA, et al. Can J Cardiol. 2014 May 9

An inverse relationship exists between 25(OH)D levels and 1-year mortality in patients aged <75 years who
present with an acute stroke (HR 3.12, P=0.054 for 25(OH)D levels <25.7 vs >25.7 nmol/L).
Daubail B, et al. Cerebrovasc Dis. 2014;37(5):364-367.


What is the approximate stroke risk over the 90 days after patients present to the ED with presumed
non-stroke dizziness
?
0.5%. Actually, 0.56%. Among these patients, stroke risk is 0.56% at 90 days; most of the risk occurs in the
first 2 days.
Kerber KA, et al. Ann Neurol. 2014;75(6):899-907.