Lauren Lacoursiere (@llacours23) profile picture

Lauren Lacoursiere

@llacours23

PGY-2 Cardiology Pharmacy Resident 🫀@NorthwesternMed

 Chicago, IL
Joined December 2021
  • Tweets19
  • Following43
  • Followers27
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Photo by Lauren Lacoursiere (@llacours23)Photo by Lauren Lacoursiere (@llacours23)
Is anyone else worried about cardiogenic shock when initiating a BB after ACS? Our study found low rates after PCI, even in those with anterior MI! Watch for elevated troponin as a potential risk factor for shock development. So proud of @llacours23 for her hard work! @UBPharm
Journal of Cardiovascular Pharmacology (@JCVPOnline) profile pictureJournal of Cardiovascular Pharmacology
@JCVPOnline12 Mar 2023
Early initiation of a beta-blocker in patients with STEMI and PCI with risk factors for cardiogenic shock does not appear to be associated with shock in most patients pubmed.ncbi.nlm.nih.gov/3682… @mayachilbert @llacourse23 @UBPharm #pharmacology #medicine #cardiovascular #troponin
This retrospective cohort study aimed to assess whether presence of defined risk factors was associated with cardiogenic shock after early beta-blocker administration in patients with a STEMI and percutaneous coronary intervention (PCI). The authors conclude that early initiation of a beta-blocker in patients with STEMI and PCI with risk factors for cardiogenic shock does not appear to be associated with shock in most patients.

ALT This retrospective cohort study aimed to assess whether presence of defined risk factors was associated with cardiogenic shock after early beta-blocker administration in patients with a STEMI and percutaneous coronary intervention (PCI). The authors conclude that early initiation of a beta-blocker in patients with STEMI and PCI with risk factors for cardiogenic shock does not appear to be associated with shock in most patients.

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Thank you!! I had so much fun sharing our research and learning about others! 🤓🫀💊
Maya Chilbert (Holsen) (@MayaHolsen) profile pictureMaya Chilbert (Holsen)@MayaHolsen19 Apr 2023
So proud of all of our residents and students showcasing their research! @llacours23 @OliviaaDenny @Chelsea_barvian
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I’M GOING TO BE A PHARMACY RESIDENT 🥺 Beyond ecstatic to have matched with @NorthwesternMed 👩🏻‍⚕️💜 See you soon Chicago! 🌟 #RxMatchDay #MatchDay2023 @UBPharm
Image from Lauren Lacoursiere (@llacours23)
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Early initiation of a beta-blocker in patients with STEMI and PCI with risk factors for cardiogenic shock does not appear to be associated with shock in most patients pubmed.ncbi.nlm.nih.gov/3682… @mayachilbert @llacourse23 @UBPharm #pharmacology #medicine #cardiovascular #troponin
This retrospective cohort study aimed to assess whether presence of defined risk factors was associated with cardiogenic shock after early beta-blocker administration in patients with a STEMI and percutaneous coronary intervention (PCI). The authors conclude that early initiation of a beta-blocker in patients with STEMI and PCI with risk factors for cardiogenic shock does not appear to be associated with shock in most patients.

ALT This retrospective cohort study aimed to assess whether presence of defined risk factors was associated with cardiogenic shock after early beta-blocker administration in patients with a STEMI and percutaneous coronary intervention (PCI). The authors conclude that early initiation of a beta-blocker in patients with STEMI and PCI with risk factors for cardiogenic shock does not appear to be associated with shock in most patients.

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Had so much fun presenting our project on beta-blocker use in STEMI patients with risk factors for cardiogenic shock 💊🫀 HUGE thank you to my mentor @MayaHolsen for the endless guidance and support you have given me over the past year ❤️ #ACCPGC22 #Cardiotwitter #twitteRx
Image from Lauren Lacoursiere (@llacours23)
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#OTILT Coagulase-negative staphylococcus = #1 cause of cardiovascular implantable electronic device infections 🦠 Vancomycin (1st line) or daptomycin/linezolid/telavancin (2nd line options) 💊 Obtain 2️⃣ sets of blood cultures prior to initiating antibiotics‼️🧫 @MayaHolsen
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#OTILT Vericiguat 💊 Patients w HFrEF optimized on GDMT but who have worsening HF (recent hospit/need for outpatient IV diuretics). VICTORIA trial - Primary outcome: composite of death from CV causes/HF hosp. - Incidence among pts using vericiguat was lower @MayaHolsen
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#OTILT Anticoagulation & NSTEMI 🩸 Fondaparinux (a parenteral factor Xa inhibitor) can be used for the duration of hospitalization or until PCI is performed in patients with an NSTEMI. Risk of catheter thrombosis w PCI: must give UFH/bivalirudin w Fondaparinux🚨 @MayaHolsen
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#OTILT ISAR-REACT 5 Trial Ticagrelor vs. prasugrel use in ACS 💊 Primary endpoint: composite of death, MI, or stroke at 1 year Secondary endpoint: bleeding The primary endpoint was significantly lower in those who received prasugrel w/o an ⬆️ in bleeding 🩸 @MayaHolsen
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#OTILT HTN Emergency 🆘 In general: ⬇️ BP by 25% within the first 1-6hrs, then normalize within 24hrs Lower BP ASAP: 1️⃣ Brain bleeds 🧠 2️⃣ Aortic dissection 🫀 Fun fact: Type A aortic dissections have a 5% mortality rate/hr ➡️ GET TO OR 🚨 @MayaHolsen
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#OTILT 🚨 Sumatriptan is contraindicated in patients with h/o CAD, coronary artery vasospasm, CVD, & PVD‼️ MOA: selective 5-HT (1B&1D) receptor agonist ➡️ vasoconstriction of cerebral/coronary vessels 🧠🫀 Use has been associated with MI and cardiac arrest 🛑 @MayaHolsen
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#OTILT Acute VT Tx 🫀 💉Procainamide (1st line, thank you PROCAMIO trial) 💉IV sotalol 💉Amiodarone - Stable w pulse: 150 mg bolus - Pts w no pulse: 300 mg IVP - Both followed by infusions, 1 mg/min x 6hrs 0.5 mg/min x18hrs @MayaHolsen
#OTILT PRORATA Trial 🚨 Using procalcitonin levels to guide antimicrobial therapy can decrease a patient’s exposure to antibiotics 🦠💊 Non-specific like D-dimer: (➖) = No infection (➕) = Infection possible Clinical application remains controversial 🤷🏻‍♀️ @MayaHolsen
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#OTILT Class Ic anti-arrhythmics flecainide and propafenone are anticholinergic and can cause heart block 🫀🚫 The higher a patients HR, the tighter they bind. ✅ Good when used in Afib ➡️ rhythm control ❌ Bad when used in sinus tachycardia ➡️ Heart block @MayaHolsen
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#OTILT Potential candidates for ICD placement include patients with: 🫀An ACS event due to irreversible causes 🫀 HF (low ejection fraction) with other ECG changes 🫀 An MI and EF 35% or less (Life Vest 1st, then reassess after 45 days. ICD if EF still <35%) @MayaHolsen
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#OTILT CABG has better outcomes than stenting with: Triple vessel disease 🫀 High-risk stenting ⚠️ Blockage in the left main artery + DM P2Y12-I use = worse outcomes in CABG 🚨 Hold clopidogrel/ticagrelor 5 days before surgery, and prasugrel 7 days before ‼️ @MayaHolsen
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Lauren Lacoursiere retweeted
ACCP Cardiology PRN (@accpcardprn) profile picture
ACCP Cardiology PRN@accpcardprn17 Mar 2022
#TBT Today's Spotlight: PLATO 🚨 - Patients with ACS +/- ST-elevation ❤️ - Ticagrelor vs. Clopidogrel 💊 - Ticagrelor significantly improved the primary composite outcome (9.8% vs. 11.7%) w/o ⬆️ bleeding @NEJM #CardioTwitter Creator: @llacours23 ⭐ ow.ly/EAWb50Ii8xm
Image from ACCP Cardiology PRN (@accpcardprn)
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#OTILT In HF it is useful to know a pt’s baseline BNP bc it can be helpful in determining whether or not they are experiencing an exacerbation. If they are fluid overloaded their BNP will ⬆️ Remember to get a new baseline BNP when starting Entresto‼️💊 #twitteRx @MayaHolsen
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#OTILT using nitroprusside can result in cyanide toxicity and metabolic acidosis due to impaired oxidative phosphorylation, shifting the production of ATP to anaerobic metabolism. Routine ABG monitoring is necessary with use! ☠️🩸 #twitteRx @MayaHolsen
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