Routine CT coronary angiography after MI is ruled out did not prevent later heart attacks

The edition in brief

TARGET-CTCA randomised 3170 UK emergency department patients with myocardial infarction ruled out but troponin above 5 ng/L to outpatient CT coronary angiography-guided care or standard care. After a median of 3 years, myocardial infarction or cardiac death occurred in 7.1% and 7.3% (HR 0.95). TRANSPORT, in cancer patients with septic shock and haemoglobin below 9 g/dL, was stopped early: a liberal threshold of 9 g/dL did not improve lactate clearance over 7 g/dL, and thrombotic events were 13% against 1%. EVER found a structured six-step early mobilisation programme in 169 ventilated Korean patients did not improve function at ICU discharge or at 12 months. Adding a multiplex PCR pneumonia panel in suspected ventilator-associated pneumonia did not significantly increase targeted antibiotic therapy at 24 hours overall (35.1% vs 23.6%). The FDA lists a Class II recall of Baxter's premixed vasopressin for manufacturing-practice deviations. Today's pearl: in septic shock, check haemoglobin against a threshold of 7 g/dL before transfusing, whatever the underlying disease.