Get Pumped: Perioperative Blood Pressure Targets & When to Stent Coronary Artery Disease

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On this week’s episode of The Rounds Table we’re honing in on important advances in cardiovascular disease management. Kieran Quinn and Paxton Bach guide listeners through the ORBITA and INPRESS trials.

It’s one of those deceptively simple sounding questions in cardiology: who should we stent? Although PCI has been around for 40 years, we are still learning more about when to use it and when not to. Paxton guides listeners through the ORBITA trial which examined outcomes after PCI versus placebo in patients with symptomatic coronary artery disease.

Next, Kieran covers the INPRESS trial. Intraoperative hypotension is associated with end organ damage and an increased risk of mortality in high risk patients; there is no consensus regarding optimal blood pressure target thresholds to support perfusion of critical organs during surgery. The INPRESS trial sought to determine if a strategy of targeting individualized systolic blood pressure, tailored to the patient’s usual value, would reduce organ dysfunction compared to usual practice.

Finally, the Good Stuff segment. Have you ever wondered what “natural flavour” is and if it is any healthier than “artificial flavour”? Kieran breaks it down for listeners. Paxton then shares an article on a vaccine against heroin addiction.

If you like what you hear, rate us on iTunes! Chat with us on Twitter @roundstable and tweet at Kieran @kieranlquinn and Paxton @paxback

The Papers

1. ORBITA: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)32714-9/fulltext

2. Triple Therapy: INPRESS: https://jamanetwork.com/journals/jama/article-abstract/2654895?resultClick=1http://www.nejm.org/doi/pdf/10.1056/NEJMoa1708454

Good Stuff

1.”Natural” vs. “Artificial” flavour: https://www.npr.org/sections/thesalt/2017/11/03/560048780/is-natural-flavor-healthier-than-artificial-flavor 

2. Heroin Vaccine: https://www.theguardian.com/science/2017/aug/26/will-heroin-vaccine-cure-west-drug-epidemic-chemical-answer-to-social-problem 

Music Credits

The Rounds Table Theme Music by Brendan Quinn, Creative Director and Composer, Vapor RMW

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Kieran Quinn


Kieran is a clinical scientist at the Sinai Health System.

Paxton Bach


Paxton Bach is a Clinical Assistant Professor in the Department of Medicine at the University of British Columbia, Associate Director for the BCCSU Clinical Addiction Medicine Fellowship Program, and works as an addiction medicine physician and preceptor at St. Paul’s Hospital.