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https://www.readbyqxmd.com/read/29353233/cardiovascular-safety-long-term-noncardiovascular-safety-and-efficacy-of-sodium-glucose-cotransporter-2-inhibitors-in-patients-with-type-2-diabetes-mellitus-a-systemic-review-and-meta-analysis-with-trial-sequential-analysis
#1
REVIEW
Xin-Lin Zhang, Qing-Qing Zhu, Yu-Han Chen, Xue-Ling Li, Fu Chen, Jian-An Huang, Biao Xu
BACKGROUND: The cardiovascular and long-term noncardiovascular safety and efficacy of SGLT2 (sodium-glucose cotransporter 2) inhibitors have not been well documented. METHODS AND RESULTS: For cardiovascular outcomes, we performed a meta-analysis with trial sequential analysis of randomized controlled trials and adjusted observational studies, each with a minimum of 26 weeks and 2000 patient-years of follow-up. For long-term noncardiovascular safety and efficacy outcome analyses, we included only randomized controlled trials with at least 2 years and 1000 patient-years of follow-up...
January 20, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29352071/worsening-renal-function-in-acute-heart-failure-patients-undergoing-aggressive-diuresis-is-not-associated-with-tubular-injury
#2
Tariq Ahmad, Keyanna Jackson, Veena S Rao, W H Wilson Tang, Meredith A Brisco-Bacik, Horng H Chen, G Michael Felker, Adrian F Hernandez, Christopher M O'Connor, Venkata S Sabbisetti, Joseph V Bonventre, F Perry Wilson, Steven G Coca, Jeffrey M Testani
Background -Worsening renal function (WRF) in the setting of aggressive diuresis for acute heart failure (AHF) treatment may reflect renal tubular injury or simply indicate a hemodynamic or functional change in glomerular filtration. Well-validated tubular injury biomarkers-NAG, NGAL, and KIM-1- are now available that can quantify the degree of renal tubularinjury. The ROSE-AHF trial provides an experimental platform for the study of mechanisms of WRF during aggressive diuresis for AHF, as the ROSE-AHF protocol dictated high dose loop diuretic therapy in all patients...
January 19, 2018: Circulation
https://www.readbyqxmd.com/read/29351897/transitions-between-circulatory-states-after-out-of-hospital-cardiac-arrest-protocol-for-an-observational-prospective-cohort-study
#3
Halvor Langeland, Daniel Bergum, Magnus Løberg, Knut Bjørnstad, Jan Kristian Damås, Tom Eirik Mollnes, Nils-Kristian Skjærvold, Pål Klepstad
BACKGROUND: The post cardiac arrest syndrome (PCAS) is responsible for the majority of in-hospital deaths following cardiac arrest (CA). The major elements of PCAS are anoxic brain injury and circulatory failure. OBJECTIVE: This study aimed to investigate the clinical characteristics of circulatory failure and inflammatory responses after out-of-hospital cardiac arrest (OHCA) and to identify patterns of circulatory and inflammatory responses, which may predict circulatory deterioration in PCAS...
January 19, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29351744/risk-factors-for-first-time-acute-myocardial-infarction-patients-in-trinidad
#4
M Bahall, T Seemungal, G Legall
BACKGROUND: The relative importance of coronary artery disease (CAD) risk varies globally. The aim of this study was to determine CAD risk factors for acute myocardial infarction (AMI) among patients in public health care institutions in Trinidad using a case-control type study design. METHODS: The sample comprised 251 AMI patients hospitalized between March 1, 2011 and April 30, 2012 and 464 age- and sex-matched non-AMI patients with no terminal or life-threatening illness and who did not undergo treatment for CAD...
January 19, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29350771/recombinant-relaxin-protects-liver-transplants-from-ischemia-damage-via-hepatocyte-glucocorticoid-receptor-from-bench-to-bedside
#5
Shoichi Kageyama, Kojiro Nakamura, Takehiro Fujii, Bibo Ke, Rebecca A Sosa, Elaine F Reed, Nakul Datta, Ali Zarrinpar, Ronald W Busuttil, Jerzy W Kupiec-Weglinski
Hepatic ischemia-reperfusion injury (IRI) represents a major risk factor of early graft dysfunction and acute/chronic rejection as well as a key obstacle to expanding the donor pool in orthotopic liver transplantation (OLT). Although glucocorticoid receptor (GR) signaling may enhance cytoprotective programs, clinical use of glucocorticoid is limited due to adverse effects, while clinical relevance of GR-facilitated cytoprotection in OLT remains unknown. We aimed to evaluate the significance of hepatic GR in clinical OLT and verify the impact of recombinant human relaxin (rhRLX), which may function as GR agonist in tissue/disease-specific manner...
January 19, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29350382/risk-factors-for-adverse-outcomes-of-acute-coronary-syndrome-patients-single-center-experience-in-long-term-follow-up-of-treated-patients
#6
Marcin Grabowski, Krzysztof J Filipiak, Grzegorz Opolski, Renata Główczyńska, Monika Gawałko, Paweł Balsam, Andrzej Cacko, Zenon Huczek, Grzegorz Karpiński, Robert Kowalik, Franciszek Majstrak, Janusz Kochman
BACKGROUND: For patients experiencing an acute coronary syndrome (ACS), a crucial time to assess their prognosis and future management is at discharge from hospital. AIM: To identify patients' risk factors of mortality during post-discharge period following an ACS hospitalization. METHODS: We studied 672 consecutive ACS patients hospitalized and discharged alive between 2002 and 2004. The analysis was done in respect of the type of ACS, i...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29348018/myocardial-inflammation-predicts-remodeling-and-neuroinflammation-after-myocardial-infarction
#7
James T Thackeray, Henri C Hupe, Yong Wang, Jens P Bankstahl, Georg Berding, Tobias L Ross, Johann Bauersachs, Kai C Wollert, Frank M Bengel
BACKGROUND: The local inflammatory tissue response after acute myocardial infarction (MI) determines subsequent healing. Systemic interaction may induce neuroinflammation as a precursor to neurodegeneration. OBJECTIVES: This study sought to assess the influence of MI on cardiac and brain inflammation using noninvasive positron emission tomography (PET) of the heart-brain axis. METHODS: After coronary artery ligation or sham surgery, mice (n = 49) underwent serial whole-body PET imaging of the mitochondrial translocator protein (TSPO) as a marker of activated macrophages and microglia...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29347907/blood-lactate-is-a-predictor-of-short-term-mortality-in-patients-with-myocardial-infarction-complicated-by-heart-failure-but-without-cardiogenic-shock
#8
Grunde Gjesdal, Oscar Ö Braun, J Gustav Smith, Fredrik Scherstén, Patrik Tydén
BACKGROUND: Mortality in patients with acute myocardial infarction (AMI) has improved substantially with modern therapy including percutaneous coronary interventions (PCI) but remains high in certain subgroups such as patients presenting with overt cardiogenic shock. However, the risk for AMI in patients presenting acutely with signs of heart failure but without cardiogenic shock is less well described. We aimed to identify risk factors for mortality in AMI patients with heart failure without overt cardiogenic shock...
January 18, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29346535/tricuspid-regurgitation-in-acute-heart-failure-is-there-any-incremental-risk
#9
Diab Mutlak, Jonathan Lessick, Shehrban Khalil, Sergey Yalonetsky, Yoram Agmon, Doron Aronson
Aim: Significant tricuspid regurgitation (TR) is common in heart failure (HF) and portends poor prognosis. We sought to determine whether the poor outcome results from the TR itself, or whether the TR is a surrogate marker of advanced left-sided myocardial or valvular heart disease. Methods and results: We studied 639 patients admitted for acute HF. The relationship between TR severity and the endpoint of readmission for HF or mortality was assessed after adjustment for multiple clinical and echocardiographic parameters...
January 15, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29346407/relaxin-reverses-inflammatory-and-immune-signals-in-aged-hearts
#10
Brian Martin, Beth Ann Gabris-Weber, Rajiv Reddy, Guillermo Romero, Ansuman Chattopadhyay, Guy Salama
BACKGROUND: 'Healthy' aging drives structural and functional changes in the heart including maladaptive electrical remodeling, fibrosis and inflammation, which lower the threshold for cardiovascular diseases such as heart failure (HF) and atrial fibrillation (AF). Despite mixed results in recent clinical trials, Relaxin-therapy for 2-days could reduce mortality by 37% at 180-days post-treatment, in patients with acute decompensated HF. Relaxin's short life-span (hours) but long-lasting protective actions led us to test the hypothesis that relaxin acts at a genomic level to reverse maladaptive remodeling in aging and HF...
2018: PloS One
https://www.readbyqxmd.com/read/29345584/mechanical-support-in-cardiogenic-shock-complicating-acute-coronary-syndrome-ready-for-prime-time
#11
Guillaume Schurtz, Marc Laine, Clement Delmas, Francois Kerbaul, Etienne Puymirat, Gilles Lemesle, Laurent Bonello
Cardiogenic shock (CS) is a major challenge in current cardiology. Over the last decade, cardiogenic shock mortality has decreased somewhat, but it still remains high, particularly when associated with ischaemic heart disease. The challenges are numerous and include prevention, accurate diagnosis, prompt management and effective therapies to support a failing heart and prevent multi-organ failure. Despite improvements in the care of acute coronary syndrome (ACS), it remains the most common cause of CS. In addition to existing medical therapy, mechanical circulatory support has been proposed for the management of ventricular failure...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345431/the-effect-of-diuresis-on-extravascular-lung-water-and-pulmonary-function-in-acute-decompensated-heart-failure
#12
Steven C Chase, Caitlin C Fermoyle, Courtney M Wheatley, Jacob J Schaefer, Lyle J Olson, Bruce D Johnson
AIMS: The effect of extravascular lung water (EVLW) and relationship to functional status as a result of acute decompensated heart failure (ADHF) are not well understood. We sought to quantify changes in clinical variables, EVLW, airway anatomy, spirometry, and diffusing capacity for carbon monoxide before and after treatment for ADHF. METHODS AND RESULTS: Fifteen patients were recruited within 24 h of hospital admission. Spirometry, diffusing capacity for carbon monoxide, and surrogates of EVLW by computed tomography were measured and were then repeated within 24 h of discharge...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29345426/single-dose-intravenous-iron-in-southeast-asian-heart-failure-patients-a-pilot-randomized-placebo-controlled-study-practice-asia-hf
#13
Tee Joo Yeo, Poh Shuan Daniel Yeo, Farid Abdul Hadi, Timothy Cushway, Kim Yee Lee, Fang Fang Yin, Anne Ching, Ruili Li, Seet Yoong Loh, Shir Lynn Lim, Raymond Ching-Chiew Wong, Bee Choo Tai, Arthur Mark Richards, Carolyn S P Lam
AIMS: Iron deficiency is highly prevalent in Southeast Asians with heart failure (HF) and associated with worse outcomes. This trial aimed to assess the effect of intravenous iron in Southeast Asians hospitalized with decompensated HF. METHODS AND RESULTS: Fifty patients hospitalized for acute decompensated HF, regardless of ejection fraction, with iron deficiency (defined as serum ferritin <300 ng/mL if transferrin saturation is <20%) were randomized to receive either one dose of intravenous ferric carboxymaltose (FCM) 1000 mg or placebo (0...
January 18, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29344912/capillary-leak-syndrome-as-a-complication-of-antibody-mediated-rejection-treatment-a-case-report
#14
Juan C Ramirez-Sandoval, Ricardo Varela-Jimenez, Luis E Morales-Buenrostro
We report a case of capillary leak that developed during treatment of antibody-mediated rejection in a kidney transplant recipient. A 53-year-old female transplant recipient experienced an increase in serum creatinine from 1.1 to 1.8 mg/dL. Antibody-mediated rejection was diagnosed by graft biopsy. She was treated with five plasmapheresis sessions (on alternate days with albumin replacement), five doses of immunoglobulin (5 g/dose at 100 mg/kg), a single dose of rituximab (500 mg), and four doses of bortezomib on days 1, 4, 7, and 10 (1...
January 17, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29344749/diagnosis-of-sleep-apnea-in-patients-with-stable-chronic-heart-failure-using-a-portable-sleep-test-diagnostic-device
#15
Inês Araújo, Filipa Marques, Sandra André, Manuel Araújo, Sara Marques, Rita Ferreira, Patrícia Moniz, Margarida Proença, Pedro Borrego, Cândida Fonseca
PURPOSE: ApneaLink is a portable device for the screening of sleep apnea, a prevalent and underdiagnosed comorbidity in heart failure patients. A prospective cross-sectional study in patients with chronic heart failure was carried out to assess the sensitivity and specificity of apnea-hypopnea index (AHI) measurements using ApneaLink against the standard polysomnography test. METHODS: Adult patients with a prior hospitalization in an acute heart failure hospital unit were recruited for the study...
January 17, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29344661/plasma-levels-of-microrna-21-126-and-423-5p-alter-during-clinical-improvement-and-are-associated-with-the-prognosis-of-acute-heart-failure
#16
Stéfanie Ingrid Dos Reis Schneider, Daiane Silvello, Nidiane Carla Martinelli, Arthur Garbin, Andréia Biolo, Nadine Clausell, Michael Andrades, Kátia Gonçalves Dos Santos, Luís Eduardo Rohde
MicroRNAs are associated with myocardial damage and heart failure (HF). The present study investigated whether the plasma levels of microRNA (miR)‑21, ‑126 and ‑423‑5p alter according to the (de)compensated state of patients with HF and are associated with all‑cause mortality. In 48 patients with HF admitted to the emergency room for an episode of acute decompensation, blood samples were collected to measure miR and B‑type natriuretic peptide levels within 24 h of hospital admission, at the time of hospital discharge, and a number of weeks post‑discharge (chronic stable compensated state)...
January 15, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29344294/cardiomyocyte-restricted-low-density-lipoprotein-receptor-related-protein-6-lrp6-deletion-leads-to-lethal-dilated-cardiomyopathy-partly-through-drp1-signaling
#17
Zhidan Chen, Yang Li, Ying Wang, Juying Qian, Hong Ma, Xiang Wang, Guoliang Jiang, Ming Liu, Yanpeng An, Leilei Ma, Le Kang, Jianguo Jia, Chunjie Yang, Guoping Zhang, Ying Chen, Wei Gao, Mingqiang Fu, Zheyong Huang, Huiru Tang, Yichun Zhu, Junbo Ge, Hui Gong, Yunzeng Zou
Low density lipoprotein receptor-related protein 6 (LRP6), a wnt co-receptor, regulates multiple functions in various organs. However, the roles of LRP6 in the adult heart are not well understood. Methods: We observed LRP6 expression in heart with end-stage dilated cardiomyopathy (DCM) by western blot. Tamoxifen-inducible cardiac-specific LRP6 knockout mouse was constructed. Hemodynamic and echocardiographic analyses were performed to these mice. Results: Cardiac LRP6 expression was dramatically decreased in patients with end-stage dilated cardiomyopathy (DCM) compared to control group...
2018: Theranostics
https://www.readbyqxmd.com/read/29344027/plasma-volume-and-renal-function-predict-six-month-survival-after-hospitalization-for-acute-decompensated-heart-failure
#18
Kenneth C Bilchick, Nathaniel Chishinga, Alex M Parker, David X Zhuo, Mitchell H Rosner, LaVone A Smith, Hunter Mwansa, Jacob N Blackwell, Peter A McCullough, Sula Mazimba
Background: Plasma volume (PV) is contracted in stable patients with heart failure (HF) due to decongestion strategies. On the other hand, increased PV can adversely affect the trajectory of HF. We therefore examined the effects of increased percentage change in PV (%ΔPV), blood urea nitrogen (BUN), and %ΔPV stratified by BUN and glomerular filtration rate (GFR) on survival after discharge in patients hospitalized for acute decompensated HF (ADHF). Methods: We used the Strauss-Davis-Rosenbaum formula to calculate the %ΔPV between baseline and hospital discharge in a cohort from the Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness trial (ESCAPE)...
December 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29343987/performance-of-the-lace-index-to-predict-30-day-hospital-readmissions-in-patients-with-chronic-obstructive-pulmonary-disease
#19
Maryam A Hakim, Frances L Garden, Matthew D Jennings, Claudia C Dobler
Background and objective: Patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (COPD) have a high 30-day hospital readmission rate, which has a large impact on the health care system and patients' quality of life. The use of a prediction model to quantify a patient's risk of readmission may assist in directing interventions to patients who will benefit most. The objective of this study was to calculate the rate of 30-day readmissions and evaluate the accuracy of the LACE index (length of stay, acuity of admission, co-morbidities, and emergency department visits within the last 6 months) for 30-day readmissions in a general hospital population of COPD patients...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/29341834/improvement-in-overall-survival-with-carfilzomib-lenalidomide-and-dexamethasone-in-patients-with-relapsed-or-refractory-multiple-myeloma
#20
David S Siegel, Meletios A Dimopoulos, Heinz Ludwig, Thierry Facon, Hartmut Goldschmidt, Andrzej Jakubowiak, Jesus San-Miguel, Mihaela Obreja, Julie Blaedel, A Keith Stewart
Purpose In the ASPIRE study of carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide plus dexamethasone (Rd) in patients with relapsed or refractory multiple myeloma, progression-free survival was significantly improved in the carfilzomib group (hazard ratio, 0.69; two-sided P < .001). This prespecified analysis reports final overall survival (OS) data and updated safety results. Patients and Methods Adults with relapsed multiple myeloma (one to three prior lines of therapy) were eligible and randomly assigned at a one-to-one ratio to receive KRd or Rd in 28-day cycles until withdrawal of consent, disease progression, or occurrence of unacceptable toxicity...
January 17, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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