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Adverse drug effect in heart failure

Hermann Blessberger, Juergen Kammler, Hans Domanovits, Oliver Schlager, Brigitte Wildner, Danyel Azar, Martin Schillinger, Franz Wiesbauer, Clemens Steinwender
BACKGROUND: Randomized controlled trials have yielded conflicting results regarding the ability of beta-blockers to influence perioperative cardiovascular morbidity and mortality. Thus routine prescription of these drugs in unselected patients remains a controversial issue. OBJECTIVES: The objective of this review was to systematically analyse the effects of perioperatively administered beta-blockers for prevention of surgery-related mortality and morbidity in patients undergoing any type of surgery while under general anaesthesia...
March 13, 2018: Cochrane Database of Systematic Reviews
Milton Packer
Three classes of anti-hyperglycaemic medications are distinguished by their urinary sodium excretion-enhancing and blood pressure-lowering actions: long-acting glucagon-like peptide-1 receptor agonists, dipeptidyl peptidase-4 inhibitors and sodium-glucose co-transporter-2 inhibitors. Yet, these drugs exert different effects on macrovascular risk. Glucagon-like peptide-1 receptor agonists reduce atherosclerotic thromboembolic events, but have little effect on heart failure; sodium-glucose co-transporter-2 inhibitors decrease the occurrence of heart failure, but have minimal effect on myocardial infarction and stroke; and dipeptidyl peptidase-4 inhibitors do not ameliorate either atherosclerotic thromboembolic events or heart failure...
March 12, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Milton Packer
Although dipeptidyl peptidase (DPP)-4 inhibitors have been reported to have a neutral effect on thromboembolic vaso-occlusive events in large-scale trials, they act to potentiate several endogenous peptides that can exert deleterious cardiovascular effects. Experimentally, DPP-4 inhibitors may augment the ability of glucagon-like peptide-1 to stimulate cyclic adenosine monophosphate in cardiomyocytes, and potentiation of the effects of stromal cell-derived factor-1 by DPP-4 inhibitors may aggravate cardiac fibrosis...
March 1, 2018: JACC. Heart Failure
Zhi-Gang Zhang, Xin-Min Liu
RATIONALE: Tolvaptan (TLV) is a new vasopressin type 2 receptor antagonist effective in patients with heart failure (HF). Accumulating evidences have revealed that treatment with TLV does not alter the blood pressure significantly. PATIENT CONCERNS: An 84-year-old man was diagnosed with acute exacerbation of chronic HF due to ischemic cardiomyopathy, arrhythmia, mitral and aortic regurgitation. Treatment with TLV increased the urine volume and improved the dyspnea...
January 2018: Medicine (Baltimore)
Young Choi, Sungmin Lim, Kwan Yong Lee, Ha-Wook Park, Jaeho Byeon, Byung-Hee Hwang, Jin Jin Kim, Yong-Seog Oh, Ho-Joong Youn, Wook Sung Jung, Ki-Bae Seung, Kiyuk Chang
BACKGROUND: The effects of renin-angiotensin system (RAS) blockade on the clinical outcome in patients with stable coronary artery disease (SCAD) are conflicting. We evaluated the long-term effects of RAS blockers (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker) on the clinical outcomes in patients with SCAD without heart failure (HF) who underwent percutaneous coronary intervention (PCI) with drug-eluting stent using a large-scale, multicenter, prospective cohort registry...
February 27, 2018: Coronary Artery Disease
Antonis Goulas, Nikolaos Raikos, Diamantis Krokos, Orthodoxia Mastrogianni, Amvrosios Orphanidis, Konstantinos Zisopoulos, Androniki Tsepa
Serotonin-specific reuptake inhibitors (SSRIs) are generally considered safe drugs but fatal adverse effects do sometimes occur, often as a consequence of interactions with other serotonin active drugs. Polypharmacy is usually a problem that the elderly encounter, but it can also have dire consequences for young people, especially when an underlying heart condition is present. Thus, failure to diagnose heart disease and the use of contraindicated medications can be a lethal combination, irrespective of age...
February 27, 2018: Forensic Science, Medicine, and Pathology
Atsushi Tanaka, Sho Komukai, Yoshisato Shibata, Hiroyoshi Yokoi, Yoshihiro Iwasaki, Tomohiro Kawasaki, Kenji Horiuchi, Koichi Nakao, Takafumi Ueno, Hitoshi Nakashima, Masahiro Tamashiro, Yutaka Hikichi, Mitsuhiro Shimomura, Motoko Tago, Shigeru Toyoda, Teruo Inoue, Atsushi Kawaguchi, Koichi Node
Pioglitazone has superior antiatherosclerotic effects compared with other classes of antidiabetic agents, and there is substantial evidence that pioglitazone improves cardiovascular (CV) outcomes. However, there is also a potential risk of worsening heart failure (HF). Therefore, it is clinically important to determine whether pioglitazone is safe in patients with type 2 diabetes mellitus (T2DM) who require treatment for secondary prevention of CV disease, since they have an intrinsically higher risk of HF...
February 27, 2018: Heart and Vessels
Jens M Hohlfeld, Jens Vogel-Claussen, Heike Biller, Dominik Berliner, Korbinian Berschneider, Hanns-Christian Tillmann, Simone Hiltl, Johann Bauersachs, Tobias Welte
BACKGROUND: Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) is associated with reduced biventricular end-diastolic volumes and increased morbidity and mortality. The combination of a long-acting β agonist (LABA) and a muscarinic antagonist (LAMA) is more effective in reducing hyperinflation than LABA-inhaled corticosteroid combination therapy but whether dual bronchodilation improves cardiac function is unknown. METHODS: We did a double-blind, randomised, two-period crossover, placebo-controlled, single-centre study (CLAIM) at the Fraunhofer Institute of Toxicology and Experimental Medicine (Hannover, Germany), a specialty clinic...
February 21, 2018: Lancet Respiratory Medicine
Jerry Dong, Hong Chen
As cancer therapeutics continues to improve and progress, the adverse side effects associated with anticancer treatments have also attracted more attention and have become extensively explored. Consequently, the importance of posttreatment follow-ups is becoming increasingly relevant to the discussion. Contemporary treatment methods, such as tyrosine kinase inhibitors, anthracycline chemotherapy, and immunotherapy regimens are effective in treating different modalities of cancers; however, these reagents act through interference with DNA replication or prevent DNA repair, causing endothelial dysfunction, generating reactive oxygen species, or eliciting non-specific immune responses...
2018: Frontiers in Cardiovascular Medicine
G Sakalauskienė, G Civinskienė, A Antuševas, P Civinskas
Edematous states caused by an excessesive extracellular fluid retention are major components of cardiovascular and renal disorders including chronic kidney disease, nephrotic syndrome, and heart failure. The use of diuretic drugs from various groups including loop duiretics are important means of pharmacological correction of these clinical conditions. Moreover, diuretics used to lower bood pressure as a part of antihypertensive treatment, reduce cardiovascular events. The response of patients to the dose of a diuretic is reflected by a sigmoid dose-response curve which can be affected by changes of sodium content in the body...
January 2018: Kardiologiia
Joana Bicker, Gilberto Alves, Ana Fortuna, Patrício Soares-da-Silva, Amílcar Falcão
Inhibition of the biosynthesis of noradrenaline is a currently explored strategy for the treatment of hypertension, congestive heart failure and pulmonary arterial hypertension. While some dopamine β-hydroxylase (DBH) inhibitors cross the blood-brain barrier (BBB) and cause central as well as peripheral effects (nepicastat), others have limited access to the brain (etamicastat, zamicastat). In this context, peripheral selectivity is clinically advantageous, in order to prevent alterations of noradrenaline levels in the CNS and the occurrence of adverse central effects...
February 8, 2018: European Journal of Pharmaceutical Sciences
Georgios Karvelas, Aikaterini Roumpi, Christoforos Komporozos, Konstantinos Syrigos
Everolimus (EVE) is now approved by many agencies for the treatment of variable neoplasms. The risk of adverse events with these agent is not adequately defined. The purpose of this review was to summarize the everolimus - induced cardiotoxic effects to patients that received the specific drug as an antineoplastic factor and evaluate any possible anti-atherogenic effects due to systemic use of the drug. PubMed was searched for articles until August 2017. Articles included an expanded-access clinical trial, as well as phase 2 or 3 clinical trials (most of them were randomized)...
February 2, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Elias B Chahine, Jonathan C Cho, Marylee V Worley
OBJECTIVE: To review the pharmacology, pharmacokinetics, pharmacodynamics, clinical efficacy, tolerability, dosing, and administration of bezlotoxumab (BEZ), as well as its place in the prevention of Clostridium difficile infection (CDI) recurrence. DATA SOURCES: A search of PubMed and Google Scholar using the terms "bezlotoxumab," "CDB1," "MDX-1388," and "MK-6072" was performed. The manufacturer's website was also reviewed to further identify relevant information...
February 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Aneesh Karkhanis, Jacqueline Wen Hui Leow, Thilo Hagen, Eric Chun Yong Chan
Dronedarone and amiodarone are structurally similar antiarrhythmic drugs. Dronedarone worsens cardiac adverse effects with unknown causes while amiodarone has no cardiac adversity. Dronedarone induces preclinical mitochondrial toxicity in rat liver and exhibits clinical hepatotoxicity. Here, we further investigated the relative potential of the antiarrhythmic drugs in causing mitochondrial injury in cardiomyocytes. Differentiated rat H9c2 cardiomyocytes were treated with dronedarone, amiodarone and their respective metabolites namely N-desbutyldronedarone (NDBD) and N-desethylamiodarone (NDEA)...
January 27, 2018: Toxicological Sciences: An Official Journal of the Society of Toxicology
Rattanachai Chanchai, Rungsrit Kanjanavanit, Krit Leemasawat, Anong Amarittakomol, Paleerat Topaiboon, Arintaya Phrommintikul
Background: Beta-blockers have been shown to decrease mortality and morbidity in heart failure with reduced ejection fraction (HFrEF) patients. However, the side effects are also dose-related, leading to the underdosing. Cost constraint may be one of the limitations of appropriate beta-blocker use; this can be improved with generic drugs. However, the effects in real life practice have not been investigated. Methods and results: This study aimed to compare the efficacy and safety of generic and brand beta-blockers in HFrEF patients...
2018: Journal of Drug Assessment
Julia Schumann, Eva C Henrich, Hellen Strobl, Roland Prondzinsky, Sophie Weiche, Holger Thiele, Karl Werdan, Stefan Frantz, Susanne Unverzagt
BACKGROUND: Cardiogenic shock (CS) and low cardiac output syndrome (LCOS) as complications of acute myocardial infarction (AMI), heart failure (HF) or cardiac surgery are life-threatening conditions. While there is a broad body of evidence for the treatment of people with acute coronary syndrome under stable haemodynamic conditions, the treatment strategies for people who become haemodynamically unstable or develop CS remain less clear. We have therefore summarised here the evidence on the treatment of people with CS or LCOS with different inotropic agents and vasodilative drugs...
January 29, 2018: Cochrane Database of Systematic Reviews
Muhammad Shariq Usman, Tariq Jamal Siddiqi, Muhammad Mustafa Memon, Muhammad Shahzeb Khan, Wasiq Faraz Rawasia, Muhammad Talha Ayub, Jayakumar Sreenivasan, Yasmeen Golzar
Background The risks and benefits of sodium-glucose co-transporter 2 (SGLT2) inhibitors on cardiovascular outcomes have not been well established. We pooled evidence from all available clinical trials to assess the cardiovascular effects of this drug. Design A systematic review and meta-analysis of randomised controlled trials. Methods We queried electronic databases (MEDLINE, Scopus, CENTRAL and from their inception to July 2017 for published and unpublished placebo controlled trials of SGLT2 inhibitors...
January 1, 2018: European Journal of Preventive Cardiology
Jeffrey W Miller, Lili Ding, Joel B Gunter, Jennifer E Lam, Erica P Lin, Joanna R Paquin, Bi Lian Li, James P Spaeth, Renee N Kreeger, Allison Divanovic, Mohamed Mahmoud, Andreas W Loepke
BACKGROUND: Acquisition of transthoracic echocardiographic (TTEcho) images in children often requires sedation. The optimal sedative for TTEcho has not been determined. Children with congenital heart disease are repeatedly exposed to sedatives and anesthetics that may affect brain development. Dexmedetomidine, which in animals alters brain structure to a lesser degree, may offer advantages in this vulnerable population. METHODS: A prospective, randomized, double-blind trial enrolled 280 children 3-24 months of age undergoing outpatient TTEcho, comparing 2...
January 23, 2018: Anesthesia and Analgesia
Sophie Wells, Ethan J Rowin, Griffin Boll, Hassan Rastegar, Wendy Wang, Martin S Maron, Barry J Maron
BACKGROUND: In the vast majority of patients with obstructive hypertrophic cardiomyopathy and drug-refractory heart failure, surgical myectomy results in reversal of heart failure symptoms. However, a small patient subgroup fails to experience sustained postoperative improvement despite relief of left ventricular outflow obstruction. Clinical profile of such patients has not been well defined. METHODS: Consecutive obstructive hypertrophic cardiomyopathy patients undergoing myectomy at Tufts Medical Center for drug refractory NYHA III/IV heart failure symptoms, 2004 to 2017, were followed postoperatively for 2...
January 15, 2018: American Journal of Medicine
Maria Gustafsson, Maria Sjölander, Bettina Pfister, Jörn Schneede, Hugo Lövheim
Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug-drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists' interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions...
January 16, 2018: Pharmacy (Basel, Switzerland)
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