Clinical Medicine Insights. Cardiology最新文献

{"title":"'A Missed Therapeutic Opportunity? SGLT-2 Inhibitor Use in General Medicine Patients With Heart Failure: A Retrospective Audit of Admissions to a Tertiary Health Service'.","authors":"Padeepa Perera,&nbsp;Ronan O'Donnabhain,&nbsp;Timothy Fazio,&nbsp;Douglas Johnson,&nbsp;Peter Lange","doi":"10.1177/11795468221133607","DOIUrl":"https://doi.org/10.1177/11795468221133607","url":null,"abstract":"<p><strong>Objective: </strong>Sodium-glucose co-transporter-2 inhibitors (SGLT2-I's) are novel oral hypoglycaemic agents, with proven decreased MACE and re-hospitalisation risk in type 2 diabetic patients with concomitant heart failure. This study aimed to assess the current practice in the use of SGLT2-I's in general medical units at a large metropolitan health service.</p><p><strong>Methods/results: </strong>A retrospective audit was conducted of patients admitted to general medicine over a 12 month period (between April 2018 and 2019). Inclusion criteria included decompensated heart failure of any aetiology and ejection fraction, and type 2 diabetes mellitus with an HbA1c ⩾ 7 within 6 months of the admission period. A total of 150 admissions fulfilled criteria. Baseline demographics and comorbidities identified an older, more comorbid population than reference trials. These included age (75% over 75 years), smoking history (46%), hypertension (83%), chronic kidney disease grade IV or V (26%), previous myocardial infarction (57%), stroke (18%), atrial fibrillation (55%) and known left ventricular ejection fraction < 50% (38%). Co-prescribed medications included ACE-I/ARB (53%), beta-blocker (67%), loop diuretic (87%), thiazide (7%), MRA (31%), insulin (57%), metformin (47%), sulphonylurea (31%), DPP-4 Inhibitor (21%), GLP-1 analogue (6%) and 15% of patients had an HbA1c > 10. There was a significant difference between patients in our study eligible for and prescribed metformin (66/111) compared to SGLT-2 inhibitors (4/25) (<i>P</i> = .013). A total of 26 patients had readmissions within 28 days, of which one had been discharged on an SGLT2-I.</p><p><strong>Conclusion: </strong>The results of this study identified significant under prescribing of SGLT2-I's in eligible type 2 diabetic patients with heart failure admitted under general medicine.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":" ","pages":"11795468221133607"},"PeriodicalIF":3.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/2a/10.1177_11795468221133607.PMC9623351.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40664025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterotaxy Syndrome with Polysplenia, Fused Adrenal Glands, and Diabetes Mellitus.","authors":"Abid M Sadiq,&nbsp;Adnan M Sadiq","doi":"10.1177/11795468221116851","DOIUrl":"https://doi.org/10.1177/11795468221116851","url":null,"abstract":"<p><p>Heterotaxy syndrome is a rare congenital heart disease with a disarrangement of the heart and abdominal organs. We present a young African female with features of heart failure, diffuse irregular cardiac murmurs, and palpable, tender epigastric mass. A chest and abdominal computed tomography (CT) identified heterotaxy syndrome with left isomerism and fused adrenal glands. This case highlights the feature of fused adrenal glands in a patient with polysplenia.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":" ","pages":"11795468221116851"},"PeriodicalIF":3.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f7/ed/10.1177_11795468221116851.PMC9520153.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Hypertension in Ghana: Analysis of an Awareness and Screening Campaign in 2019.","authors":"Elliot Koranteng Tannor,&nbsp;Obed Ofori Nyarko,&nbsp;Yaw Adu-Boakye,&nbsp;Saabea Owusu Konadu,&nbsp;Gilda Opoku,&nbsp;Frank Ankobea-Kokroe,&nbsp;Mercy Opare-Addo,&nbsp;Lambert Tetteh Appiah,&nbsp;Evans Xorse Amuzu,&nbsp;Gilgal Justice Ansah,&nbsp;Kate Appiah-Boateng,&nbsp;Emmanuel Ofori,&nbsp;Daniel Ansong","doi":"10.1177/11795468221120092","DOIUrl":"https://doi.org/10.1177/11795468221120092","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is an important public health menace globally and in sub-Saharan Africa. The prevalence of hypertension is on the rise in low- and lower-middle-income countries (LMIC) such as Ghana. This rise led to the adoption of the May Measurement Month (MMM) initiative, a global blood pressure screening campaign. We aimed to create awareness and present the findings of the 2019 MMM screening campaign in the Ashanti region of Ghana.</p><p><strong>Methods: </strong>Ghana was 1 of 92 countries that participated in this global community-based cross-sectional study in May 2019. Participants (⩾18 years) were recruited by opportunistic sampling. The blood pressures of participants were measured 3 times and the mean of the last 2 was used for the analysis. Summary statistics were used to describe the data. Simple and multiple logistic regression models were used to determine the predictors of hypertension.</p><p><strong>Results: </strong>We screened 3080 participants with a mean age of 39.8 ± 16.8 years. The prevalence of hypertension was 27.3% among participants. Two-thirds of the hypertensives were unaware of their condition and only 49.5% of participants with a history of hypertension on medication were controlled. Predictors of hypertension in a multiple logistic regression were increasing age (OR = 1.05 (CI 1.04-1.06), <i>P</i> < .001) and high body mass index (OR = 1.06 (1.02-1.10), <i>P</i> = .005).</p><p><strong>Conclusion: </strong>The MMM initiative is highly commendable and of huge public health importance in LMICs like Ghana. Population-based health programs such as the MMM initiative is encouraged to shape appropriate public health policies to reduce the prevalence of hypertension.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":" ","pages":"11795468221120092"},"PeriodicalIF":3.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/1b/10.1177_11795468221120092.PMC9434666.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40346274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vasoactive Biomarkers in Patients With Vasovagal Syncope During Head-Up Tilt Test: A Case-Control Study.","authors":"Cláudia Madeira Miranda,&nbsp;Rose Mary Ferreira Lisboa da Silva,&nbsp;Vanessa Peruhybe-Magalhães,&nbsp;Josep Brugada","doi":"10.1177/11795468221116848","DOIUrl":"https://doi.org/10.1177/11795468221116848","url":null,"abstract":"<p><strong>Background: </strong>Vasovagal syncope (VVS) is the most common cause of syncope. Some stages of its pathophysiological mechanisms remain unclear. Vasoactive substances such as nitric oxide metabolites (NOx) and endothelin (ET) may be involved during acute orthostatic stress.</p><p><strong>Objective: </strong>To analyze plasma changes in NOx and ET and heart rate variability (HRV) in the supine positions (T1) and during the head-up tilt test (HUTT) (T2), in patients with VVS (case group) and control group.</p><p><strong>Methods: </strong>Thirty-seven patients (17 in the case group and 20 in the control group), matched for age and sex (mean aged 31.8 years) underwent HUTT with simultaneous HRV recording and venipuncture. Blood samples were collected during phases T1 and T2 and the analysis was performed without knowledge of the HUTT result.</p><p><strong>Results: </strong>In the total sample, there was an increase in NOx values (<i>P</i> = .014), however there was no increase in ET values from phase T1 to phase T2. Patients with VVS tended to increase plasma NOx values (<i>P</i> = .057) and had significantly higher plasma values compared to ET (<i>P</i> = .033) between phases T1 to T2. In the control group, there was no significant change in the values of these vasoactive substances. Regarding HRV, there were a decrease in the component HF (high frequency) and increased of the LF (low frequency)/HF ratio during HUTT.</p><p><strong>Conclusions: </strong>There was an increase in ET during HUTT occurred only in the case group. These patients are more likely to have an imbalance between antagonistic vasoactive biomarkers during orthostatic stress.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":" ","pages":"11795468221116848"},"PeriodicalIF":3.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/ec/10.1177_11795468221116848.PMC9421056.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40334635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety, Feasibility and Economic Analysis of Same Day Discharge Following Elective Percutaneous Coronary Intervention.","authors":"Kais Hyasat,&nbsp;Giuseppe Femia,&nbsp;Karam Alzuhairi,&nbsp;Andrew Ha,&nbsp;Joseph Kamand,&nbsp;Edmund Hasche,&nbsp;Rohan Rajaratnam,&nbsp;Sidney Lo,&nbsp;Hamid Almafragy,&nbsp;Kevin Liou,&nbsp;Joseph Chiha,&nbsp;Kaleab Asrress","doi":"10.1177/11795468221116852","DOIUrl":"https://doi.org/10.1177/11795468221116852","url":null,"abstract":"<p><strong>Background: </strong>Advances in percutaneous coronary intervention (PCI) has made the possibility of facilitating same day discharge (SDD) of patients undergoing intervention. We sought to investigate the feasibility, safety and economic impact of such a service.</p><p><strong>Methods: </strong>We retrospectively collected data on all patients undergoing outpatient PCI at our institution over a 12-month period. We included in-hospital and 30-day major adverse cardiac events (MACE), vascular complications, acute kidney injury and any re-hospitalisations. We analysed the cost effectiveness of SDD compared to overnight admission post PCI and staged PCI following diagnostic angiography.</p><p><strong>Results: </strong>A total of 147 patients undergoing PCI with 129 patients deemed suitable for SDD (88%). Mean age was 65.7 years. Most patients had type C lesions (60.3%); including 4 chronic total occlusions (CTOs). At 30-day follow-up there were no MACE events (0%). There were 10 (7.8%) re-hospitalisations of which majority (70%) were non cardiac presentations. We also included cost analysis for an elective PCI with SDD, which equated to $2090 per patient (total of $269 610 for cohort). Elective PCI with an overnight admission was $4440 per patient (total of $572 760 for cohort), an additional $2350 per patient (total $303 150). Total cost of an angiogram followed by a staged PCI with an overnight stay was $4700 per patient (total $606 300).</p><p><strong>Conclusion: </strong>SDD is safe and feasible in the majority of patients that have elective coronary angiography that require PCI. SDD leads to a significant reduction in total cost and hospital stay of patients undergoing elective PCI.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":" ","pages":"11795468221116852"},"PeriodicalIF":3.0,"publicationDate":"2022-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/27/24/10.1177_11795468221116852.PMC9421009.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40334633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes Following Simple or Complex Stenting for Coronary Bifurcation Lesions: A Meta-Analysis.","authors":"Qun Zhang,&nbsp;Hengshan Huan,&nbsp;Yu Han,&nbsp;Han Liu,&nbsp;Shukun Sun,&nbsp;Bailu Wang,&nbsp;Shujian Wei","doi":"10.1177/11795468221116842","DOIUrl":"https://doi.org/10.1177/11795468221116842","url":null,"abstract":"<p><strong>Background: </strong>Stent placement remains a challenge for coronary bifurcation lesions. While both simple and complex stenting strategies are available, it is unclear which one results in better clinical outcomes. This meta-analysis aims to explore the long-term prognosis following treatment with the 2 stenting strategies.</p><p><strong>Method: </strong>Randomized controlled trials found from searches of the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials were included in this meta-analysis. The complex stent placement strategy was identified as the control group, and the simple stent placement strategy was identified as the experimental group. Data were synthesized with a random effects model. The quality of the randomized controlled trials was assessed by Jadad scale scores. The clinical endpoints at 6 months, 1 year, and 5 years were analyzed.</p><p><strong>Results: </strong>A total of 11 randomized controlled trials met the inclusion criteria. A total of 2494 patients were included in this meta-analysis. The odds ratio [OR] of the major adverse cardiac events (MACEs) at 6 months was 0.85 (95% confidence interval [CI] 0.53-1.35; <i>P</i> = .49, <i>I</i> ² = 0%). The OR of the MACEs at 1 year was 0.61 (95% CI 0.36-1.05; <i>P</i> = .08, <i>I</i> ² = 0%). The OR of the MACEs at 5 years was 0.69 (95% CI 0.51-0.92; <i>P</i> = .01, <i>I</i> ² = 0%). Compared with the complex strategy, the simple strategy was associated with a lower incidence of MACEs at 5 years.</p><p><strong>Conclusion: </strong>Compared to the complex stenting strategy, the simple stenting strategy can better reduce the occurrence of long-term MACEs for coronary bifurcation lesions.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":" ","pages":"11795468221116842"},"PeriodicalIF":3.0,"publicationDate":"2022-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3a/55/10.1177_11795468221116842.PMC9379967.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40708643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Does Comorbid Status Implication with the End Status of Corona Virus Disease (Covid-19) Patients","authors":"Fauzie Rahman, Melati Noormaulidya Putri, M. Syarif, I. Aflanie, Endah Labati S, Husnul Fatimah, Zuhrufa Wanna Yolanda","doi":"10.52845/cmi/2022-3-3-2","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-3-2","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"47 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73650414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Cancers with a Novel Combination of Re-PurposedPharmaceuticals and Some Nutriceuticals","authors":"R. Marsh, T. Itinteang","doi":"10.52845/cmi/2022-3-3-1","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-3-1","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"56 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77862301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacroiliitis in patients with low backache with Normal Lumbosacral spine MRI","authors":"Dr. Bushra Mohsen Abdulla","doi":"10.52845/cmi/2022-3-2-1","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-1","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"86 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73041324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Charecteristics of Pressure Sore of Spinal Cord Injury Patients Attentded at Crp","authors":"Mahbub Hossain","doi":"10.52845/cmi/2022-3-2-5","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-5","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"35 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78528454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}