Heart Asia最新文献

{"title":"Antiplatelet agents for preventing pre-eclampsia and its complications.","authors":"Lelia Duley, Shireen Meher, Kylie E Hunter, Anna Lene Seidler, Lisa M Askie","doi":"10.1002/14651858.CD004659.pub3","DOIUrl":"10.1002/14651858.CD004659.pub3","url":null,"abstract":"<p><strong>Background: </strong>Pre-eclampsia is associated with deficient intravascular production of prostacyclin, a vasodilator, and excessive production of thromboxane, a vasoconstrictor and stimulant of platelet aggregation. These observations led to the hypotheses that antiplatelet agents, low-dose aspirin in particular, might prevent or delay development of pre-eclampsia.</p><p><strong>Objectives: </strong>To assess the effectiveness and safety of antiplatelet agents, such as aspirin and dipyridamole, when given to women at risk of developing pre-eclampsia.</p><p><strong>Search methods: </strong>For this update, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (30 March 2018), and reference lists of retrieved studies. We updated the search in September 2019 and added the results to the awaiting classification section of the review.</p><p><strong>Selection criteria: </strong>All randomised trials comparing antiplatelet agents with either placebo or no antiplatelet agent were included. Studies only published in abstract format were eligible for inclusion if sufficient information was available. We would have included cluster-randomised trials in the analyses along with individually-randomised trials, if any had been identified in our search strategy. Quasi-random studies were excluded. Participants were pregnant women at risk of developing pre-eclampsia. Interventions were administration of an antiplatelet agent (such as low-dose aspirin or dipyridamole), comparisons were either placebo or no antiplatelet.</p><p><strong>Data collection and analysis: </strong>Two review authors assessed trials for inclusion and extracted data independently. For binary outcomes, we calculated risk ratio (RR) and its 95% confidence interval (CI), on an intention-to-treat basis. For this update we incorporated individual participant data (IPD) from trials with this available, alongside aggregate data (AD) from trials where it was not, in order to enable reliable subgroup analyses and inclusion of two key new outcomes. We assessed risk of bias for included studies and created a 'Summary of findings' table using GRADE.</p><p><strong>Main results: </strong>Seventy-seven trials (40,249 women, and their babies) were included, although three trials (relating to 233 women) did not contribute data to the meta-analysis. Nine of the trials contributing data were large (> 1000 women recruited), accounting for 80% of women recruited. Although the trials took place in a wide range of countries, all of the nine large trials involved only women in high-income and/or upper middle-income countries. IPD were available for 36 trials (34,514 women), including all but one of the large trials. Low-dose aspirin alone was the intervention in all the large trials, and most trials overall. Dose in the large trials was 50 mg (1 trial, 1106 women), 60 mg (5 trials, 22,322 women), 75mg (1 tri","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":"10 1","pages":""},"PeriodicalIF":8.8,"publicationDate":"2019-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6820858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90505839","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":"Statin adherence and persistence on secondary prevention of cardiovascular disease in Taiwan.","authors":"Wen-Yi Shau, Chao-Lun Lai, Shih-Ting Huang, Shu-Ting Chen, Jim Z Li, Selwyn Fung, Vicki C Tse, Mei-Shu Lai","doi":"10.1136/heartasia-2018-011176","DOIUrl":"10.1136/heartasia-2018-011176","url":null,"abstract":"<p><strong>Background: </strong>Evidence and treatment guidelines support the use of statins in patients with established atherosclerotic cardiovascular disease (ASCVD) for secondary prevention of subsequent cardiovascular (CV) event. However, treatment adherence and persistence are still a concern.</p><p><strong>Methods: </strong>We constructed a retrospective population-based cohort of patients, who initiated statin treatment within 90 days after discharge from hospital for ASCVD using the claims database of Taiwan National Health Insurance. Proportion of days covered (PDC) was used to measure statin adherence, and PDC ≥80% was defined as good adherence. The study outcomes were subsequent rehospitalisation or in-hospital death due to composite ASCVD, myocardial infarction or ischaemic stroke. Their associations with statin prescription adherence or persistence were analysed using time-dependent Cox proportional hazards model.</p><p><strong>Results: </strong>The study cohort included 185 252 postdischarge statin initiators. There were 50 015 subsequent ASCVD rehospitalisations including 2858 in-hospital death during 7 years of study period. Good adherence was significantly associated with lower risk of ASCVD rehospitalisation (adjusted HR (aHR) 0.90; 95% CI 0.87 to 0.92) and significantly lower risk of in-hospital death (aHR 0.59; 95% CI 0.53 to 0.65). Compared with constant use of statin, patients in the three less persistent states (recent stop, non-persistence and intermittent use) were associated with higher risk of subsequent ASCVD rehospitalisation, aHRs were 1.16, 1.13 and 1.26, respectively (all p<0.05). The increased risks were consistent with specific outcome of acute myocardial infarction and ischaemic stroke. Also, patients in the recent stop period had significantly higher risk for fatal CV event.</p><p><strong>Conclusions: </strong>Good adherence and persistence to statin therapy are significantly associated with lower risk of secondary ASCVD rehospitalisation and in-hospital death.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":"e011176"},"PeriodicalIF":0.0,"publicationDate":"2019-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47817482","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":"Association of school hours with outcomes of out-of-hospital cardiac arrest in schoolchildren","authors":"A. Yamashita, Hisanori Kurosaki, Kohei Takada, Yoshio Tanaka, Yoshitaka Hamada, Tetsuya Ishita, Minoru Kubo, H. Inaba","doi":"10.1136/heartasia-2019-011236","DOIUrl":"https://doi.org/10.1136/heartasia-2019-011236","url":null,"abstract":"Objective To investigate the association of school hours with outcomes of schoolchildren with out-of-hospital cardiac arrest (OHCA). Methods From the 2005–2014 nationwide databases, we extracted the data for 1660 schoolchildren (6–17 years) with bystander-witnessed OHCA. Univariate analyses followed by propensity-matching procedures and stepwise logistic regression analyses were applied. School hours were defined as 08:00 to 18:00. Results The neurologically favourable 1-month survival rate during school hours was better than that during non-school hours only on school days: 18.4% and 10.5%, respectively. During school hours on school days, patients with OHCA more frequently received bystander cardiopulmonary resuscitation (CPR) and public access defibrillation (PAD), and had a shockable initial rhythm and presumed cardiac aetiology. The neurologically favourable 1-month survival rate did not significantly differ between school hours on school days and all other times of day after propensity score matching: 16.4% vs 16.1% (unadjusted OR 1.02; 95% CI 0.69 to 1.51). Stepwise logistic regression analysis during school hours on school days revealed that shockable initial rhythm (adjusted OR 2.44; 95% CI 1.12 to 5.42), PAD (adjusted OR 3.32; 95% CI 1.23 to 9.10), non-exogenous causes (adjusted OR 5.88; 95% CI 1.85 to 20.0) and a shorter emergency medical service (EMS) response time (adjusted OR 1.15; 95% CI 1.02 to 1.32) and witness-to-first CPR interval (adjusted OR 1.08; 95% CI 1.01 to 1.15) were major factors associated with an improved neurologically favourable 1-month survival rate. Conclusions School hours are not an independent factor associated with improved outcomes of OHCA in schoolchildren. The time delays in CPR and EMS arrival were independently associated with poor outcomes during school hours on school days.","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2019-011236","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45555960","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":"Anaesthesia use in catheter ablation for atrial fibrillation: a systematic review and meta-analysis of observational studies","authors":"K. H. C. Li, T. Sang, C. Chan, M. Gong, Yingzhi Liu, A. Jesuthasan, Guangping Li, Tong Liu, M. H. S. Lam, William K. K. Wu, M. Chan, Fang-zhou Liu, Cheng Chen, J. Ho, Yunlong Xia, G. Tse","doi":"10.1136/heartasia-2018-011155","DOIUrl":"https://doi.org/10.1136/heartasia-2018-011155","url":null,"abstract":"Objectives This meta-analysis and systematic review seeks to compare both characteristic parameters and procedural outcomes of atrial fibrillation (AF) catheter ablation in patients under general anaesthesia (GA)/deep sedation and mild/moderate sedation. Background Catheter ablation has become a widely applied intervention for treating symptomatic AF and arrhythmias that are refractory to medical therapy. It can be conducted through from mild sedation to GA. Methods PubMed and Embase were searched up to July 2018 for randomised controlled trials, cohort and observational studies that assessed the outcomes of catheter ablation under GA/deep sedation or mild/moderate sedation. Nine studies were included in this meta-analysis after screening with the inclusion and exclusion criteria. Heterogeneity between studies and publication bias was evaluated by I2 index and Egger’s regression, respectively. Results Our meta-analysis found catheter AF ablation with GA/deep sedation to be associated with reduced risk of recurrence (RR: 0.79, 95% CI 0.56 to 1.13, p=0.20) and complications (RR: 0.95, 95% CI 0.64 to 1.42, p=0.82), though statistically insignificant. In terms of procedural parameters, there was no significant difference between the two groups for both procedural time (SMD: −0.13, 95% CI −0.90 to 0.63, p=0.74) and fluoroscopy time (SMD: −0.41, 95% CI −1.40 to 0.58, p=0.41). Univariate meta-regression did not reveal any covariates as a moderating factor for complication and recurrence risk. Conclusion Apart from an increased likelihood of procedural success, ablation by GA/deep sedation was found to be non-significantly different from the mild/moderate sedation approach in both procedural parameters and outcome measures.","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011155","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45074348","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":"Clinical consequences of poor adherence to lipid-lowering therapy in patients with cardiovascular disease: can we do better?","authors":"H. Klimis, C. Chow","doi":"10.1136/heartasia-2019-011200","DOIUrl":"https://doi.org/10.1136/heartasia-2019-011200","url":null,"abstract":"There is high-quality evidence demonstrating that early initiation of statin use following an acute coronary syndrome (ACS) and persistent use thereafter reduces the risk of major adverse cardiovascular events (MACE) including mortality. However, despite the overwhelming evidence, adherence remains suboptimal and the medications frequently discontinued.1 Here we discuss the data on lipid-lowering therapy among patients with cardiovascular disease and discuss some potential interventions that address the gap.\u0000\u0000Among those with established atherosclerotic cardiovascular disease (ASCVD), poor statin adherence has been reported to be 47.2% in real-world registry data.2 Discontinuation rates have been reported ranging from 14%3 to 26.5%4 at 12 months in both large multicentre randomised clinical trial (RCT) data and national registries, with long-term discontinuation being 51% after 7 years in a large-scale RCT involving 39 countries.3 In a systematic review including 28 studies (5 nested case–control and 22 cohort studies), adherence to statin use in patients at high risk of ASCVD and those with established ASCVD was associated with a reduction in subsequent cardiovascular events (OR 1.22–5.26) and improved survival (OR 1.79–5.00).5 The US National Cardiovascular data Registry’s PINNACLE database (data collected at the point of care at cardiology practices) was used in a large study that showed that in 1 029 633 adults with known ASCVD, 27.9% did not receive any lipid-lowering medication.6 Similarly, other registries demonstrate high proportions of patients not receiving lipid-lowering therapy within the first year following an ACS in Australia7 and New Zealand8—22% and 25% respectively.\u0000\u0000Prescription of statins at the time of discharge after ACS is associated with continued use,7 and a range of data demonstrates significant gaps in use of lipid-lowering drugs among patients with cardiovascular disease. In the CONCORDANCE trial, failure to discharge patients on guideline-recommended therapies was 10 …","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2019-011200","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47538989","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":"Cardioprotective medication adherence among patients with coronary heart disease in China: a systematic review.","authors":"Zhao Ni,&nbsp;Latefa Dardas,&nbsp;Bei Wu,&nbsp;Ryan Shaw","doi":"10.1136/heartasia-2018-011173","DOIUrl":"10.1136/heartasia-2018-011173","url":null,"abstract":"<p><p>In China, poor cardioprotective medication adherence is a key reason for the high mortality rate of coronary heart disease (CHD). The aims of this systematic review are to (1) describe and synthesise factors that influence medication adherence among Chinese people with CHD, (2) evaluate the current status of intervention studies, and (3) discuss directions of future research to improve medication adherence. A comprehensive search using PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Global Health and PsycINFO was undertaken to describe poor adherence in China. Thirty-three eligible articles were included in the study. The review shows that there are multiple contributing factors to poor medication adherence, including patients' sociodemographic characteristics, health status and medication characteristics. In addition, from patients' perspective, lack of medication-related knowledge, such as the name, function, dosage and frequency, contributes to poor adherence. From physicians' perspective, a gap exists between CHD secondary prevention guidelines and clinical practice in China. Follow-up phone calls, educational lectures, booklets and reminder cards were common methods found to be effective in improving medication adherence. This systematic review indicates that cardioprotective medications were commonly prescribed as secondary prevention medication to patients with CHD in China, but adherence to these medications gradually decreased during a follow-up period. Therefore, more research should be conducted on how to establish high-quality health educational programmes aimed at increasing patients' medication adherence.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":"e011173"},"PeriodicalIF":0.0,"publicationDate":"2019-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2018-011173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37411277","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":"The influence of frailty under direct oral anticoagulant use in patients with atrial fibrillation.","authors":"Takashi Yamamoto,&nbsp;Kentaro Yamashita,&nbsp;Kiichi Miyamae,&nbsp;Yuichiro Koyama,&nbsp;Masataka Izumimoto,&nbsp;Yoshihiro Kamimura,&nbsp;Satoko Hayakawa,&nbsp;Kazutaka Mori,&nbsp;Takaaki Yamada,&nbsp;Yasushi Tomita,&nbsp;Toyoaki Murohara","doi":"10.1136/heartasia-2019-011212","DOIUrl":"https://doi.org/10.1136/heartasia-2019-011212","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a prognostic factor in patients with atrial fibrillation (AF). However, there is no report on the associations between frailty and clinical adverse events in patients with AF taking direct oral anticoagulants (DOAC). The factors related to the occurrence of clinical adverse events are still under discussion. Therefore, we examined the associations between frailty and clinical adverse events in patients with AF taking DOAC in daily clinical practice.</p><p><strong>Methods: </strong>We retrospectively evaluated 240 consecutive patients with AF who had been newly prescribed DOAC in our hospital from April 2016 through May 2017. Data collected included Clinical Frailty Scale (CFS) scores, laboratory results and basic demographic information.</p><p><strong>Results: </strong>During the mean follow-up period of 13.4 months, 20 patients died (7.6 per 100 person-years), stroke or systemic embolism occurred in seven patients (2.6 per 100 person-years) and major bleeding occurred in 11 patients (4.2 per 100 person-years). We defined these adverse events as composite end points, and we estimated adjusted HRs and 95% CIs for risk factors using the Cox proportional hazard regression model. Frailty (defined as a CFS score of 5 or more; HR: 3.71; 95% CI: 1.59 to 8.65), female sex (HR: 3.49; 95% CI: 1.73 to 7.07), serum albumin level (HR: 0.47; 95% CI: 0.28 to 0.79) and malignancy (HR: 4.02; 95% CI: 1.83 to 8.84) were independent predictors of the composite end points.</p><p><strong>Conclusions: </strong>Frailty, female sex, hypoalbuminaemia and malignancy were associated with clinical adverse events in patients with AF who were prescribed DOAC.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":"e011212"},"PeriodicalIF":0.0,"publicationDate":"2019-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2019-011212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37411279","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":"Severe adverse events following benzathine penicillin G injection for rheumatic heart disease prophylaxis: cardiac compromise more likely than anaphylaxis.","authors":"Shannon Marantelli,&nbsp;Robert Hand,&nbsp;Jonathan Carapetis,&nbsp;Andrea Beaton,&nbsp;Rosemary Wyber","doi":"10.1136/heartasia-2019-011191","DOIUrl":"https://doi.org/10.1136/heartasia-2019-011191","url":null,"abstract":"<p><strong>Objective: </strong>Secondary prophylaxis through long-term antibiotic administration is essential to prevent the progression of acute rheumatic fever to rheumatic heart disease (RHD). Benzathine penicillin G (BPG) has been shown to be the most efficacious antibiotic for this purpose; however, adverse events associated with BPG administration have been anecdotally reported. This study therefore aimed to collate case reports of adverse events associated with BPG administration for RHD prophylaxis.</p><p><strong>Study design: </strong>A literature review was used to explore reported adverse reactions to BPG and inform development of a case report questionnaire. This questionnaire was circulated through professional networks to solicit retrospective reports of adverse events from treating physicians. Returned surveys were tabulated and thematically analysed. Reactions were assessed using the Brighton Collaboration case definition to identity potential anaphylaxis.</p><p><strong>Results: </strong>We obtained 10 case reports from various locations, with patients ranging in age from early-teens to adults. All patients had clinical or echocardiogram-obtained evidence of valvular disease. The majority of patients (80%) had received BPG prior to the event with no previous adverse reaction. In eight cases, the reaction was fatal; in one case resuscitation was successful and in one case treatment was not required. Only three cases met Level 1 Brighton criteria consistent with anaphylaxis.</p><p><strong>Conclusion: </strong>These results indicate that anaphylaxis is not a major cause of adverse reactions to BPG. An alternative mechanism for sudden death following BPG administration in people with severe RHD is proposed.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":"e011191"},"PeriodicalIF":0.0,"publicationDate":"2019-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2019-011191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37411278","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":"Effects of heat stroke on surface ECG: a study on clinical outcomes.","authors":"Amal Paul,&nbsp;Reginald Alex,&nbsp;John Roshan Jacob,&nbsp;Bijesh Yadav","doi":"10.1136/heartasia-2019-011221","DOIUrl":"https://doi.org/10.1136/heartasia-2019-011221","url":null,"abstract":"<p><strong>Aims: </strong>Classic heat stroke is associated with high in-hospital mortality and morbidity. The relation between the ECG findings in heat stroke and the clinical outcomes of these patients has not been studied. The aim of this study was to describe the electrocardiographic features in patients with classic heat stroke and to determine if there is any correlation of ECG findings with in-hospital outcomes.</p><p><strong>Methods: </strong>We performed a retrospective study on 50 patients with classic heat stroke during summer months of 2016-2018. All 12-lead electrocardiographic recordings obtained from these patients were subjected to in-depth analysis. Statistical analysis was done to determine the correlation of electrocardiographic findings with in-hospital outcomes.</p><p><strong>Results: </strong>37 patients were in sinus rhythm, while supraventricular arrhythmias including atrial fibrillation (n=6), ectopic atrial tachycardia (n=4) and atrial flutter (n=2) were observed in the rest. There was a high prevalence of QTc prolongation, low voltage P waves, conduction defects like incomplete right bundle branch block and repolarisation abnormalities. The ratio of QRS voltage in the limb leads to that in precordial leads was ≤0.5 in nearly three-fourths of the patients. Among the observed electrocardiographic features, low P-wave voltage (<0.01 mV) in lead II was found to have statistically significant correlation with adverse in-hospital outcome (OR 8.93, p=0.04), after adjustment for clinical covariates.</p><p><strong>Conclusion: </strong>There was high incidence of atrial arrhythmias in patients with classic heat stroke. A low P-wave voltage (<0.01 mV) in lead II was predictive of adverse in-hospital outcome in this cohort of patients.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":"e011221"},"PeriodicalIF":0.0,"publicationDate":"2019-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2019-011221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37411280","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 of performing transoesophageal echocardiography in patients with oesophageal varices.","authors":"Dania Hudhud,&nbsp;Haytham Allaham,&nbsp;Mohammad Eniezat,&nbsp;Tariq Enezate","doi":"10.1136/heartasia-2019-011223","DOIUrl":"https://doi.org/10.1136/heartasia-2019-011223","url":null,"abstract":"<p><strong>Introduction: </strong>Oesophageal varices (EV) are one of the complications of liver cirrhosis that carries a risk of rupture and bleeding. The safety of performing transesophageal echocardiography (TEE) in patients with pre-existing EV is not well described in literature. Therefore, this retrospective study has been conducted to evaluate the safety of preforming TEE in this group of patients.</p><p><strong>Methods: </strong>The study population was extracted from the 2016 Nationwide Readmissions Data using International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System for EV, TEE and in-hospital outcomes. Study endpoints included in-hospital all-cause mortality, hospital length of stay, postprocedural gastrointestinal bleeding and oesophageal perforation.</p><p><strong>Results: </strong>A total of 81 328 discharges with a diagnosis of EV were identified, among which 242 had a TEE performed during the index hospitalisation. Mean age was 58.3 years, 36.6% female. In comparison to the no-TEE group, the TEE group was associated with comparable in-hospital all-cause mortality (7.0% vs 6.7%, p=0.86) and bleeding (0.9% vs 1.1%, p=0.75); however, TEE group was associated with longer hospital stay (14.9 days vs 6.9 days, p<0.01). There were no reported oesophageal perforations.</p><p><strong>Conclusions: </strong>TEE is not a common procedure performed in patients with pre-existing EV. TEE seems to be a safe diagnostic tool for evaluation of heart diseases in this group of patients.</p>","PeriodicalId":12858,"journal":{"name":"Heart Asia","volume":" ","pages":"e011223"},"PeriodicalIF":0.0,"publicationDate":"2019-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/heartasia-2019-011223","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37392496","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}