Heart and Circulatory System最新文献

{"title":"Venous Thromboembolic Disease Among the Lebanese Population: A Retrospective Observational Study","authors":"S. Tatari, H. Kordi, A. Allouch, A. El-Sayed, N. Chamoun, E. Ramia, S. Kabbani","doi":"10.31487/j.hcs.2020.01.04","DOIUrl":"https://doi.org/10.31487/j.hcs.2020.01.04","url":null,"abstract":"Aims: To assess the characteristics and risk factors for patients presenting with venous thromboembolic\u0000disease (VTE) in Lebanon.\u0000Methods: This was a retrospective, multicenter study that was conducted between the years of 2018-2019\u0000in Lebanon. All medical charts with positive findings for VTE were included. Data on baseline\u0000characteristics, risk factors, signs and symptoms of disease, diagnostic findings, treatment, readmission and\u0000mortality rates at 1 year were collected.\u0000Results: 1500 charts were reviewed. We included 132 confirmed diagnosis with deep vein thrombosis\u0000(DVT) or pulmonary embolism (PE). Out of 132 patients 43% were diagnosed with DVT, 42% with PE and\u000015% having both DVT and PE. Mean age was 61 years. Current smokers were 36%. Coronary artery disease\u0000was found in 19.5%, diabetes in 11%, atrial fibrillation in 10.5% and malignancy in 30% of the cases.\u0000Readmission rate within 1 year was 35%. In hospital mortality was 13% and one-year mortality was 22%.\u0000Characteristics of patients diagnosed with DVT vs patients diagnosed with PE were comparable. However,\u0000we noted that chronic kidney disease was more prevalent in patients with DVT than in patients with PE\u0000(25% vs 5% respectively; p- 0.002). Obesity was found less in patients with DVT than in patients with PE\u0000(2% vs 12% respectively; p-0.042). Patients with malignancy were diagnosed more with DVTs than with\u0000PE; however, the p-value was not statistically significant (39% vs 24% respectively; p-0.086). Patients with\u0000recent infection in the prior month of diagnosis was noted to be a predisposing factor for PE than for DVT\u0000(21% vs 9% respectively; p-0.04). Mortality within one year was significantly associated with male gender\u0000(p-0.009) and having a diagnosis of DVT+PE (p-0.005).\u0000Conclusion: Our study revealed a high burden of VTE in Lebanon. Malignancy and prior infection were a\u0000predisposing factor for VTE. The readmission rate and the one-year mortality were significantly elevated.\u0000Mortality was significantly associated with the diagnosis of combined DVT and PE at the same time.\u0000","PeriodicalId":145553,"journal":{"name":"Heart and Circulatory System","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130072261","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":"Perioperative Statin Reloading in Cardiac Surgery: A Review","authors":"Chengyuan Zhang","doi":"10.31487/j.hcs.2020.01.01","DOIUrl":"https://doi.org/10.31487/j.hcs.2020.01.01","url":null,"abstract":"Introduction: There is good evidence that perioperative statin therapy is cardioprotective and reduces\u0000postoperative complications after cardiac surgery in statin-naive patients. However, most cardiac surgical\u0000patients will already be established on chronic statin therapy. Clinical and experimental evidence suggests\u0000that additional doses of statin treatment in this setting may be able to provide further benefit.\u0000Methods: MEDLINE using the OVID interface was searched to December 2019 for randomised controlled\u0000trials of statin reloading in cardiac surgery.\u0000Results: 932 papers were identified of which 5 met eligibility criteria. No study demonstrated a significant\u0000difference in clinical endpoints. One study found a 7.3% absolute risk reduction in the odds of postoperative\u0000atrial fibrillation which did not reach significance. Two further studies reported a reduction in\u0000proinflammatory cytokines. One of these also demonstrated decreased markers of cardiac and renal injury.\u0000Discussion: Although statin reloading is cardioprotective in animal models, there is little translational\u0000evidence in humans. Current evidence suggests a protective effect of perioperative statin therapy for atrial\u0000fibrillation. However, this was not replicated by any of the reloading trials. Furthermore, studies were small\u0000trials with significant heterogeneity in both baseline and intervention statin regimens. We conclude that the\u0000current evidence base does not support additional statin therapy in patients on chronic statin treatment\u0000scheduled for cardiac surgery.","PeriodicalId":145553,"journal":{"name":"Heart and Circulatory System","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124066369","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}