Medical Principles and Practice最新文献

{"title":"Effectiveness of Hormonal Therapy for Post-Menopausal Women with Hormone Receptor-Positive Advanced Breast Cancer: A Systematic Review and Meta-Analysis of Clinical Trials.","authors":"Vitalis C Okwor, Juliet C Okwor, Maryjane K Ukwuoma, Sara B Mitha, Martins C Nweke","doi":"10.1159/000545264","DOIUrl":"10.1159/000545264","url":null,"abstract":"<p><strong>Objective: </strong>Breast cancer (BC) cells exhibit mutations over time, conferring resistance to therapeutic approaches. We attempted to ascertain the efficacy of selected hormonal therapy for advanced BC.</p><p><strong>Methods: </strong>This is a systematic review and meta-analysis of clinical trials. We searched Medline, PubMed, Cochrane Library, Web of Science, and others. Studies that investigated the effectiveness of hormonal therapy for HR positive (HR+) advanced BC were included. The outcomes were progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). A random-effect meta-analysis model was employed. The study protocol was registered with the International Prospective Register of Systematic Reviews: CRD42023431939.</p><p><strong>Results: </strong>Twenty-one studies were included in the meta-analysis with an overall sample size of 8,482. ORR and PFS between aromatase inhibitors (AIs) and other hormonal therapies: selective oestrogen receptor degrader, selective oestrogen modulator (SERM) and androgen inhibitors showed no significant difference (OR = 1.122 [0.917-1.374], p = 0.263; OR = 0.010 [0.000-1.292], p = 0.063), respectively. Subgroup analysis showed a statistically significant difference in ORR in favour of patients who received SERM compared to AI (OR = 1.362 [1.033-1.795], p = 0.028). For OS, no significant difference was observed among anastrozole, letrozole, and exemestane recepients (OR = 1.718 [0.021-139.128], p = 0.809).</p><p><strong>Conclusion: </strong>Given the above findings, clinical decisions could be based on factors such as the line of cancer treatment, adverse events, drug dosing, and individual drug benefits. Although newer combination therapies are being adopted, the agents explored in this review are still widely used in clinical practice for HR+ BC.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-22"},"PeriodicalIF":2.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12092009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter on \"Risks of New-Onset Atrial Fibrillation after Coronary Artery Bypass Grafting\".","authors":"Sameh Alagha, Serkan Mola, Mehmet Çeber, Alp Yıldırım","doi":"10.1159/000545222","DOIUrl":"10.1159/000545222","url":null,"abstract":"","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-2"},"PeriodicalIF":2.9,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12052358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143616272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D Supplementation Mediates a Shift toward Anti-Inflammatory Cytokine Response in Multiple Sclerosis.","authors":"Suhail Al-Shammri, Arpita Chattopadhyay, Raj Raghupathy","doi":"10.1159/000544106","DOIUrl":"10.1159/000544106","url":null,"abstract":"<p><strong>Objective: </strong>In this study, we assessed the impact of vitamin D (Vit-D) supplementation on cytokine profile in newly diagnosed drug-naïve multiple sclerosis (MS) patients.</p><p><strong>Methods: </strong>We recruited 16 patients with incident MS; those were followed up for 12 months. Serum levels of 25-hydroxy-Vit-D were measured at recruitment and follow-up. Peripheral blood mononuclear cells were isolated from blood samples and stimulated with a mitogen in tissue culture to elicit cytokine production. Culture supernatants were tested after 4 days post-culture for levels of pro-inflammatory (TNF-α, interferon [IFN]-gamma, interleukin [IL]-6, IL-12) and anti-inflammatory cytokines (IL-4, IL-5, IL-10).</p><p><strong>Results: </strong>Baseline blood sample analysis revealed that patients had low Vit-D levels (16.8 [12.41-31.4] nmol/L). Thirteen patients expressed a normal intact parathyroid hormone (iPTH) (5.5 [4.2-6.9]) and were given Caltrate D twice a day; 3 patients having elevated iPTH (mean ± SD: 12.8 ± 1.5) were prescribed 50,000 IU Vit-D once weekly and Caltrate D twice daily. IFN-β1α was prescribed after a confirmed diagnosis of relapsing-remitting MS in 13 patients; 3 patients declined immunotherapy. Irrespective of immunotherapy, we observed a gradual and significant decrease in pro-inflammatory cytokine levels and a steady significant decline in ratios of several pro-inflammatory to anti-inflammatory cytokines. The patients with higher pro-inflammatory to anti-inflammatory cytokine ratios were more prone to having relapses.</p><p><strong>Conclusions: </strong>Low Vit-D levels and elevated pro-inflammatory cytokines in drug-naïve MS patients suggest a potential immune-pathogenic role for hypovitaminosis D in MS development. Vit-D supplementation may exert protective effects by modulating the immune-inflammatory response, emphasizing its therapeutic importance in MS management.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-9"},"PeriodicalIF":2.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Trends and Challenges in Global Health Dental Education: Scoping Review.","authors":"Beatriz Helena Wolpe, Isabela Rodacoski, Victor Augusto Danelle, Maria Rosa Machado Prado, William Augusto Gomes de Oliveira Bellani","doi":"10.1159/000544113","DOIUrl":"10.1159/000544113","url":null,"abstract":"<p><p>Oral health is vital to overall well-being but faces significant global challenges, necessitating reform in dental education. Global oral health education empowers professionals to address these issues, promoting global competencies,s and preventive approaches. The objective was to map scientific articles that approach global oral health education, its practical reality, and curricular inclusion in undergraduate dental programs. This study is a scoping review following the Joanna Briggs Institute's approach, with searches in databases such as PubMed and SciELO using the keywords \"global health\" and \"education, dental,\" along with the Boolean operator AND. After excluding studies outside of the scope of the research and duplicate articles, 26 articles were selected for analysis. Among the analyzed articles, the need to further discuss the following topics was observed: trends and challenges in global dental education, oral health inequalities and the need for global approaches, and the integrating global health into the dental curriculum. The reviewed studies highlight the importance of adapting curricula to global needs, emphasizing the integration of oral health into global health policies and the promotion of interprofessional competencies. The review underscores the need to internationalize dental education and prepare future dentists to address oral health inequalities, with global partnerships and interprofessional collaboration being essential for the success of these initiatives. The conclusion shows that global oral health education should include preventive and interdisciplinary approaches, preparing professionals for global challenges. This requires integrating global health competencies into curricula and promoting international collaborations in dental education.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-12"},"PeriodicalIF":2.9,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Distal Radial Artery Access versus Proximal Radial Artery Access for Cardiac Procedures: A Systematic Review and Meta-Analysis.","authors":"Mohammad Ebad Ur Rehman, Hafsa Arshad Azam Raja, Muhammad Osama, Aisha Kakakhail, Muhammad Hassan Waseem, Muhammad Mukhlis, Muhammad Abdullah Ali, Zain Ul Abideen, Muhammad Shoaib, Zahir Ud Din, Ammara Tahir, Muhammad Zohaib Ul Hassan, Usman Mazhar, Syed Tehseen Haider, Sajeel Saeed, Abdulqadir J Nashwan","doi":"10.1159/000543817","DOIUrl":"10.1159/000543817","url":null,"abstract":"<p><strong>Objective: </strong>Cardiac catheterization using the distal radial artery (DRA) access, at the level of the anatomical snuff box post-radial artery bifurcation, may be linked to a lower rate of arterial occlusion and better hemostasis. In this meta-analysis, we compare DRA versus proximal radial artery (PRA) access in cardiac catheterization or angiography.</p><p><strong>Methods: </strong>A detailed literature search was performed on PubMed, Cochrane, Embase, and <ext-link ext-link-type=\"uri\" xlink:href=\"http://Clinicaltrials.gov\" xmlns:xlink=\"http://www.w3.org/1999/xlink\">Clinicaltrials.gov</ext-link> from inception till June 2024. Risk ratios (RRs) and mean differences (MDs) were pooled for categorical and continuous outcomes, respectively. Random effects meta-analysis was undertaken on RevMan.</p><p><strong>Results: </strong>Our meta-analyses include 21 randomized controlled trials with 9,539 patients (DRA 4,761, PRA 4,778). DRA significantly reduced 24-h radial artery occlusion rates (RR 0.30, 95% CI: 0.23 to 0.40, p ≤ 0.00001) and time to hemostasis (minutes) (MD -44.46, 95% CI: -50.64 to -38.92, p < 0.00001), whereas PRA was significantly superior in terms of the puncture success rate (RR 0.96, 95% CI: 0.93 to 0.99, p < 0.01), the crossover rate (RR 2.89, 95% CI: 2.02 to 4.15, p < 0.00001), and puncture attempts (MD 0.69, 95% CI: 0.37 to 1.00, p = 0.00001).</p><p><strong>Conclusion: </strong>DRA was associated with a lower risk of occlusion and lower time to hemostasis, but required a greater number of puncture attempts and had lower success rate. Further research is required to elucidate the most optimal approach.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-10"},"PeriodicalIF":2.9,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Valproate Therapy for Seizures, Migraines, and Bipolar Disorders.","authors":"Laxminarayana Kurady Bairy, Sampath Madhyastha","doi":"10.1159/000543555","DOIUrl":"10.1159/000543555","url":null,"abstract":"<p><p>Valproate, a widely utilized medication for epilepsy, mood disorders, and migraines, has attracted attention for its potential therapeutic benefits extending beyond its traditional uses. This review article compiles recent findings on the expanded utility of valproate outside of epilepsy, mood disorders, and migraines. The review acknowledges conflicting results, discusses opportunities for future research, and underlines both well-established and lesser-known adverse effects, along with possible interventions to mitigate these side effects. In addition to treating generalized and focal epilepsy, valproate has shown efficacy in managing status epilepticus, migraines, and manic episodes of bipolar disorder in conjunction with lithium. Anticipated as a valuable resource, this review aims to furnish researchers and clinicians with the most current and comprehensive information on the uses of valproate.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"1-15"},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Urinary Tract Infections and Antibiotic Susceptibility Patterns of Uropathogens among Neonates in Maternity Hospital, Kuwait: A Six-Year Retrospective Study.","authors":"Ola H Moghnia, Hessah S Al Otaibi, Aisha M Al Haqqan, Elie S Sokhn, Seema S Pathan, Nawar E Abdulaziz, Habiba Y Mohammed, Noura A Al-Sweih","doi":"10.1159/000543368","DOIUrl":"10.1159/000543368","url":null,"abstract":"<p><strong>Objective: </strong>Urinary tract infections (UTIs) are common in neonates. Understanding the changes in the prevalence of common uropathogens is essential for early diagnosis and effective treatment of UTIs. This study aimed to identify etiological agents and determine the local antibiotic susceptibility patterns of uropathogens causing UTIs.</p><p><strong>Subjects and methods: </strong>A retrospective cross-sectional descriptive study from January 2017 to December 2022 was conducted on hospitalized neonates at Maternity Hospital, Kuwait. Urine samples from neonates were analyzed to identify isolates, and antimicrobial susceptibility testing was determined using the VITEK® 2 system.</p><p><strong>Results: </strong>Out of 3,996 urine samples processed, 282 (7%) samples yielded significant bacteriuria, mostly from male 185 (65.6%). Gram-negative isolates were the most common 141 (50%), followed by yeasts 84 (29.8%) and Gram-positive isolates 57 (20.2%). The common uropathogens were Klebsiella pneumoniae 50 (17.7%), followed by Escherichia coli 47 (16.8%), Candida albicans 39 (13.8%), Enterococcus faecalis 34 (12%), and Staphylococcus epidermidis 17 (6%). High resistance rates were observed among Enterobacterales against ampicillin, cephalothin, cefuroxime, cefotaxime, nitrofurantoin, amoxicillin-clavulanic acid, ceftazidime, and trimethoprim-sulfamethoxazole. A total of 28 (56%) K. pneumoniae and 18 (38.3%) E. coli were extended-spectrum beta-lactamase producers.</p><p><strong>Conclusion: </strong>Gram-negative isolates are considered the predominant causative agents of UTIs in neonates at Maternity Hospital. Reduced antibiotic susceptibility to commonly used antibiotics poses a notable challenge in the clinical management of neonates with UTIs. This study underscores the importance of proactive surveillance in monitoring causative organisms and antibiotic susceptibility in neonates.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"250-261"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Dose Escalation of Ustekinumab in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis.","authors":"Mohammad Ebad Ur Rehman, Ammara Tahir, Amna Hussain, Aizaz Ali, Abu Huraira Bin Gulzar, Abdul Qadeer Khan, Maha Sajjad, Fatima Shahid, Shahroon Zahid, Ummara Aslam, Talha Bin Yasin, Aqsa Bilal, Tehreem Fatima, Muhammad Sheraz Hameed, Tehseen Haider, Sajeel Saeed, Abdulqadir J Nashwan","doi":"10.1159/000543831","DOIUrl":"10.1159/000543831","url":null,"abstract":"<p><strong>Background: </strong>Ustekinumab is an effective drug in the treatment of inflammatory bowel disease (IBD), but inadequate response or loss of response is reported in several patients. Dose escalation by intravenous reinduction or interval shortening may be a suitable option to recapture response. We undertook a systematic review and meta-analysis to assess the efficacy of dose escalation in IBD patients receiving ustekinumab.</p><p><strong>Methods: </strong>A systematic literature search was conducted on PubMed, Embase, Clinicaltrails.gov, and Cochrane from inception to June 1, 2024. We conducted a proportional meta-analysis on MetaXL. Our primary outcomes were clinical response and clinical remission.</p><p><strong>Results: </strong>Twenty-eight articles were included (n = 2,129 patients). Eighteen studies (692 patients out of 1,218) reported clinical response, with pooled prevalence of 55% (95% CI: 46-65%). Out of 1,041 patients, 524 showed clinical remission with pooled prevalence of 51% (95% CI: 42-59%).</p><p><strong>Conclusion: </strong>This systematic review and meta-analysis showcased promising results, in terms of clinical response and remission, in IBD patients receiving dose escalation of ustekinumab.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"226-237"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Relationship between CD44 Expression and Gleason Grade among Prostate Adenocarcinoma and Benign Prostatic Hyperplasia: A Cross-Sectional Study.","authors":"Joben Kianparsa, Masood Soltanipur, Mohammadreza Jalali Nadoushan","doi":"10.1159/000544021","DOIUrl":"10.1159/000544021","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to investigate the expression of cluster of differentiation 44 (CD44) in prostate adenocarcinoma (PAC) compared to benign prostatic hyperplasia (BPH) to address the need for biomarkers that can aid in grading classification and prognosis.</p><p><strong>Methods: </strong>In this cross-sectional study, the CD44 expression in the tissue samples of the PAC and BPH was examined with hematoxylin and eosin and immunohistochemistry methods. The Gleason scores and grades and percentage of CD44 expression for specimens were determined. Data were analyzed using IBM SPSS version 23.0 software.</p><p><strong>Results: </strong>This study included 80 PAC and 83 BPH samples. The mean expression of CD44 in PAC samples was significantly lower than in BPH samples (28.59 ± 14.84 vs. 47.82 ± 14.65, p < 0.001). A moderate to strong significant negative correlation was found between CD44 expression and total Gleason scores and Gleason grade groups (r: -0.743, p < 0.001; r: -0.732, p < 0.001, respectively). Ordinal logistic regression showed that lower CD44 expression was associated with higher odds of advanced disease (OR = 0.884, p < 0.001).</p><p><strong>Conclusion: </strong>This study highlights CD44 expression not only as a potential biomarker for PAC diagnosis but also potential guide to therapeutic decision-making. Patients exhibiting lower CD44 levels may require closer monitoring and more aggressive treatment strategies, while those with higher expression may be candidates for less intensive management. Overall, our findings advocate for further investigation into CD44 as a biomarker for prostate cancer aggressiveness, which could ultimately enhance personalized treatment approaches and improve the patient outcomes.</p>","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"271-280"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Implantable Cardioverter Defibrillator Shocks in Heart Failure Patients Undergoing Diuretic Therapy.","authors":"Ilke Erbay, Naile Eris Gudul, Ugur Kokturk, Pelin Aladag, Meltem Kandazoglu, Ahmet Avci","doi":"10.1159/000542172","DOIUrl":"10.1159/000542172","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Implantable cardioverter defibrillators (ICDs) are the standard treatment for patients with reduced left ventricular ejection fraction (LVEF ≤35%) to reduce the risk of sudden cardiac death. Loop diuretics can cause electrolyte imbalances, leading to an increased incidence of ICD shocks. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have shown cardiovascular benefits in patients with heart failure (HF), but their effects on ventricular arrhythmias and ICD shocks, particularly in patients receiving different doses of loop diuretics, are not fully understood. This study evaluated the effects of furosemide dose and SGLT2i use on ICD shocks in HF patients with reduced left ventricular ejection fraction (HFrEF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;HFrEF patients using oral furosemide and undergoing ICD implantation in our clinic were followed for 12 months to monitor ICD shocks for ventricular arrhythmias. They were grouped according to daily oral furosemide dose and SGLT2i use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 175 patients, the use of high-dose furosemide (&gt;80 mg/day) was significantly higher in the ICD shock group compared to the non-shock group (38.8% vs. 16.7%, p = 0.001), while the use of SGLT2i was lower (19.4% vs. 45.4%, p &lt; 0.001). ICD shocks occurred in 67.6% of patients on high-dose furosemide without SGLT2i and 30.0% with SGLT2i (p &lt; 0.001). Multivariate analysis identified the absence of SGLT2i as an independent predictor of ICD shocks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;SGLT2i was associated with reduced ventricular arrhythmias and ICD shocks in HF patients, even when high doses of furosemide were used. The absence of SGLT2i in HF treatment was an independent predictor of ICD shocks.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Implantable cardioverter defibrillators (ICDs) are the standard treatment for patients with reduced left ventricular ejection fraction (LVEF ≤35%) to reduce the risk of sudden cardiac death. Loop diuretics can cause electrolyte imbalances, leading to an increased incidence of ICD shocks. Sodium-glucose cotransporter-2 inhibitors (SGLT2is) have shown cardiovascular benefits in patients with heart failure (HF), but their effects on ventricular arrhythmias and ICD shocks, particularly in patients receiving different doses of loop diuretics, are not fully understood. This study evaluated the effects of furosemide dose and SGLT2i use on ICD shocks in HF patients with reduced left ventricular ejection fraction (HFrEF).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;HFrEF patients using oral furosemide and undergoing ICD implantation in our clinic were followed for 12 months to monitor ICD shocks for ventricular arrhythmias. They were grouped according to daily oral furosemide dose and SGLT2i use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Out of 175 patients, the use of high-dose furosemide (&gt;80 mg/day) was significantly higher in the ICD shock group compared to the non-shock group (38.8% v","PeriodicalId":18455,"journal":{"name":"Medical Principles and Practice","volume":" ","pages":"179-190"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}