Clinics and Practice最新文献

{"title":"Bone Marrow Aplasia and Neutropenic Fever Following Azathioprine Dose Escalation in a TPMT-Deficient Patient with Crohn's Disease and Psoriatic Arthritis-A CARE-Compliant Case.","authors":"Krzysztof Wroński, Michał Tadeusz Holecki, Natalia Boguszewska, Marzena Skrzypczak-Zielińska, Jerzy Tadeusz Chudek","doi":"10.3390/clinpract15060114","DOIUrl":"10.3390/clinpract15060114","url":null,"abstract":"<p><p><b>Background:</b> Myelotoxicity, usually manifested by moderate leukopenia (particularly neutropenia), is a well-known adverse drug reaction to azathioprine (AZA) therapy. Thiopurine methyltransferase (<i>TMPT</i>) and nucleoside diphosphate-linked moiety X-type motif 15 (<i>NUDT15)</i> genotyping are not routinely performed in patients starting AZA therapy due to their low cost-effectiveness. Additionally, the concomitant use of xanthine oxidase inhibitors and 5-aminosalicylates may slow the metabolism of 6-mercaptopurine. <b>Case Description:</b> We describe a case of a 26-year-old Caucasian man with Crohn's disease and psoriatic arthritis treated with mesalazine and AZA (100 mg daily) who developed prolonged bone marrow aplasia and neutropenic fever after increasing the daily dose of AZA from 100 to 150 mg (from 44 to 66 mg/m²), without frequent total blood count monitoring. Discontinuation of AZA, multiple transfusions of red blood cells and platelet concentrate, filgrastim, empirical antibiotic therapy, and antiviral and antifungal prophylaxis were obtained after 11 days complete recovery of bone marrow aplasia. <b>Methods:</b> Genomic DNA genotyping of coding regions of <i>TPMT</i> (exons 2-9) and <i>NUDT15</i> (exons 1-3). <b>Results:</b> Heterozygous alleles in the untranslated region (c.460G>A and c.719A>G) associated with TPMT deficiency and a benign variant (c.*7G>A) in the 3'-UTR of <i>NUDT15</i> with no effect on enzyme activity were found. <b>Conclusions:</b> This case highlights the importance of monitoring the total blood count frequently during the first weeks of treatment with moderate-to-high doses of AZA. Furthermore, the interaction between AZA and mesalazine may play a significant role in the development of prolonged bone marrow aplasia.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486566","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":"Comparing Stenting with Medical Therapy Versus Medical Therapy Alone in Patients with Intracranial Atherosclerotic Stenosis: A Current Systematic Review and Meta-Analysis.","authors":"Khalid Bin Aziz, Hussam Alhathlol, Fahad Bin Aziz, Mohammed Alshammari, Mohammed Ali Alhefdhi, Abdulrahman M Alrasheed, Nawwaf Alfayez, Thamer S Alhowaish","doi":"10.3390/clinpract15060113","DOIUrl":"10.3390/clinpract15060113","url":null,"abstract":"<p><p><b>Background:</b> Intracranial atherosclerotic stenosis (ICAS) is a significant cause of ischemic stroke worldwide, with high recurrence rates despite optimal medical therapy. While endovascular stenting has been proposed as an adjunctive treatment, its clinical benefit remains controversial as a first line therapy. <b>Objective:</b> To evaluate the efficacy and safety of stenting plus medical therapy (STN+MT) compared to medical therapy alone (MT) in patients with symptomatic ICAS through a systematic review and meta-analysis of randomized controlled trials (RCTs). <b>Methods</b>: We systematically searched PubMed, Web of Science, the Cochrane Library, Embase, Scopus, and EBSCO for RCTs comparing STN+MT with MT in adult patients with symptomatic ICAS. Primary outcomes included transient ischemic attack (TIA), stroke, intracerebral hemorrhage (ICH), and death at 30 days and 1 year. Pooled risk ratios with 95% confidence intervals were calculated using random-effects or fixed-effects models as appropriate. Meta-regression was conducted to assess effect modification by study-level characteristics. <b>Results</b>: Four trials comprising 990 patients were included. STN+MT was associated with significantly higher 30-day risk of stroke and ICH compared to MT alone. No significant differences in TIA, stroke, ICH, or death were found at 1 year. Meta-regression revealed no significant effect modifiers, suggesting consistent findings across subgroups. <b>Conclusions</b>: Our meta-analysis consolidates the evidence that intracranial stenting as a first line therapy offers no significant advantage over medical therapy in preventing stroke in symptomatic ICAS, while it does pose added early risks. This holds true across different trials, patient demographics, and clinical scenarios examined. The consistency of this message across multiple RCTs provides a high level of evidence to guide practice. At present, aggressive medical therapy alone should be the default management for most patients. Endovascular intervention should be reserved for clinical trial settings or carefully selected salvage cases, until and unless new evidence emerges to change the risk-benefit calculus such as the promising use of balloon angioplasty in the BASIS trial.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486567","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":"Validation, Content Validity, and Reliability of the Spanish SE-OAM Questionnaire: Assessing Nursing Self-Efficacy in Oral Anticoagulant Therapy Management.","authors":"Juan Ramón de-Moya-Romero, Raquel Valera-Lloris, Elena Chover-Sierra, Laura Fernández-Puerta, Alexis Caballero-Bonafé, Antonio Martínez-Sabater","doi":"10.3390/clinpract15060111","DOIUrl":"10.3390/clinpract15060111","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Oral anticoagulant therapy (OAT) has been prescribed for over seventy years to prevent thromboembolic complications associated with various conditions. The emergence of direct-acting oral anticoagulants (DOACs) has reduced the use of vitamin K antagonists (VKAs), but specific clinical scenarios still necessitate VKAs. Nurses play a crucial role in managing OAT, and their self-efficacy is essential for optimal patient outcomes. This study aims to validate and adapt the Nursing Self-Efficacy for Oral Anticoagulant Therapy Management (SE-OAM) questionnaire to Spanish (SE-OAM-SV) to assess nurses' self-efficacy in managing OAT. <b>Methods:</b> A methodological design was employed to develop the validity and reliability of the SE-OAM-SV. The process included translation and back-translation, expert review, and a pilot study. Content validity was analyzed using the content validity index (CVI), modified kappa coefficient, and Aiken's V. A descriptive cross-sectional study was conducted with 100 nurses across Spain to test the SE-OAM-SV and identify comprehension issues. Internal consistency was assessed via Cronbach's alpha. <b>Results:</b> The translation process highlighted some items requiring clarification, which were resolved through expert consultation. The SE-OAM-SV demonstrated adequate content validity with a global CVI of 0.86. The pilot study revealed an average participant age of 41.3 years and 17.3 years of professional experience. The SE-OAM-SV showed high internal consistency with a Cronbach's alpha of 0.96. The average score of participants on the SE-OAM-SV was 56.8 points, indicating room for improvement in all aspects of the scale. <b>Conclusion</b>: The SE-OAM-SV is a reliable and valid tool for measuring nurses' self-efficacy in managing OAT in Spanish-speaking communities. This tool can facilitate the development of educational programs and public policies to enhance nurses' self-efficacy and improve patient outcomes. The availability of the SE-OAM-SV supports larger-scale studies and validation in other Spanish-speaking countries.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486527","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":"Administering Parenteral Medications in Managing Patients with Acute Arousal in the Behavioral Assessment Unit of the Emergency Department in Hospital Settings.","authors":"Harshini M Liyanage, Katy Boyce, Yiting Gong, Theresa Koo, Soumitra Das, Naveen Thomas","doi":"10.3390/clinpract15060112","DOIUrl":"10.3390/clinpract15060112","url":null,"abstract":"<p><p><b>Background/Objectives</b>: The administration of parenteral medications is essential in managing acute arousal within the Behavioral Assessment Unit (BAU) of the emergency department (ED), where timely and effective intervention is critical. This study aims to evaluate current practices surrounding the use of parenteral medications for patients with acute agitation, focusing on adherence to protocols, medication safety, documentation accuracy, and patient outcomes. <b>Methods</b>: A retrospective analysis was conducted on 177 cases from December 2023 to February 2024. The study assessed the demographics, diagnoses, treatment protocols, and patient outcomes, with a particular emphasis on the use of parenteral medications such as benzodiazepines and antipsychotics. The relationship between medication administration and involuntary admission, mechanical restraint usage, and patient outcomes was also explored. <b>Results</b>: The majority of patients were aged between 21 and 30 years, and there was a predominance of male patients across both groups. Schizophrenia was the most common diagnosis, with a higher prevalence in the parenteral group (34%) compared to the oral-only group (24%), and personality disorders were more frequent in the parenteral group. Intramuscular (IM) medication administration was strongly associated with the use of mechanical restraint, with patients receiving IM medication being 35 times more likely to require restraint, emphasizing the link between more intensive treatment approaches and behavioral challenges. The most frequently administered medications were diazepam (40.6%) and olanzapine (36.5%), with olanzapine, droperidol, and diazepam most commonly used parenterally. Documentation of physical assessments prior to parenteral administration was present in most cases, though comprehensive evaluations such as ECGs were inconsistently performed. <b>Conclusions</b>: Parenteral medications, including benzodiazepines and antipsychotics, were effective in rapidly stabilizing patients, but the study emphasizes reducing dependency on mechanical restraints. Tailoring treatment to patient characteristics and employing alternative de-escalation strategies can improve safety and align with recovery-oriented care. This study highlights the need for evidence-based practices to optimize care and improve patient outcomes in ED settings. Further research is needed to explore long-term outcomes and refine non-coercive care approaches.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486563","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":"Multicenter Study of Comorbidities in Patients with Periprosthetic Fractures After Total Hip Arthroplasty and Their Association with Immediate Postoperative Complications.","authors":"Victor Niculescu, Alexandru Lisias Dimitriu, Delia Carmen Nistor-Cseppento, Sebastian Tirla, Anamaria Gherle, Bogdan Uivaraseanu, Cristian Burnei","doi":"10.3390/clinpract15060110","DOIUrl":"10.3390/clinpract15060110","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Periprosthetic fractures (PFs) can occur in both the upper and lower limbs, commonly resulting from falls at the same level. The frequency of PFs following total hip arthroplasty (THA) ranges from 0.045% to 4.1%, and this incidence is influenced by several factors, including age, gender, the type of prosthesis used, and existing comorbidities. Previous studies on this subject have been small in scale and did not adequately address the associated comorbidities, which pose a challenge for the aging population. This study aims to comparatively assess the incidence of THA-related PFs, immediate postoperative complications, and comorbidities in patients with PFs from three emergency hospitals. <b>Methods:</b> A retrospective observational study was conducted from 1 January to 31 December 2024, in which 54 patients with PFs hospitalized in three emergency hospitals (Bucharest, Oradea, and Ploiești) were evaluated, divided into Group B (<i>n</i> = 29), Group O (<i>n</i> = 14), and Group P (<i>n</i> = 11). <b>Results:</b> Of all patients with PFs, 81.48% had minor complications-grade 1, 9.26% had grade 2 complications (complications requiring medical treatment or other minor interventions), and 3.70% had complications requiring surgery or invasive procedures. Clavien-Dindo grade 5 (patient death) had an incidence of 3.70%. Cardiac pathology was the most common pathology; hypertension predominated in Group O (42.85%). Alzheimer's disease was associated in 7 patients (12.96%). Without associated pathology, about 13% of patients were identified. Diabetes mellitus also occurred frequently in 31.50%. Data analysis indicates a very weak positive correlation between the Dindo Index and the Charlson Comorbidity Index (r = 0.046), which is not statistically significant (<i>p</i> = 0.628). The effect size, measured by Fisher's z, is also reported as 0.046. <b>Conclusions:</b> No significant differences were found among the evaluated centers regarding therapeutic approaches, postoperative complications, and associated comorbidities. Furthermore, there is insufficient evidence to suggest a significant association between the Charlson Comorbidity Index and the Clavien-Dindo Index.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486511","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":"Atypically Displaced Meniscal Tears: An Educational Review with Focus on MRI and Arthroscopy.","authors":"Paolo Spinnato, Paola Franceschi, Giuseppe Martinese, Anna Parmeggiani, Valerio D'Agostino, Silvia Ferraro, George R Matcuk, Stefano Zaffagnini, Alberto Grassi","doi":"10.3390/clinpract15060109","DOIUrl":"10.3390/clinpract15060109","url":null,"abstract":"<p><p>This review article on atypically displaced meniscal tears serves as a critical reminder for radiologists and orthopedic surgeons. It highlights and details uncommon lesions that may be overlooked during MRI evaluation and/or arthroscopic exploration. The knowledge of their existence can enable radiologists to critically assess any meniscal abnormality, keeping in mind its possible arthroscopic presentation. This is essential for assisting the surgeon in making an accurate preoperative diagnosis. In fact, these atypical lesions pose great challenges to surgeons in terms of the technical aspects of their treatment. Often, they could require additional arthroscopic portals for their identification or the need for special devices or instrumentations for the repair. Knowing these challenges in advance is thus imperative for properly planning a proficient surgery. The correct diagnosis and description of tear patterns, including extent and location, allow optimal pre-operative planning with the choice of the indicated approach. Radiologists should know how to recognize menisci tears, even with atypical dislocation patterns. Particularly, in the case of 'minus' detection or thickness reduction in a meniscus, the possible displaced fragment should be carefully searched for, even in atypical sites.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486565","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":"Maternal Disorders Associated with Morbidity and Mortality in a Metropolis of Kazakhstan.","authors":"Aigerim Turekulova, Nurzhamal Dzhardemaliyeva, Alibek Mereke, Mukhtar Kulimbet","doi":"10.3390/clinpract15060108","DOIUrl":"10.3390/clinpract15060108","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Hypertensive disorders of pregnancy, including pre-eclampsia and eclampsia, are leading causes of maternal morbidity and mortality worldwide and in Kazakhstan. This study aims to assess the burden of hypertensive disorders of pregnancy and main maternal disorders in Almaty, Kazakhstan, using the disability adjusted life years (DALY) methodology. <b>Methods</b>: We conducted a retrospective analysis of women aged 18 and above in Almaty, Kazakhstan, from 2018 to 2020. The medical claim data were retrieved from the Almaty city branch of the Republican Center for Electronic Health Care. Incidence-based DALY were calculated. <b>Results</b>: The total DALY increased for severe pre-eclampsia from 109.3 in 2018 to 187.2 in 2020 per 100,000 population and eclampsia from 3.1 in 2018 to 159.3 in 2020 per 100,000 population. Also, the 25-29 years age group had the largest increase in percent change (5.8) in the total DALY for hypertensive disorders of pregnancy. In addition, the 20-24 years age groups had the largest increase in percent change in the total DALY for severe pre-eclampsia (25.8) and eclampsia (80.5). <b>Conclusions</b>: Our findings highlight an increase in the burden of maternal disorders, especially for severe pre-eclampsia and eclampsia, in Almaty, Kazakhstan, from 2018 to 2020. Younger women bear a significant share of this burden, compounded by the pandemic's impact on healthcare services.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12191608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486509","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":"Alpha-Synuclein Seed Amplification Assays in Parkinson's Disease: A Systematic Review and Network Meta-Analysis.","authors":"Jamir Pitton Rissardo, Ana Leticia Fornari Caprara","doi":"10.3390/clinpract15060107","DOIUrl":"10.3390/clinpract15060107","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Assessment of α-synuclein (αSyn) seed amplification assays (αSyn-SAA) accuracy in distinguishing Parkinson's disease (PD) from controls using cerebrospinal fluid (CSF), blood, skin, extracellular vesicles (ECV), saliva, olfactory mucosa (OM), gastrointestinal tract (GIT), and submandibular gland (SMG).</p><p><strong>Methodology: </strong>PubMed was searched for articles from 2010 to January 2025. The quality assessment used robvis. Diagnostic values with a 95% confidence interval (CI) were obtained. Z-test, Wald CI, and ANOVA were performed. Diagnostic odds ratio (DOR) was used.</p><p><strong>Results: </strong>αSyn-SAAs showed strong diagnostic performance in distinguishing PD from controls across various tissue and fluid types. Overall, αSyn-SAAs demonstrated high sensitivity (86%) and specificity (92%). Among all biomatrices, CSF, skin, blood, and ECV yielded the highest diagnostic accuracy, with sensitivity and specificity approaching or exceeding 90%. In contrast, saliva, oral mucosa, and gastrointestinal tract samples showed more modest sensitivity, though specificity remained relatively high. ECV, CSF, skin, and blood matrices also demonstrated the highest DOR, supporting their potential clinical utility.</p><p><strong>Conclusions: </strong>ECV and blood warrant priority in αSyn-SAA for high accuracy and minimal invasiveness, while GIT, OM, and oral samples show limited utility; saliva and SMG need refinement.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486564","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":"Reverse Linear Neuro Periodization Model for Rehabilitation After Arthroscopic Rotator Cuff Repair: A Narrative Review.","authors":"Georgios Kakavas, Emmanouil Brilakis, Maria Papatzikou, Nikolaos Malliaropoulos, Jean Mazeas, Florian Forelli","doi":"10.3390/clinpract15060105","DOIUrl":"10.3390/clinpract15060105","url":null,"abstract":"<p><p>Periodization is a concept of systematic progression in training and rehabilitation. The rehabilitation literature, however, is scarce, with information about optimally designing resistance training programs based on periodization principles for injured athletes. This periodization model-reverse linear neuro periodization-is a model proposed for the long-term rehabilitation needed after an arthroscopic rotator cuff repair. With recent evidence supporting neural contributions to shoulder injuries and the rate of recovery, rehabilitation protocols may benefit from incorporating approaches that target the sensorimotor system. Integrating motor learning principles (external focus and differential learning) and new technologies (virtual reality, laser pointers, stroboscopic glasses) may bolster current shoulder rehabilitation protocols and improve patient recovery times and outcomes. Such an understanding allows well-informed sport rehabilitation specialists to better bridge the gap between the preparation for competition widely used by coaches and the treatment of injuries that may occur.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486514","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":"Predictors of Major Adverse Cardiovascular Events in Stable Patients After ST Elevation Myocardial Infarction.","authors":"Lidija Savic, Damjan Simic, Ratko Lasica, Gordana Krljanac, Sanja Stankovic, Igor Mrdovic, Milika Asanin","doi":"10.3390/clinpract15060106","DOIUrl":"10.3390/clinpract15060106","url":null,"abstract":"<p><strong>Background/aim: </strong>The aim of this study was to determine predictors of major adverse cardiovascular events, including MACE (mortality, non-fatal recurrent infarction, non-fatal stroke, and target vessel revascularization-TVR) in stable post-STEMI patients.</p><p><strong>Method: </strong>We analyzed STEMI patients without cardiogenic shock at admission included in our STEMI Register. The patients were treated with primary PCI. The follow-up period was eight years.</p><p><strong>Results: </strong>From 1 December 2006 to 31 December 2016, a total of 3079 patients were included in the Register. In the first year, MACE was registered in 348 (11.3%) patients. The remaining patients were considered stable. They were included in further analysis. At eight years, the rates were as follows: MACE 3.9%, non-fatal recurrent infarction 2.1%, TVR 1.8%, non-fatal stroke 0.5%, and mortality 2.1%. Predictors for 8-year MACE were age >60 years (60-69 vs. <60 years HR 1.65; 70-79 vs. <60 years HR 1.82; ≥80 vs. <60 years HR 3.16), EF < 50% (EF 40-49% HR 2.38; EF < 40% HR 2.32), diabetes mellitus (HR 1.49), and 3-vessel coronary artery disease (HR 1.44).</p><p><strong>Conclusions: </strong>Four predictors identified stable post-STEMI patients who remained at a higher risk for the occurrence of MACE. Stable post-STEMI patients with one or more of these risk factors may require more aggressive secondary prevention measures or a personalized approach to improve their prognosis.</p>","PeriodicalId":45306,"journal":{"name":"Clinics and Practice","volume":"15 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12192057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486513","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}