Introduction: The incidence and pattern of neurological complications after congenital cardiac surgery have been changing over the years due to improvement in surgical technique and perioperative management. The aim of this study was to evaluate the incidence and pattern of neurological injury in our institute. Materials and Methods: We retrospectively reviewed all pediatric patients who underwent noncontrast computed tomography of the brain for suspected postoperative neurological injury occurring during the 1st week after pediatric cardiac surgery between April 2016 and February 2020. We identified neurological injury as patients having ischemic infarct and intracranial hemorrhage. Results: A total of 2971 pediatric cardiac surgeries were performed at our institute. Sixty-seven patients (2.25%) developed neurological injury. Fifty-five patients (82%) developed ischemic infarct while 12 patients (18%) had intracranial hemorrhagic. Pattern of ischemic infarct included global hypoxic injury in 30 patients (54.5%), posterior cerebral artery territory in 9 patients (16.3%), middle cerebral artery territory in 8 patients (14.5%), multiterritory involvement in 5 patients (9.0%), and anterior cerebral artery territory in 3 patients (5.4%). In patients with intracranial hemorrhage, 5 patients (7.4%) developed subarachnoid hemorrhage (SAH), 4 patients (5.9%) developed subdural hemorrhage, and 3 patients (4.4%) developed intraparenchymal hemorrhage. Conclusions: Neurological complication accounts for significant morbidity and mortality after congenital cardiac surgery. In our study, ischemic infarct accounted for 82% cases. In ischemic infarct, global ischemia was the most common type and carried high risk of mortality. In hemorrhage group, SAH was the most common finding. Nevertheless, the aim of this study was to characterize the current incidence of acute clinically evident neurologic complications in children undergoing congenital cardiac surgery in a tertiary hospital, although acute neurologic morbidity appears to be appreciably lower than in the past at our institution.
{"title":"Postoperative neurological deficits with incidence and the various arterial territories involved in patients undergoing congenital cardiac surgery: A single-center analysis","authors":"Kumar Rahul, Pankaj Garg, Vishal Aggarwal, Sarvesh Kumar, Vivek Tewarson, Karan Kaushik, Satish Kumar","doi":"10.4103/rcm.rcm_40_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_40_23","url":null,"abstract":"Introduction: The incidence and pattern of neurological complications after congenital cardiac surgery have been changing over the years due to improvement in surgical technique and perioperative management. The aim of this study was to evaluate the incidence and pattern of neurological injury in our institute. Materials and Methods: We retrospectively reviewed all pediatric patients who underwent noncontrast computed tomography of the brain for suspected postoperative neurological injury occurring during the 1st week after pediatric cardiac surgery between April 2016 and February 2020. We identified neurological injury as patients having ischemic infarct and intracranial hemorrhage. Results: A total of 2971 pediatric cardiac surgeries were performed at our institute. Sixty-seven patients (2.25%) developed neurological injury. Fifty-five patients (82%) developed ischemic infarct while 12 patients (18%) had intracranial hemorrhagic. Pattern of ischemic infarct included global hypoxic injury in 30 patients (54.5%), posterior cerebral artery territory in 9 patients (16.3%), middle cerebral artery territory in 8 patients (14.5%), multiterritory involvement in 5 patients (9.0%), and anterior cerebral artery territory in 3 patients (5.4%). In patients with intracranial hemorrhage, 5 patients (7.4%) developed subarachnoid hemorrhage (SAH), 4 patients (5.9%) developed subdural hemorrhage, and 3 patients (4.4%) developed intraparenchymal hemorrhage. Conclusions: Neurological complication accounts for significant morbidity and mortality after congenital cardiac surgery. In our study, ischemic infarct accounted for 82% cases. In ischemic infarct, global ischemia was the most common type and carried high risk of mortality. In hemorrhage group, SAH was the most common finding. Nevertheless, the aim of this study was to characterize the current incidence of acute clinically evident neurologic complications in children undergoing congenital cardiac surgery in a tertiary hospital, although acute neurologic morbidity appears to be appreciably lower than in the past at our institution.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366104","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}
Satyapriya Mohanty, Abhinav Kumar, A. Banerjee, Pranjit Deb, Debasish Das
It is extremely rare to encounter primary malignant tumors of the heart. Rhabdomyoma constitutes approximately 20% of all primary malignant tumors of the heart. Rhabdomyoma commonly arises from the ventricular wall, and rarely, they arise from the atrial wall and mimic symptomatic atrioventricular valve stenosis. We describe an extremely rare case of left atrial (LA) rhabdomyosarcoma detected during the transesophageal echocardiography arising from the posterior wall of the left atrium protruding into the left ventricle causing obstruction of the mitral valve. Our case is a rare case of LA rhabdomyosarcoma presenting with mitral inflow obstruction and symptomatically mimicking severe rheumatic mitral stenosis with atrial fibrillation and fast ventricular rate with orthopnea secondary to LA failure and passive pulmonary venous congestion.
{"title":"An unusual presentation of a rare case of rhabdomyosarcoma of the left atrium as severe rheumatic mitral stenosis with atrial fibrillation, fast ventricular rate, and left atrial failure","authors":"Satyapriya Mohanty, Abhinav Kumar, A. Banerjee, Pranjit Deb, Debasish Das","doi":"10.4103/rcm.rcm_2_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_2_23","url":null,"abstract":"It is extremely rare to encounter primary malignant tumors of the heart. Rhabdomyoma constitutes approximately 20% of all primary malignant tumors of the heart. Rhabdomyoma commonly arises from the ventricular wall, and rarely, they arise from the atrial wall and mimic symptomatic atrioventricular valve stenosis. We describe an extremely rare case of left atrial (LA) rhabdomyosarcoma detected during the transesophageal echocardiography arising from the posterior wall of the left atrium protruding into the left ventricle causing obstruction of the mitral valve. Our case is a rare case of LA rhabdomyosarcoma presenting with mitral inflow obstruction and symptomatically mimicking severe rheumatic mitral stenosis with atrial fibrillation and fast ventricular rate with orthopnea secondary to LA failure and passive pulmonary venous congestion.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364421","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}
Aortopulmonary window (APW) is a rare congenital heart disease. In general, surgical closure is the mainstay of treatment. There are few case reports describing transcatheter closure of an APW. Here we report a case of a APW device closure under general anaesthesia by a multifunctional occluder device in a three-year-old boy.
{"title":"Transcatheter closure of the aortopulmonary window with a multifunctional occluder device","authors":"Amit Mandal","doi":"10.4103/rcm.rcm_42_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_42_23","url":null,"abstract":"Aortopulmonary window (APW) is a rare congenital heart disease. In general, surgical closure is the mainstay of treatment. There are few case reports describing transcatheter closure of an APW. Here we report a case of a APW device closure under general anaesthesia by a multifunctional occluder device in a three-year-old boy.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365235","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":"Predictions of adherence to treatment in patients referred to the heart failure clinic of Shahid Rajaee Hospital in Tehran","authors":"Sidhi Laksono","doi":"10.4103/rcm.rcm_38_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_38_23","url":null,"abstract":"","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365332","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}
Ö. Karaaslan, Atik Aksoy, Murat Oğuz Özilhan, Ü. Güray, M. Selçuk, H. Selçuk, O. Maden
Background: Malignant ventricular arrhythmias are a common cause of death in ischemic heart diseases. Implantable cardioverter-defibrillators (ICDs) demonstrate significant efficacy in reducing mortality linked to ventricular arrhythmias. Statins exhibit the potential to stabilize the atherosclerotic and ischemic burden, thereby potentially manifesting indirect anti-arrhythmic effects. This study evaluated the relationship between statin levels and arrhythmic events in patients with primary prevention ICDs for ischemic cardiomyopathy. Methods: This study was conducted as a retrospective observational study at a single center, involving consecutive patients who were admitted to the cardiology outpatient clinic and underwent primary prevention ICD. The study population was stratified into two groups based on statin usage. Results: This study included a cohort of 80 patients diagnosed with ischemic cardiomyopathy who underwent primary prevention implantation of ICDs. Group 1 consisted of 24 patients who were prescribed low-dose statins, whereas Group 2 consisted of 56 patients who were prescribed high-dose statins. Univariate and multivariate analyses showed that left ventricular ejection fraction and use of low-dose statins were independent predictors of arrhythmic events. Conclusion: The study cohort exhibited comparable clinical and laboratory characteristics, suggesting that statin dosage is associated with malignant arrhythmic events in a homogeneous patient population.
{"title":"The association between statin dosage and malignant ventricular arrhythmias in patients with primary prevention implantable cardioverter-defibrillators for ischemic cardiomyopathy","authors":"Ö. Karaaslan, Atik Aksoy, Murat Oğuz Özilhan, Ü. Güray, M. Selçuk, H. Selçuk, O. Maden","doi":"10.4103/rcm.rcm_45_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_45_23","url":null,"abstract":"Background: Malignant ventricular arrhythmias are a common cause of death in ischemic heart diseases. Implantable cardioverter-defibrillators (ICDs) demonstrate significant efficacy in reducing mortality linked to ventricular arrhythmias. Statins exhibit the potential to stabilize the atherosclerotic and ischemic burden, thereby potentially manifesting indirect anti-arrhythmic effects. This study evaluated the relationship between statin levels and arrhythmic events in patients with primary prevention ICDs for ischemic cardiomyopathy. Methods: This study was conducted as a retrospective observational study at a single center, involving consecutive patients who were admitted to the cardiology outpatient clinic and underwent primary prevention ICD. The study population was stratified into two groups based on statin usage. Results: This study included a cohort of 80 patients diagnosed with ischemic cardiomyopathy who underwent primary prevention implantation of ICDs. Group 1 consisted of 24 patients who were prescribed low-dose statins, whereas Group 2 consisted of 56 patients who were prescribed high-dose statins. Univariate and multivariate analyses showed that left ventricular ejection fraction and use of low-dose statins were independent predictors of arrhythmic events. Conclusion: The study cohort exhibited comparable clinical and laboratory characteristics, suggesting that statin dosage is associated with malignant arrhythmic events in a homogeneous patient population.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365425","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}
M. Shojaeifard, Pegah Salehi, Mahsa Akbarian, Somayeh Mohebbi, M. Alavi, Leyla Aliabadi, Sara Shemshadi, Saied Hosseini
For patients with a small aorta, surgeons may use techniques such as the Manouguian method in addition to aortic valve replacement (AVR) to prevent patient prosthetic mismatch. These methods have been shown to have good outcomes and few complications. However, in this case presentation, a rare complication occurred in a 47-year-old woman who underwent AVR plus Manouguian surgery. After the surgery, her echocardiography revealed iatrogenic supra-aortic stenosis. The diagnosis was confirmed with computed tomography angiography, and the patient underwent surgery again at the site of the stenosis. Fortunately, the surgery was successful, and the stenosis was completely resolved.
{"title":"Complicated aortic root enlargement in a patient who underwent aortic valve replacement","authors":"M. Shojaeifard, Pegah Salehi, Mahsa Akbarian, Somayeh Mohebbi, M. Alavi, Leyla Aliabadi, Sara Shemshadi, Saied Hosseini","doi":"10.4103/rcm.rcm_46_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_46_23","url":null,"abstract":"For patients with a small aorta, surgeons may use techniques such as the Manouguian method in addition to aortic valve replacement (AVR) to prevent patient prosthetic mismatch. These methods have been shown to have good outcomes and few complications. However, in this case presentation, a rare complication occurred in a 47-year-old woman who underwent AVR plus Manouguian surgery. After the surgery, her echocardiography revealed iatrogenic supra-aortic stenosis. The diagnosis was confirmed with computed tomography angiography, and the patient underwent surgery again at the site of the stenosis. Fortunately, the surgery was successful, and the stenosis was completely resolved.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366227","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}
S. Boudagh, Mohammad Amin Shahrbaf, A. Sadeghpour, Shirin Manshouri, M. Kamali, Akbar Nikpajouh, H. Bodagh, H. Pasha, P. Moradnejad
Background and Aims: Infective endocarditis (IE) is associated with several morbidities and high rate of mortality. Predicting these morbidities can be helpful in managing patients and can prevent possible complications, result from IE. In this study, we aimed to evaluate the association between C-reactive protein (CRP), N-terminal pro brain natriuretic peptide (BNP), monocyte to high density lipoprotein (HDL) ratio Charlson comorbidity index, and European System for Cardiac Operative Risk Evaluation (Euro SCORE) in complicated cases of IE. Materials and Methods: This prospective study was conducted on a referral center from January 2017 to December 2020. Patients with definite or possible diagnosis of IE based on the modified Duke criteria were included in this study. Demographic information and serum levels of N-terminal pro BNP, D-Dimer, CRP were evaluated in patients. In addition, we used Charlson comorbidity index and The Euro SCORE for subjective assessment. Results: One hundred and four patients (64 males, median age: 58) included in the final analysis. Intracardiac involvement, central nervous system (CNS) complications and systemic complications were observed in nine patients (9.7%), 16 patients (15.4%), and eight patients (7.7%) respectively. The mortality rate was 14.4%. D-dimer (P = 0.008), pro-BNP (P = 0.008), and Charlson criteria (P = 0.012) were higher in patients with systematic complications. In addition, NT pro-BNP was significantly associated with CNS complications (P = 0.04) and D-Dimer level was significantly associated with in-hospital mortality (P = 0.008). Conclusion: Serum biomarkers such as pro-BNP and D-dimer, and comorbidity indices can be used for risk stratification of patients with IE. The level of pro-BNP is significantly associated with CNS complications and the level of D-dimer is significantly with mortality in patients with IE.
{"title":"Prognostic value of cardiac and noncardiac biomarkers in infective endocarditis: A prospective cross-sectional study","authors":"S. Boudagh, Mohammad Amin Shahrbaf, A. Sadeghpour, Shirin Manshouri, M. Kamali, Akbar Nikpajouh, H. Bodagh, H. Pasha, P. Moradnejad","doi":"10.4103/rcm.rcm_12_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_12_23","url":null,"abstract":"Background and Aims: Infective endocarditis (IE) is associated with several morbidities and high rate of mortality. Predicting these morbidities can be helpful in managing patients and can prevent possible complications, result from IE. In this study, we aimed to evaluate the association between C-reactive protein (CRP), N-terminal pro brain natriuretic peptide (BNP), monocyte to high density lipoprotein (HDL) ratio Charlson comorbidity index, and European System for Cardiac Operative Risk Evaluation (Euro SCORE) in complicated cases of IE. Materials and Methods: This prospective study was conducted on a referral center from January 2017 to December 2020. Patients with definite or possible diagnosis of IE based on the modified Duke criteria were included in this study. Demographic information and serum levels of N-terminal pro BNP, D-Dimer, CRP were evaluated in patients. In addition, we used Charlson comorbidity index and The Euro SCORE for subjective assessment. Results: One hundred and four patients (64 males, median age: 58) included in the final analysis. Intracardiac involvement, central nervous system (CNS) complications and systemic complications were observed in nine patients (9.7%), 16 patients (15.4%), and eight patients (7.7%) respectively. The mortality rate was 14.4%. D-dimer (P = 0.008), pro-BNP (P = 0.008), and Charlson criteria (P = 0.012) were higher in patients with systematic complications. In addition, NT pro-BNP was significantly associated with CNS complications (P = 0.04) and D-Dimer level was significantly associated with in-hospital mortality (P = 0.008). Conclusion: Serum biomarkers such as pro-BNP and D-dimer, and comorbidity indices can be used for risk stratification of patients with IE. The level of pro-BNP is significantly associated with CNS complications and the level of D-dimer is significantly with mortality in patients with IE.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.3,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139365168","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}
Background: Major adverse cardiovascular events (MACEs) are frequently encountered in patients undergoing noncardiac surgeries. This study evaluated the utility of cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) to predict MACE in elderly patients (aged ≥60 years) undergoing noncardiac surgeries. Methods: This comparative cross-sectional study was carried out at a tertiary care center in India between November 2016 and August 2018. A total of 136 consecutive patients (aged ≥60 years) presenting for noncardiac surgeries under general/spinal/regional anesthesia in the departments of surgery, orthopedics, or gynecology were included in the study. Patients with chronic kidney disease stages 4 and 5 and those receiving hemodialysis or peritoneal dialysis for renal failure were excluded from the study. Peripheral blood samples for BNP and cTnI were obtained within 24 h preoperatively. The primary endpoint was the occurrence of MACE, defined as the composite of cardiac death, nonfatal myocardial infarction, heart failure, arrhythmias, and cardiac arrest at 6 days postsurgery. Results: The mean age of patients was 69.41 ± 7.56 years. Females comprised 54.1% of the study population. During the perioperative period and follow-up of 6 days, 12 MACE were recorded. Preoperative cTnI levels alone or both cTnI and BNP together (cTnI levels >0.07 ng/mL and BNP levels >40 pg/mL) increased significantly in the patients who experienced MACE (P < 0.05). The area under receiver operating characteristics curve for cTnI and BNP for predicting perioperative cardiac events was 0.817 (95% confidence interval [CI] 0.646–0.988; P < 0.001) and 0.520 (95% CI 0.337–0.704; P = 0.817), respectively. Conclusions: In elderly patients undergoing noncardiac surgeries, a preoperative assessment of BNP and cTnI may help in the assessment of MACE.
{"title":"Utility of preoperative brain natriuretic peptide and cardiac troponin I in predicting perioperative major adverse cardiovascular events in elderly patients undergoing noncardiac surgery","authors":"Sujay Renga, AnakhaAbdul Shereef Sabiathu Beevi","doi":"10.4103/rcm.rcm_18_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_18_23","url":null,"abstract":"Background: Major adverse cardiovascular events (MACEs) are frequently encountered in patients undergoing noncardiac surgeries. This study evaluated the utility of cardiac troponin I (cTnI) and brain natriuretic peptide (BNP) to predict MACE in elderly patients (aged ≥60 years) undergoing noncardiac surgeries. Methods: This comparative cross-sectional study was carried out at a tertiary care center in India between November 2016 and August 2018. A total of 136 consecutive patients (aged ≥60 years) presenting for noncardiac surgeries under general/spinal/regional anesthesia in the departments of surgery, orthopedics, or gynecology were included in the study. Patients with chronic kidney disease stages 4 and 5 and those receiving hemodialysis or peritoneal dialysis for renal failure were excluded from the study. Peripheral blood samples for BNP and cTnI were obtained within 24 h preoperatively. The primary endpoint was the occurrence of MACE, defined as the composite of cardiac death, nonfatal myocardial infarction, heart failure, arrhythmias, and cardiac arrest at 6 days postsurgery. Results: The mean age of patients was 69.41 ± 7.56 years. Females comprised 54.1% of the study population. During the perioperative period and follow-up of 6 days, 12 MACE were recorded. Preoperative cTnI levels alone or both cTnI and BNP together (cTnI levels >0.07 ng/mL and BNP levels >40 pg/mL) increased significantly in the patients who experienced MACE (P < 0.05). The area under receiver operating characteristics curve for cTnI and BNP for predicting perioperative cardiac events was 0.817 (95% confidence interval [CI] 0.646–0.988; P < 0.001) and 0.520 (95% CI 0.337–0.704; P = 0.817), respectively. Conclusions: In elderly patients undergoing noncardiac surgeries, a preoperative assessment of BNP and cTnI may help in the assessment of MACE.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136208389","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}
Context: It seems that the threat of death increases among diabetic patients with coronavirus infection disease-2019 (COVID-19). Statins have anti-inflammatory and anti-thrombogenic properties along with lowering blood cholesterol. Therefore, statins could be considered as an important factor in reducing the mortality rates in diabetic patients with COVID-19. This systematic review and meta-analysis study was performed to investigate the effect of statin on mortality in diabetic patients with COVID-19. Evidence Acquisition: This study was done based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases such as PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from December 2019 until the end of September 2022. Meta-analysis was used by the comprehensive meta-analysis software to combine the results. A funnel plot and Egger’s regression test were used to investigate the publication bias. Results: Six studies were included in the meta-analysis. Nine thousand five hundred and thirty-three diabetic patients with COVID-19 were studied. The heterogeneity between studies was significant. According to the meta-analysis, using the random-effects model, we found that the rate of mortality due to COVID-19 in diabetic patients who used statins was 9% lower than other patients. Publication bias between studies included in the meta-analysis was not significant. Conclusions: In this study, there was no significant difference between the mortality rates of diabetic people with COVID-19 who used statins and individuals who did not consume statins – this difference was just 9%. Therefore, it could be said that more clinical trials are needed to ensure the clinical efficacy of statins among diabetic patients with COVID-19.
背景:患有冠状病毒感染-2019 (COVID-19)的糖尿病患者的死亡威胁似乎有所增加。他汀类药物具有抗炎和抗血栓形成的特性以及降低血液中的胆固醇。因此，他汀类药物可被认为是降低糖尿病合并COVID-19患者死亡率的重要因素。本系统综述和荟萃分析研究旨在探讨他汀类药物对糖尿病合并COVID-19患者死亡率的影响。证据获取:本研究是根据系统评价和荟萃分析指南的首选报告项目完成的。从2019年12月到2022年9月底，检索了PubMed、Embase、Scopus、Web of Science和Cochrane Library等电子数据库。采用综合meta分析软件对结果进行综合分析。采用漏斗图和Egger回归检验检验发表偏倚。结果:6项研究被纳入meta分析。对9533例糖尿病合并COVID-19患者进行了研究。研究间的异质性显著。根据meta分析，使用随机效应模型，我们发现使用他汀类药物的糖尿病患者因COVID-19的死亡率比其他患者低9%。纳入meta分析的研究之间的发表偏倚不显著。结论:在这项研究中，使用他汀类药物的COVID-19糖尿病患者和未使用他汀类药物的患者的死亡率没有显著差异，差异仅为9%。因此，需要更多的临床试验来确保他汀类药物在糖尿病合并COVID-19患者中的临床疗效。
{"title":"Effect of statin on mortality in diabetic patients with COVID-19: A systematic review and meta-analysis","authors":"Kamran Roudini, Azin Alizadehasl, DavoodKhoda Amorzideh, Nashmil Ghadimi, Hossein Hosseinifard, Sara Kaveh, NiloufarAkbari Parsa","doi":"10.4103/rcm.rcm_39_22","DOIUrl":"https://doi.org/10.4103/rcm.rcm_39_22","url":null,"abstract":"Context: It seems that the threat of death increases among diabetic patients with coronavirus infection disease-2019 (COVID-19). Statins have anti-inflammatory and anti-thrombogenic properties along with lowering blood cholesterol. Therefore, statins could be considered as an important factor in reducing the mortality rates in diabetic patients with COVID-19. This systematic review and meta-analysis study was performed to investigate the effect of statin on mortality in diabetic patients with COVID-19. Evidence Acquisition: This study was done based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases such as PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from December 2019 until the end of September 2022. Meta-analysis was used by the comprehensive meta-analysis software to combine the results. A funnel plot and Egger’s regression test were used to investigate the publication bias. Results: Six studies were included in the meta-analysis. Nine thousand five hundred and thirty-three diabetic patients with COVID-19 were studied. The heterogeneity between studies was significant. According to the meta-analysis, using the random-effects model, we found that the rate of mortality due to COVID-19 in diabetic patients who used statins was 9% lower than other patients. Publication bias between studies included in the meta-analysis was not significant. Conclusions: In this study, there was no significant difference between the mortality rates of diabetic people with COVID-19 who used statins and individuals who did not consume statins – this difference was just 9%. Therefore, it could be said that more clinical trials are needed to ensure the clinical efficacy of statins among diabetic patients with COVID-19.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136208198","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}
Despite many well-documented benefits of the transvenous implantable cardioverter-defibrillator in appropriate patients, there is a strong preference today for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation due to the significant late complications associated with intravenous leads, especially in young patients. We report on an 18-year-old woman with S-ICD due to hypertrophic cardiomyopathy who had idiopathic dextroscoliosis. In the follow-up analysis, we observed a disturbance in the normal detection of QRS complexes by the device, which significantly reduced when the patient changed the position from standing to supine and when the brace was closed. According to the absence of lead displacement in the chest radiograph, S-ICD sense impairment was suggested due to skeletal deformity. Due to not solving this problem with device reprogramming, we had to reposition of the S-ICD lead in our patient.
{"title":"Subcutaneous implantable cardioverter-defibrillator lead repositioning due to device sensing impairment in a patient with scoliosis","authors":"Farzad Kamali, Mahsa Nourani, Mahdiyeh Mahdinejadshani, Samira Shirazi, SeyedAli Pourmomeni","doi":"10.4103/rcm.rcm_15_23","DOIUrl":"https://doi.org/10.4103/rcm.rcm_15_23","url":null,"abstract":"Despite many well-documented benefits of the transvenous implantable cardioverter-defibrillator in appropriate patients, there is a strong preference today for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation due to the significant late complications associated with intravenous leads, especially in young patients. We report on an 18-year-old woman with S-ICD due to hypertrophic cardiomyopathy who had idiopathic dextroscoliosis. In the follow-up analysis, we observed a disturbance in the normal detection of QRS complexes by the device, which significantly reduced when the patient changed the position from standing to supine and when the brace was closed. According to the absence of lead displacement in the chest radiograph, S-ICD sense impairment was suggested due to skeletal deformity. Due to not solving this problem with device reprogramming, we had to reposition of the S-ICD lead in our patient.","PeriodicalId":21031,"journal":{"name":"Research in Cardiovascular Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136208197","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}
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