Thalassemia is a hereditary blood disorder characterized by reduced hemoglobin production, leading to chronic anemia. A major complication of thalassemia is iron overload, primarily due to regular blood transfusions and increased gastrointestinal iron absorption, which can lead to iron overload cardiomyopathy, a significant cause of morbidity and mortality in thalassemia patients. This review aims to provide an in-depth analysis of the pathophysiological mechanisms underlying iron overload cardiomyopathy in thalassemia, examining how excessive iron accumulation disrupts cardiac function through oxidative stress, cellular damage, and altered calcium homeostasis. Clinical manifestations, including fatigue, arrhythmias, and heart failure, are discussed alongside diagnostic strategies such as echocardiography and cardiac MRI for early detection and monitoring. Management approaches focusing on iron chelation therapy, lifestyle modifications, and advanced interventions like gene therapy are explored. The review also highlights the importance of early diagnosis, regular monitoring, and patient adherence to therapy to prevent the progression of cardiomyopathy. Recent advances in treatment and future research directions, including personalized medicine, and gene editing technologies, are presented. Addressing the challenges in managing iron overload in thalassemia patients is crucial for improving outcomes and enhancing quality of life.
{"title":"Thalassemia and iron overload cardiomyopathy: Pathophysiological insights, clinical implications, and management strategies","authors":"Bagus Aditya Ansharullah MD , Henry Sutanto MD, MSc, PhD , Pradana Zaky Romadhon MD","doi":"10.1016/j.cpcardiol.2024.102911","DOIUrl":"10.1016/j.cpcardiol.2024.102911","url":null,"abstract":"<div><div>Thalassemia is a hereditary blood disorder characterized by reduced hemoglobin production, leading to chronic anemia. A major complication of thalassemia is iron overload, primarily due to regular blood transfusions and increased gastrointestinal iron absorption, which can lead to iron overload cardiomyopathy, a significant cause of morbidity and mortality in thalassemia patients. This review aims to provide an in-depth analysis of the pathophysiological mechanisms underlying iron overload cardiomyopathy in thalassemia, examining how excessive iron accumulation disrupts cardiac function through oxidative stress, cellular damage, and altered calcium homeostasis. Clinical manifestations, including fatigue, arrhythmias, and heart failure, are discussed alongside diagnostic strategies such as echocardiography and cardiac MRI for early detection and monitoring. Management approaches focusing on iron chelation therapy, lifestyle modifications, and advanced interventions like gene therapy are explored. The review also highlights the importance of early diagnosis, regular monitoring, and patient adherence to therapy to prevent the progression of cardiomyopathy. Recent advances in treatment and future research directions, including personalized medicine, and gene editing technologies, are presented. Addressing the challenges in managing iron overload in thalassemia patients is crucial for improving outcomes and enhancing quality of life.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102911"},"PeriodicalIF":3.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548810","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}
Pub Date : 2024-10-21DOI: 10.1016/j.cpcardiol.2024.102885
Hodo Abdikarim , Mustafe Abdillahi Ali , Abdirizak Hassan Abokor , Omer Adam Farih , Asma Mahamoud Abdillahi , Abdirashid M. Yousuf , Abdisalam Hassan Muse
Background
Cardiovascular diseases (CVDs) are a leading cause of death globally, particularly in low- and middle-income countries. While data on heart disease prevalence in Somaliland is limited, the 2020 Somaliland Demographic and Health Survey (SLDHS) provides a valuable opportunity to assess this critical public health issue.
Methods
This study analyzed data from the 2020 SLDHS, a nationally representative cross-sectional survey. We included 18,930 individuals after data cleaning and variable selection. Heart disease was the outcome variable, while demographic and socioeconomic factors, including age, sex, region, residence, wealth, tobacco use, diabetes, and hypertension, were analyzed as predictors using STATA version 17.
Results
The prevalence of heart disease in Somaliland was 0.7 % (95 % CI [0.6 %, 0.9 %]). Significant associations were observed with: Sool region (AOR 1.86–6.821, p = 0.000), female sex (AOR 1.086–2.508, p = 0.019), older age groups (AOR 1.182–9.621, 1.073–11.247, 1.899–19.504 and 4.126–38.282, p = 0.023, 0.038, 0.002, 0.000 respectively), rural residence (AOR 1.025–2.198, p = 0.037), tobacco use, diabetes, and hypertension.
Conclusion
This study highlights the importance of regional disparities, gender differences, and the impact of modifiable risk factors like tobacco use, diabetes, and hypertension in influencing heart disease prevalence in Somaliland. These findings emphasize the need for targeted interventions and public health strategies to address these factors and improve cardiovascular health outcomes in the region.
背景：心血管疾病（CVDs）是导致全球死亡的主要原因，尤其是在中低收入国家。虽然有关索马里兰心脏病发病率的数据有限，但 2020 年索马里兰人口与健康调查（SLDHS）为评估这一重要的公共卫生问题提供了宝贵的机会：本研究分析了 2020 年索马里兰人口与健康调查的数据，这是一项具有全国代表性的横断面调查。经过数据清理和变量选择，我们纳入了 18930 人。心脏病是结果变量，而人口和社会经济因素，包括年龄、性别、地区、居住地、财富、吸烟、糖尿病和高血压，则作为预测因素使用 STATA 17 版进行分析：索马里兰的心脏病发病率为 0.7%（95% CI [0.6%，0.9%]）。与下列因素有显著关联126-38.282，P= 0.023、0.038、0.002、0.000）、农村居民（AOR 1.025-2.198，P= 0.037）、吸烟、糖尿病和高血压：本研究强调了地区差异、性别差异以及烟草使用、糖尿病和高血压等可改变的风险因素在影响索马里兰心脏病发病率方面的重要性。这些发现强调，需要采取有针对性的干预措施和公共卫生战略来解决这些因素，并改善该地区的心血管健康状况。
{"title":"Prevalence and determinants of heart disease in Somaliland: An analysis of the 2020 Somaliland demographic and health survey (SLDHS)","authors":"Hodo Abdikarim , Mustafe Abdillahi Ali , Abdirizak Hassan Abokor , Omer Adam Farih , Asma Mahamoud Abdillahi , Abdirashid M. Yousuf , Abdisalam Hassan Muse","doi":"10.1016/j.cpcardiol.2024.102885","DOIUrl":"10.1016/j.cpcardiol.2024.102885","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular diseases (CVDs) are a leading cause of death globally, particularly in low- and middle-income countries. While data on heart disease prevalence in Somaliland is limited, the 2020 Somaliland Demographic and Health Survey (SLDHS) provides a valuable opportunity to assess this critical public health issue.</div></div><div><h3>Methods</h3><div>This study analyzed data from the 2020 SLDHS, a nationally representative cross-sectional survey. We included 18,930 individuals after data cleaning and variable selection. Heart disease was the outcome variable, while demographic and socioeconomic factors, including age, sex, region, residence, wealth, tobacco use, diabetes, and hypertension, were analyzed as predictors using STATA version 17.</div></div><div><h3>Results</h3><div>The prevalence of heart disease in Somaliland was 0.7 % (95 % CI [0.6 %, 0.9 %]). Significant associations were observed with: Sool region (AOR 1.86–6.821, <em>p =</em> 0.000), female sex (AOR 1.086–2.508, <em>p =</em> 0.019), older age groups (AOR 1.182–9.621, 1.073–11.247, 1.899–19.504 and 4.126–38.282, <em>p =</em> 0.023, 0.038, 0.002, 0.000 respectively), rural residence (AOR 1.025–2.198, <em>p =</em> 0.037), tobacco use, diabetes, and hypertension.</div></div><div><h3>Conclusion</h3><div>This study highlights the importance of regional disparities, gender differences, and the impact of modifiable risk factors like tobacco use, diabetes, and hypertension in influencing heart disease prevalence in Somaliland. These findings emphasize the need for targeted interventions and public health strategies to address these factors and improve cardiovascular health outcomes in the region.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102885"},"PeriodicalIF":3.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512414","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}
Pub Date : 2024-10-20DOI: 10.1016/j.cpcardiol.2024.102892
Mansimran Singh Dulay , Raheel Ahmed , Alexander Liu , Rui Shi , Joseph Okafor , Alessia Azzu , Iosif Karalis , Kamleshun Ramphul , John Arun Baksi , Kshama Wechalekar , Rajdeep Khattar , Owais Dar , Peter Collins , Athol Umfrey Wells , Vasilis Kouranos , Rakesh Sharma
Background
Cardiac Resynchronisation Therapy (CRT) has demonstrated short and long-term benefit in heart failure with reduced ejection fraction (HFrEF), including ischaemic (ICM) and non-ischaemic cardiomyopathy. However, there is a paucity of evidence regarding its role in cardiac sarcoidosis (CS).
Methods
Consecutive CS patients with CRT and baseline left ventricle ejection fraction (LVEF)≤40 referred to one specialist hospital in London between November 2008-March 2023 were retrospectively reviewed. The baseline characteristics, short-term echocardiographic, clinical parameters and long-term primary and secondary outcomes were compared against a cohort of ICM patients with CRT and baseline LVEF≤40. Patients with incomplete follow-up were excluded. The primary endpoint was a composite of all-cause mortality, cardiac transplantation or heart failure hospitalisation. Secondary endpoint included ventricular arrhythmic events.
Results
63 CS and 93 ICM patients were analysed. A greater proportion of ICM patients male with older ages overall (both p < 0.01), whereas a larger proportion of CS patients had atrioventricular block and heart failure hospitalisations (both p < 0.01). Both cohorts demonstrated significant serial increase in left ventricular (LV) ejection fraction and reduction in LV end-systolic and end-diastolic volumes (p < 0.01). After a mean follow up of 40.9 (±32.0) months, the primary and secondary endpoint was reached by significantly more CS patients (log-rank p = 0.008 and log-rank p = 0.004). Age (HR: 1.12 (95 %CI 1.06-1.17, p < 0.001) and presence of CS (HR: 8.33 (95 %CI 3.03-22.93, p < 0.001) were independent predictors of the primary endpoint on multivariable analysis.
Conclusion
CS patients with CRT demonstrated reverse remodelling, but had adverse long-term primary and secondary outcomes when compared to ICM patients.
{"title":"Ascertaining the prognostic role of cardiac resynchronisation therapy in cardiac sarcoidosis: A comparison with ischaemic cardiomyopathy","authors":"Mansimran Singh Dulay , Raheel Ahmed , Alexander Liu , Rui Shi , Joseph Okafor , Alessia Azzu , Iosif Karalis , Kamleshun Ramphul , John Arun Baksi , Kshama Wechalekar , Rajdeep Khattar , Owais Dar , Peter Collins , Athol Umfrey Wells , Vasilis Kouranos , Rakesh Sharma","doi":"10.1016/j.cpcardiol.2024.102892","DOIUrl":"10.1016/j.cpcardiol.2024.102892","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac Resynchronisation Therapy (CRT) has demonstrated short and long-term benefit in heart failure with reduced ejection fraction (HFrEF), including ischaemic (ICM) and non-ischaemic cardiomyopathy. However, there is a paucity of evidence regarding its role in cardiac sarcoidosis (CS).</div></div><div><h3>Methods</h3><div>Consecutive CS patients with CRT and baseline left ventricle ejection fraction (LVEF)≤40 referred to one specialist hospital in London between November 2008-March 2023 were retrospectively reviewed. The baseline characteristics, short-term echocardiographic, clinical parameters and long-term primary and secondary outcomes were compared against a cohort of ICM patients with CRT and baseline LVEF≤40. Patients with incomplete follow-up were excluded. The primary endpoint was a composite of all-cause mortality, cardiac transplantation or heart failure hospitalisation. Secondary endpoint included ventricular arrhythmic events.</div></div><div><h3>Results</h3><div>63 CS and 93 ICM patients were analysed. A greater proportion of ICM patients male with older ages overall (both p < 0.01), whereas a larger proportion of CS patients had atrioventricular block and heart failure hospitalisations (both p < 0.01). Both cohorts demonstrated significant serial increase in left ventricular (LV) ejection fraction and reduction in LV end-systolic and end-diastolic volumes (p < 0.01). After a mean follow up of 40.9 (±32.0) months, the primary and secondary endpoint was reached by significantly more CS patients (log-rank p = 0.008 and log-rank p = 0.004). Age (HR: 1.12 (95 %CI 1.06-1.17, p < 0.001) and presence of CS (HR: 8.33 (95 %CI 3.03-22.93, p < 0.001) were independent predictors of the primary endpoint on multivariable analysis.</div></div><div><h3>Conclusion</h3><div>CS patients with CRT demonstrated reverse remodelling, but had adverse long-term primary and secondary outcomes when compared to ICM patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102892"},"PeriodicalIF":3.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480086","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}
Pub Date : 2024-10-19DOI: 10.1016/j.cpcardiol.2024.102889
Fan Yang , Jierui Wang , Shouling Wu , Shuohua Chen , Liufu Cui
Objective
This study aimed to investigate the effect of the ratio of cumUHR on MI, based on the hypothesis that higher exposure to the ratio of cumUHR is associated with a higher risk of MI.
Methods
Participants who underwent three examinations between 2006 and 2010 were selected. The cumUHR from baseline to the third check was calculated, multiplying the mean between consecutive checks by the time interval between visits. The association between cumUHR and MI and its progression was evaluated by Cox proportional hazards regression model. The cumulative incidence of endpoint events between cumUHR groups was compared using a log-rank test. Stratification by age, sex, and BMI was further performed.
Results
A total of 53,697 people, with an average age of 53.08 years, 78 % of whom were male, with a median follow-up of 10.51 years and 744 myocardial infarction events, were enrolled. The highest cumUHR quartile, MI, had the highest cumulative incidence (log-rank P < 0.01). Multivariate COX regression analysis showed that in the fully adjusted model, there was a high level of concentration in the highest cumUHR quartile (HR, 1.52; 95 % CI, 1.20-1.92) and participants with longer duration of high UHR exposure (HR, 1.55; 95 % CI, 1.22-1.97).
Conclusions
The risk of MI increases with cumUHR and is influenced by the time course of cumUHR. In particular, in people aged ≥ 60 years, males, and BMI < 28 kg/m2, the risk of MI is more affected by the level of UHR, and more attention should be paid to controlling the level of UHR.
{"title":"Effect of cumulative uric acid to high-density lipoprotein cholesterol ratio on myocardial infarction in prospective cohorts","authors":"Fan Yang , Jierui Wang , Shouling Wu , Shuohua Chen , Liufu Cui","doi":"10.1016/j.cpcardiol.2024.102889","DOIUrl":"10.1016/j.cpcardiol.2024.102889","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the effect of the ratio of cumUHR on MI, based on the hypothesis that higher exposure to the ratio of cumUHR is associated with a higher risk of MI.</div></div><div><h3>Methods</h3><div>Participants who underwent three examinations between 2006 and 2010 were selected. The cumUHR from baseline to the third check was calculated, multiplying the mean between consecutive checks by the time interval between visits. The association between cumUHR and MI and its progression was evaluated by Cox proportional hazards regression model. The cumulative incidence of endpoint events between cumUHR groups was compared using a log-rank test. Stratification by age, sex, and BMI was further performed.</div></div><div><h3>Results</h3><div>A total of 53,697 people, with an average age of 53.08 years, 78 % of whom were male, with a median follow-up of 10.51 years and 744 myocardial infarction events, were enrolled. The highest cumUHR quartile, MI, had the highest cumulative incidence (log-rank P < 0.01). Multivariate COX regression analysis showed that in the fully adjusted model, there was a high level of concentration in the highest cumUHR quartile (HR, 1.52; 95 % CI, 1.20-1.92) and participants with longer duration of high UHR exposure (HR, 1.55; 95 % CI, 1.22-1.97).</div></div><div><h3>Conclusions</h3><div>The risk of MI increases with cumUHR and is influenced by the time course of cumUHR. In particular, in people aged ≥ 60 years, males, and BMI < 28 kg/m<sup>2</sup>, the risk of MI is more affected by the level of UHR, and more attention should be paid to controlling the level of UHR.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102889"},"PeriodicalIF":3.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480089","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}
Pub Date : 2024-10-19DOI: 10.1016/j.cpcardiol.2024.102887
Aluisio Andrade-Lima , Natan D. Silva Junior , Marcel R. Chehuen , Roberto S. Miyasato , Patricia C. Brum , Edilamar M. Oliveira , Anthony S. Leicht , Nelson Wolosker , Claudia L.M. Forjaz
Purpose
This study investigated whether: 1) walking training (WT) changes cardiovascular load after walking until maximal intermittent claudication (IC) in patients with peripheral artery disease (PAD); and 2) acute and chronic cardiovascular responses to walking were related to each other.
Methods
A randomized, controlled, parallel-group design was employed. Thirty-two men with PAD and IC were randomly assigned to one of two groups: WT (n=16) or control (CO, n=16) twice a week for 12 weeks. The WT group completed 15, 2-min bouts of walking at moderate intensity interspersed with 2-min upright resting intervals per session. The CO group completed 30 minutes of stretching per session. At Baseline and after 12 weeks, both groups underwent a progressive walking session to maximal IC (3.2 km/h, 2% increase in grade every 2 min). Systolic blood pressure (BP), diastolic BP, heart rate (HR), and rate pressure product (RPP) were measured pre- and post-walking. Data were analyzed by three-way mixed ANOVAs. Pearson correlations were used to explore the association between the acute and chronic responses.
Results
WT significantly reduced pre- and post-walking systolic BP (p<0.001), diastolic BP (p<0.001), and RPP (p<0.001). No significant correlations were found between the acute and chronic changes observed for all variables (all p>0.05).
Conclusion
In patients with PAD, WT decreased cardiovascular load assessed before and after walking to maximal IC. Furthermore, the acute and chronic cardiovascular responses to walking were not associated. Thus, WT may reduce the risk of immediate post-walking cardiac events in susceptible patients.
目的：本研究探讨了以下问题：1) 外周动脉疾病（PAD）患者在步行至最大间歇性跛行（IC）后，步行训练（WT）是否会改变心血管负荷；以及 2) 步行的急性和慢性心血管反应是否相互关联：方法：采用随机对照平行组设计。32 名患有 PAD 和 IC 的男性被随机分配到两组中的一组：WT组（n=16）或对照组（CO，n=16），每周两次，为期12周。WT 组完成 15 次、每次 2 分钟的中等强度步行，中间穿插 2 分钟的直立休息。CO 组每次完成 30 分钟的伸展运动。在基线和 12 周后，两组都进行了渐进式步行训练，以达到最大 IC（3.2 公里/小时，每 2 分钟坡度增加 2%）。步行前后测量了收缩压、舒张压、心率和率压乘积。数据采用三方混合方差分析。皮尔逊相关性用于探讨急性和慢性反应之间的关联：结果：WT 能明显降低步行前后的收缩压（P0.05）：结论：在 PAD 患者中，WT 可降低步行至最大 IC 前后的心血管负荷。此外，步行的急性和慢性心血管反应并无关联。因此，WT 可以降低易感患者在步行后立即发生心脏事件的风险。
{"title":"Walking training decreases cardiovascular load after walking to maximal intermittent claudication in patients with peripheral artery disease","authors":"Aluisio Andrade-Lima , Natan D. Silva Junior , Marcel R. Chehuen , Roberto S. Miyasato , Patricia C. Brum , Edilamar M. Oliveira , Anthony S. Leicht , Nelson Wolosker , Claudia L.M. Forjaz","doi":"10.1016/j.cpcardiol.2024.102887","DOIUrl":"10.1016/j.cpcardiol.2024.102887","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigated whether: 1) walking training (WT) changes cardiovascular load after walking until maximal intermittent claudication (IC) in patients with peripheral artery disease (PAD); and 2) acute and chronic cardiovascular responses to walking were related to each other.</div></div><div><h3>Methods</h3><div>A randomized, controlled, parallel-group design was employed. Thirty-two men with PAD and IC were randomly assigned to one of two groups: WT (n=16) or control (CO, n=16) twice a week for 12 weeks. The WT group completed 15, 2-min bouts of walking at moderate intensity interspersed with 2-min upright resting intervals per session. The CO group completed 30 minutes of stretching per session. At Baseline and after 12 weeks, both groups underwent a progressive walking session to maximal IC (3.2 km/h, 2% increase in grade every 2 min). Systolic blood pressure (BP), diastolic BP, heart rate (HR), and rate pressure product (RPP) were measured pre- and post-walking. Data were analyzed by three-way mixed ANOVAs. Pearson correlations were used to explore the association between the acute and chronic responses<strong>.</strong></div></div><div><h3>Results</h3><div>WT significantly reduced pre- and post-walking systolic BP (p<0.001), diastolic BP (p<0.001), and RPP (p<0.001). No significant correlations were found between the acute and chronic changes observed for all variables (all p>0.05).</div></div><div><h3>Conclusion</h3><div>In patients with PAD, WT decreased cardiovascular load assessed before and after walking to maximal IC. Furthermore, the acute and chronic cardiovascular responses to walking were not associated. Thus, WT may reduce the risk of immediate post-walking cardiac events in susceptible patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102887"},"PeriodicalIF":3.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480093","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}
<div><div>Over the past 70 years, there has been extensive research focused on preventing chemotherapy-related cardiovascular complications. However, the current state of cardio-oncology research has raised more questions than answers. Experimental studies often present data that are difficult to compare and, at times, contradictory. One notable limitation in translating experimental findings to clinical practice is the reliance on models that administer only one chemotherapeutic drug to experimental animals, despite the common use of multidrug cancer treatments in real clinical settings. This article aims to discuss our own experience in modeling an experimental rat model of cardiomyopathy induced by the administration of two chemotherapeutic drugs, doxorubicin (adriamycin) and cyclophosphamide (AC mode of chemotherapy) – Avagimyan A., et al model, along with a subsequent review of morphological changes based on our personal archive.<ul><li><span>1.</span><span><div>AC - Doxorubicin (Adriamycin) + Cyclophosphamide</div></span></li><li><span>2.</span><span><div>CaMKII - Calcium/Calmodulin-dependent protein kinase II</div></span></li><li><span>3.</span><span><div>Circ-INSR - Circulating Insulin Receptor</div></span></li><li><span>4.</span><span><div>CVDs - Cardiovascular Diseases</div></span></li><li><span>5.</span><span><div>CP – Cardioprotector</div></span></li><li><span>6.</span><span><div>GLUT - Glucose Transporter</div></span></li><li><span>7.</span><span><div>HF – Heart Failure</div></span></li><li><span>8.</span><span><div>ICAM - Intercellular Adhesion Molecule</div></span></li><li><span>9.</span><span><div>IL - Interleukin</div></span></li><li><span>10.</span><span><div>IκBα - Inhibitor of kappa B alpha</div></span></li><li><span>11.</span><span><div>MMP - Matrix Metalloproteinase</div></span></li><li><span>12.</span><span><div>MyD88 - Myeloid Differentiation Primary Response 88</div></span></li><li><span>13.</span><span><div>NADP+ - Nicotinamide Adenine Dinucleotide Phosphate</div></span></li><li><span>14.</span><span><div>NADPH - Nicotinamide Adenine Dinucleotide Phosphate Hydrogen</div></span></li><li><span>15.</span><span><div>NF-κB - Nuclear Factor kappa B</div></span></li><li><span>16.</span><span><div>NLRP3 - Nucleotide-binding domain, leucine-rich repeat containing protein 3</div></span></li><li><span>17.</span><span><div>NOS - Nitric Oxide Synthase</div></span></li><li><span>18.</span><span><div>Nrf2 - Nuclear factor erythroid 2-related factor 2</div></span></li><li><span>19.</span><span><div>NT-proBNP - N-terminal pro-B-type natriuretic peptide</div></span></li><li><span>20.</span><span><div>PLN - Phospholamban</div></span></li><li><span>21.</span><span><div>RyR - Ryanodine receptor</div></span></li><li><span>22.</span><span><div>SERCA2a - Sarco/Endoplasmic Reticulum Calcium ATPase 2a</div></span></li><li><span>23.</span><span><div>Sirt3 - Sirtuin 3</div></span></li><li><span>24.</span><span><div>SMAD3 - Mothers Against Decapenta
在过去的 70 年中，人们对预防化疗相关心血管并发症进行了广泛的研究。然而，心血管肿瘤学研究的现状是问题多于答案。实验研究中的数据往往难以比较，有时甚至相互矛盾。将实验结果转化为临床实践的一个显著局限是，尽管在实际临床环境中普遍使用多种药物治疗癌症，但实验动物却只能依赖于使用一种化疗药物的模型。本文旨在讨论我们自己在建立由两种化疗药物多柔比星（阿霉素）和环磷酰胺（AC 化疗模式）诱导的心肌病实验大鼠模型方面的经验--Avagimyan A. 等人的模型，以及随后根据我们的个人档案对形态学变化的回顾。
{"title":"Doxorubicin and cyclophosphamide mode of chemotherapy–related cardiomyopathy: Review of preclinical model","authors":"Ashot Avagimyan , Lev Kakturskiy , Nana Pogosova , Giulia Ottaviani , Manfredi Rizzo , Nizal Sarrafzadegan","doi":"10.1016/j.cpcardiol.2024.102882","DOIUrl":"10.1016/j.cpcardiol.2024.102882","url":null,"abstract":"<div><div>Over the past 70 years, there has been extensive research focused on preventing chemotherapy-related cardiovascular complications. However, the current state of cardio-oncology research has raised more questions than answers. Experimental studies often present data that are difficult to compare and, at times, contradictory. One notable limitation in translating experimental findings to clinical practice is the reliance on models that administer only one chemotherapeutic drug to experimental animals, despite the common use of multidrug cancer treatments in real clinical settings. This article aims to discuss our own experience in modeling an experimental rat model of cardiomyopathy induced by the administration of two chemotherapeutic drugs, doxorubicin (adriamycin) and cyclophosphamide (AC mode of chemotherapy) – Avagimyan A., et al model, along with a subsequent review of morphological changes based on our personal archive.<ul><li><span>1.</span><span><div>AC - Doxorubicin (Adriamycin) + Cyclophosphamide</div></span></li><li><span>2.</span><span><div>CaMKII - Calcium/Calmodulin-dependent protein kinase II</div></span></li><li><span>3.</span><span><div>Circ-INSR - Circulating Insulin Receptor</div></span></li><li><span>4.</span><span><div>CVDs - Cardiovascular Diseases</div></span></li><li><span>5.</span><span><div>CP – Cardioprotector</div></span></li><li><span>6.</span><span><div>GLUT - Glucose Transporter</div></span></li><li><span>7.</span><span><div>HF – Heart Failure</div></span></li><li><span>8.</span><span><div>ICAM - Intercellular Adhesion Molecule</div></span></li><li><span>9.</span><span><div>IL - Interleukin</div></span></li><li><span>10.</span><span><div>IκBα - Inhibitor of kappa B alpha</div></span></li><li><span>11.</span><span><div>MMP - Matrix Metalloproteinase</div></span></li><li><span>12.</span><span><div>MyD88 - Myeloid Differentiation Primary Response 88</div></span></li><li><span>13.</span><span><div>NADP+ - Nicotinamide Adenine Dinucleotide Phosphate</div></span></li><li><span>14.</span><span><div>NADPH - Nicotinamide Adenine Dinucleotide Phosphate Hydrogen</div></span></li><li><span>15.</span><span><div>NF-κB - Nuclear Factor kappa B</div></span></li><li><span>16.</span><span><div>NLRP3 - Nucleotide-binding domain, leucine-rich repeat containing protein 3</div></span></li><li><span>17.</span><span><div>NOS - Nitric Oxide Synthase</div></span></li><li><span>18.</span><span><div>Nrf2 - Nuclear factor erythroid 2-related factor 2</div></span></li><li><span>19.</span><span><div>NT-proBNP - N-terminal pro-B-type natriuretic peptide</div></span></li><li><span>20.</span><span><div>PLN - Phospholamban</div></span></li><li><span>21.</span><span><div>RyR - Ryanodine receptor</div></span></li><li><span>22.</span><span><div>SERCA2a - Sarco/Endoplasmic Reticulum Calcium ATPase 2a</div></span></li><li><span>23.</span><span><div>Sirt3 - Sirtuin 3</div></span></li><li><span>24.</span><span><div>SMAD3 - Mothers Against Decapenta","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102882"},"PeriodicalIF":3.0,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480088","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}
Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.
A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (n = 130) and 13 retrospective studies (n = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.
UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.
UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.
{"title":"Current evidence of unicuspid aortic valve in young adults: A systematic review and metanalysis","authors":"Andreina Carbone MD , Francesco Ferrara MD, PhD , Roberta Bottino MD , Valentina Russo MD , Salvatore Rega MD , Giuseppe Limongelli MD, PhD , Eduardo Bossone MD, PhD , Arturo Evangelista MD, PhD","doi":"10.1016/j.cpcardiol.2024.102884","DOIUrl":"10.1016/j.cpcardiol.2024.102884","url":null,"abstract":"<div><div>Unicuspid aortic valve (UAV) is a rare congenital valvular anomaly, often misdiagnosed as the more prevalent bicuspid aortic valve (BAV). The aim of this study was to explore demographic, clinical characteristics, diagnosis, surgical options, short and long term outcomes of young adults with UAV.</div><div>A systematic review and meta-analysis of literature were conducted for studies (1971-2024) including patients (≥ 14 years old) with diagnosis of UAV. Among the 2953 studies retrieved, 67 case reports, 6 case series (<em>n</em> = 130) and 13 retrospective studies (<em>n</em> = 918), were included in the analysis. Data from retrospective studies were aggregated using a random effects model for estimating the pooled risk ratio and mean difference.</div><div>UAV is mostly unicommissural in adults (mean age 36 years old at diagnosis, 76–79 % males). The most common conditions associated in UAV patients were aortic coarctation (from 3.8 to 12 %), ventricular septal defect (3 %) and Turner syndrome (3 %). In general, the diagnosis was performed with TTE and confirmed with TEE (+/- 3D-TEE). The most common types of surgery were AVR. Dilated ascending aorta was described in 44 % and 35 % of retrospective studies and case reports, respectively. Concomitant ascending aorta replacement/repair was reported 38 % and 27 % of retrospective studies and case reports, respectively. Overall survival was reported in 3 studies, ranging from 95 to 98 % at 10 years.</div><div>UAV should be considered a separate entity from BAV. Further investigations with regards to the possibility of a familial incidence, associated histopathological changes in the aorta, and ideal follow up and intervention are needed.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102884"},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480087","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}
Pub Date : 2024-10-18DOI: 10.1016/j.cpcardiol.2024.102888
Ibrahim Halil Satıcı RN , Derya Tülüce PhD, RN
Background
This study was conducted with descriptive design to determine the level of knowledge and quality of life of individuals suffering from coronary artery disease.
Methods
The study was conducted with 236 patients who applied to the cardiology outpatient clinic of a training and research hospital between November 2021 and April 2022. The data of the study were collected by personal information form, coronary artery disease education questionnaire-II and cardiac health profile scale.
Results
The patients’ total mean score for the coronary artery disease education questionnaire-II was 25.71±12.49. According to the total score obtained from the coronary artery disease education questionnaire-II, it was determined that 49.2% of the patients had an "insufficient" knowledge level, 44.5% "Poor", and 5.9% "Acceptable". Knowledge level of only one patient was good. In the chest pain classification of the cardiac health profile scale, the chest pain level of 28.4% of the patients was the "class II". Total mean score of the patients for the cardiac health profile scale was 679.88±245.89.
Discussion
It was found that the level of knowledge of the participants about coronary artery disease was insufficient and their level of quality of life was moderate. It is recommended to organize education programs based on the education, culture, perception of health, spoken language in order to elevate their knowledge level and thus their level of quality of life.
{"title":"The level of knowledge related to the disease and quality of life among coronary artery patients","authors":"Ibrahim Halil Satıcı RN , Derya Tülüce PhD, RN","doi":"10.1016/j.cpcardiol.2024.102888","DOIUrl":"10.1016/j.cpcardiol.2024.102888","url":null,"abstract":"<div><h3>Background</h3><div>This study was conducted with descriptive design to determine the level of knowledge and quality of life of individuals suffering from coronary artery disease.</div></div><div><h3>Methods</h3><div>The study was conducted with 236 patients who applied to the cardiology outpatient clinic of a training and research hospital between November 2021 and April 2022. The data of the study were collected by personal information form, coronary artery disease education questionnaire-II and cardiac health profile scale.</div></div><div><h3>Results</h3><div>The patients’ total mean score for the coronary artery disease education questionnaire-II was 25.71±12.49. According to the total score obtained from the coronary artery disease education questionnaire-II, it was determined that 49.2% of the patients had an \"insufficient\" knowledge level, 44.5% \"Poor\", and 5.9% \"Acceptable\". Knowledge level of only one patient was good. In the chest pain classification of the cardiac health profile scale, the chest pain level of 28.4% of the patients was the \"class II\". Total mean score of the patients for the cardiac health profile scale was 679.88±245.89.</div></div><div><h3>Discussion</h3><div>It was found that the level of knowledge of the participants about coronary artery disease was insufficient and their level of quality of life was moderate. It is recommended to organize education programs based on the education, culture, perception of health, spoken language in order to elevate their knowledge level and thus their level of quality of life.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102888"},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480092","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}
Pub Date : 2024-10-18DOI: 10.1016/j.cpcardiol.2024.102890
Sindew Mahmud Ahmed , Aynie Berhane , Jenber Fekade
Objectives
The aim of this study was to assess quality of life and associated factors among hypertensive patients attending in public hospital at Addis Ababa.
Methods and material
An institutional -based cross-sectional study was conduct among adults in Addis Ababa selected public hospitals. Systematic sampling technique was used to select 423 study participants after proportional allocation was made on each hospital. Data was collected by questionnaire adapted from WHO STEP wise approach to Surveillance on NCDs modified by the FMOH and EPHI. Data entry, cleaning by data exploration and analysis was done by using SPSS. Descriptive and logistic regression models were used for data analysis. The result was considered statistically significant at p < 0.05.
Result
The magnitude of high health-related quality of life in hypertensive patients was 53.6% (with 95% CI: 48.6-58.6). Having experienced any complications co morbidities HRQOL (AOR = 7.177; CI = 4.761–9.698), Starting treatment for hypertension below 3 years were (AOR= 3.029: CI=2.406-9.133, higher educational level (AOR=3.477: CI= 0.708-17.059), age 40 and above (AOR=3.216: CI= 1.073-9.643), having an income of <3000birr (AOR=1.75: CI= 1.14-2.68) were significantly associated with the dependent variable.
Conclusions and recommendation
This study showed the magnitude of low health-related quality of life in hypertensive patients is high. Having complications or co morbidities, starting treatment for hypertension below 3 years, being educated, older age, income of less than 3000 per month were factors associated to low health related quality of life in hypertensive patients.
{"title":"Health related quality of life and associated factors among hypertensive patients attending public hospitals in Addis Ababa, Ethiopia, 2024","authors":"Sindew Mahmud Ahmed , Aynie Berhane , Jenber Fekade","doi":"10.1016/j.cpcardiol.2024.102890","DOIUrl":"10.1016/j.cpcardiol.2024.102890","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this study was to assess quality of life and associated factors among hypertensive patients attending in public hospital at Addis Ababa.</div></div><div><h3>Methods and material</h3><div>An institutional -based cross-sectional study was conduct among adults in Addis Ababa selected public hospitals. Systematic sampling technique was used to select 423 study participants after proportional allocation was made on each hospital. Data was collected by questionnaire adapted from WHO STEP wise approach to Surveillance on NCDs modified by the FMOH and EPHI. Data entry, cleaning by data exploration and analysis was done by using SPSS. Descriptive and logistic regression models were used for data analysis. The result was considered statistically significant at p < 0.05.</div></div><div><h3>Result</h3><div>The magnitude of high health-related quality of life in hypertensive patients was 53.6% (with 95% CI: 48.6-58.6). Having experienced any complications co morbidities HRQOL (AOR = 7.177; CI = 4.761–9.698), Starting treatment for hypertension below 3 years were (AOR= 3.029: CI=2.406-9.133, higher educational level (AOR=3.477: CI= 0.708-17.059), age 40 and above (AOR=3.216: CI= 1.073-9.643), having an income of <3000birr (AOR=1.75: CI= 1.14-2.68) were significantly associated with the dependent variable.</div></div><div><h3>Conclusions and recommendation</h3><div>This study showed the magnitude of low health-related quality of life in hypertensive patients is high. Having complications or co morbidities, starting treatment for hypertension below 3 years, being educated, older age, income of less than 3000 per month were factors associated to low health related quality of life in hypertensive patients.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102890"},"PeriodicalIF":3.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142480090","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}
Pub Date : 2024-10-10DOI: 10.1016/j.cpcardiol.2024.102878
Ayesha Younas , Zainab Awan , Tehreem Khan , Samay Mehta , Aqsa Munir , Hafsa Arshad Azam Raja , Hritvik Jain , Ahmed Raza , Ayesha Sehar , Raheel Ahmed , Abdulqadir J. Nashwan
Introduction
Myocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI.
Methods
A Comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI from inception till May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, incidence of cardiac arrest, hospitalization urgency, incidence of recurrent MI, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and mean differences (MD) were pooled under the random-effects model.
Results
Eleven trials with 7161 patients were included in our analysis out of which 3546 (49.51 %) were allocated to colchicine and 3591 (50.14 %) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR = 0.75, 95 % CI: 0.60-0.94, P = 0.01, I2 = 47 %), and hospitalization urgency (RR = 0.46, 95 % CI: 0.31-0.68, P = 0.0001, I2 = 0 %) but statistically significant increment in adverse gastrointestinal events (RR = 1.86, 95 % CI: 1.14-3.02, P = 0.01, I2 = 79 %). However, all-cause mortality (RR = 1.00, 95 % CI: 0.72-1.39, P = 0.98, I2 = 0 %), incidence of cardiac arrest (RR = 0.81, 95 % CI: 0.33-1.95, P = 0.63, I2 = 0), incidence of stroke (RR = 0.45, 95 % CI: 0.17-1.19, P = 0.11, I2 = 36 %), incidence of recurrent MI (RR = 0.78, 95 % CI: 0.57-1.06, P = 0.11, I2 = 11 %) and the levels of hs-CRP (MD= -0.87, 95 %CI: -1.80-0.06, P=0.07, I2=67 % remained comparable across the two groups.
Conclusion
The use of colchicine post-MI reduces the composite of adverse cardiovascular events, and hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence, incidence of recurrent MI and the levels of hs-CRP. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.
{"title":"The effect of colchicine on myocardial infarction: An updated systematic review and meta-analysis of randomized controlled trials","authors":"Ayesha Younas , Zainab Awan , Tehreem Khan , Samay Mehta , Aqsa Munir , Hafsa Arshad Azam Raja , Hritvik Jain , Ahmed Raza , Ayesha Sehar , Raheel Ahmed , Abdulqadir J. Nashwan","doi":"10.1016/j.cpcardiol.2024.102878","DOIUrl":"10.1016/j.cpcardiol.2024.102878","url":null,"abstract":"<div><h3>Introduction</h3><div>Myocardial infarction (MI) is associated with a significant post-event inflammatory response which further contributes to post-MI prognosis. Colchicine, an anti-inflammatory agent, exhibits potential benefits in various cardiovascular conditions such as coronary artery disease, pericarditis and atrial fibrillation. This meta-analysis predominantly aimed to provide an up-to-date evaluation of the efficacy and safety of colchicine in reducing adverse cardiovascular events in patients following acute MI.</div></div><div><h3>Methods</h3><div>A Comprehensive search was conducted on PubMed, Cochrane Library, Scopus, Google Scholar and clinicaltrials.gov for randomized controlled trials (RCTs) investigating the effect of colchicine on patients with MI from inception till May 2024. Our primary outcome was a composite of adverse cardiovascular events, while secondary outcomes included all-cause mortality, incidence of stroke, incidence of cardiac arrest, hospitalization urgency, incidence of recurrent MI, adverse gastrointestinal events and levels of high-sensitivity C - reactive protein (Hs-CRP). Risk ratios (RR) and mean differences (MD) were pooled under the random-effects model.</div></div><div><h3>Results</h3><div>Eleven trials with 7161 patients were included in our analysis out of which 3546 (49.51 %) were allocated to colchicine and 3591 (50.14 %) received placebo. Colchicine demonstrated statistically significant reduction in the composite of adverse cardiovascular events (RR = 0.75, 95 % CI: 0.60-0.94, P = 0.01, I<sup>2</sup> = 47 %), and hospitalization urgency (RR = 0.46, 95 % CI: 0.31-0.68, P = 0.0001, I<sup>2</sup> = 0 %) but statistically significant increment in adverse gastrointestinal events (RR = 1.86, 95 % CI: 1.14-3.02, P = 0.01, I<sup>2</sup> = 79 %). However, all-cause mortality (RR = 1.00, 95 % CI: 0.72-1.39, P = 0.98, I<sup>2</sup> = 0 %), incidence of cardiac arrest (RR = 0.81, 95 % CI: 0.33-1.95, P = 0.63, I<sup>2</sup> = 0), incidence of stroke (RR = 0.45, 95 % CI: 0.17-1.19, P = 0.11, I<sup>2</sup> = 36 %), incidence of recurrent MI (RR = 0.78, 95 % CI: 0.57-1.06, P = 0.11, I<sup>2</sup> = 11 %) and the levels of hs-CRP (MD= -0.87, 95 %CI: -1.80-0.06, P=0.07, I<sup>2</sup>=67 % remained comparable across the two groups.</div></div><div><h3>Conclusion</h3><div>The use of colchicine post-MI reduces the composite of adverse cardiovascular events, and hospitalization urgency but increases adverse gastrointestinal events. However, colchicine does not impact all-cause mortality, cardiac arrest, stroke incidence, incidence of recurrent MI and the levels of hs-CRP. Large scale multicenter RCTs especially with longer follow-up duration are warranted to validate these findings.</div></div>","PeriodicalId":51006,"journal":{"name":"Current Problems in Cardiology","volume":"50 1","pages":"Article 102878"},"PeriodicalIF":3.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407191","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}
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