Anatolian Journal of Cardiology最新文献

Background: AngioJet rheolytic thrombectomy (ART) system has been widely used as a catheter-directed treatment (CDT) method in acute pulmonary embolism (PE), however, there has been a controversy regarding the safety of its use. In this systematic review and meta-analysis, we evaluated the efficacy and safety outcomes of ART in patients with PE.

Methods: Our meta-analysis have been based on search in the MEDLINE, EMBASE, and Cochrane Library for studies published up to August 2022. The primary outcomes were overall pooled rates of major bleeding (MB) and minor bleeding (mB), worsening renal function (WRF), bradycardia/conduction disturbance (BCD), and PE-related and all-cause mortality in patients who underwent ART.

Results: Among the 233 studies documented at initial search, 24 studies were eligible for meta-analysis, and a total of 427 PE patients who underwent ART were evaluated. Overall pooled rates of MB and mB were 9.6% (95% CI 5.9%-15.2%) and 9.2% (95% CI 6.1%-13.6%), transient BCD and WRF were 18.2% (95% CI 12.4%-26%) and 15% (95% CI 10%-21.8%), and PE-related death and all-cause death were 12.7% (95% CI 9.1%-17.3%) and 15% (95% CI 11%-20%), respectively. However, significant heterogeneity and some evidence of funnel plot asymmetry and publication bias were noted for MB, BCD and WRF, but not for PE-related death and all-cause death.

Conclusion: Overall pooled rates of bleeding events, BCD and WRF episodes, PE-related death and all-cause death may be considered as encouraging results for efficacy and safety issues of ART utilization in specific scenarios of acute PE, and a reappraisal for black-box warning on ART seems to be necessary.

Background: QRS fragmentation (fQRS) is a depolarization disorder that can be detected on routine electrocardiography (ECG). Current evidence suggests that fQRS is a prognosticator of adverse cardiovascular events. This study aimed to assess the relationship between fQRS and all-cause mortality in critically unwell coronavirus disease 2019 (COVID-19) patients and to investigate the significance of associated abnormalities on echocardiography.

Methods: A retrospective cohort study of COVID-19 patients in a critical care setting was performed. Electrocardiography was performed on presentation to hospital, admission to the critical care unit, and at subsequent points according to clinical need. Transthoracic echocardiography was performed at clinical discretion to assess for structural and functional cardiac abnormalities. Primary outcome was in-hospital mortality and secondary outcome was the need for mechanical invasive ventilation.

Results: Totally, 212 consecutive patients were included of which 120 (57%) exhibited fQRS and inferior leads were involved in 88% of the patients. Overall, fQRS was a significant predictor of mortality [65% vs. 44% P =.003; multivariate odds ratio = 2.96, 95% confidence interval (CI): 1.42-6.40, P =.005] and inferior fQRS itself was a significant predictor of mortality (P =.03). There was no significant association between fQRS and the need for invasive mechanical ventilation. A total of 112 patients underwent echocardiography. There was a greater incidence of right ventricular (RV) dilatation in the fQRS group (16% vs. 2% respectively, P =.02) and pulmonary hypertension (33% vs. 14% respectively, P =.03) based on echocardiographic criteria.

Conclusion: Our study demonstrates that fQRS is significantly associated with RV dilation, pulmonary hypertension, and mortality in critically unwell COVID-19 patients.

Background: The risk of contrast-associated acute kidney injury is relatively higher in patients with diabetes mellitus compared to non-diabetics. Recent trials have revealed the renoprotective effects of sodium-glucose cotransporter 2 (SGLT2) inhibitors. We aimed to investigate the possible preventive effect of SGLT2 inhibitors against contrast-associated acute kidney injury in the diabetic population who underwent coronary angiography with a diagnosis of stable angina or acute coronary syndrome.

Methods: This was a cross-sectional and single-center study. We enrolled 345 patients with type II diabetes mellitus who were divided into 2 groups: using an SGLT2 inhibitor (group 1; n = 133) in addition to other antidiabetic medication and not using an SGLT2 inhibitor (group 2; n = 212). Both groups were compared in terms of contrast-associated acute kidney injury incidence. We also compared groups for the duration of hospitalization.

Results: Baseline characteristics (age, sex, risk factors and medications) and laboratory findings were similar between the 2 groups. The means of administered contrast volume were also similar (160.42 (± 70.31) mL vs. 158.72 (± 81.24) mL, P = 0.83) between groups 1 and 2, respectively. We found that contrast-associated acute kidney injury incidence was significantly higher in group 2 compared to group 1 (n = 56 (26.4%) vs. n = 12 (9.0%), P < 0.001). The duration of hospitalization was significantly longer in group 2 (3.25 (± 2.03) days) than in group 1 (2.54 (± 1.39) days) (P = 0.001).

Conclusion: We found that contrast-associated acute kidney injury was significantly lower, and the duration of hospitalization was significantly shorter in diabetic patients using SGLT2 inhibitors compared to non-users.

Background: In recent years, studies reported that the incidence of infective endocarditis (IE) has increased despite the decrease in rheumatic heart diseases, great advances in medical and surgical treatment methods, and prophylactic antibiotic therapies. However, there is no bibliometric analysis based on the visual mapping method in the literature. In the study, we aimed to analyze the hot topics in IE, the distribution of publications in terms of country, institution, journal, author, and their relationships by assessing IE articles published in the 130 years between 1892 and 2022.

Methods: Publications before 2023 were analyzed using the keywords 'infective' and 'endocarditis' in the Scopus database.

Results: Approximately 25% of the publications on IE were from the USA followed by Japan, France, and the UK. A total of 116 keywords were used at least 15 times and the keywords were categorized into 9 clusters by the VOSviewer program. The keywords used more than 100 times except 'infective endocarditis' were 'echocardiography,' 'mortality,' 'surgery,' 'Staphylococcus aureus,' 'cardiac surgery,' 'epidemiology,' and 'prognosis' 247, 191, 152, 142, 130, 122, and 119 times, respectively. To the best of our knowledge, the study is the most comprehensive study globally on IE with the widest time range including the visual mapping method.

Conclusion: Since our study reveals the changes in the literature related to infective endocarditis, we think that it will be a guide in planning new research studies. We believe that periodic repetition of bibliometric analyses and keyword mapping studies will contribute to the quantitative and qualitative development of scientific productivity globally.