International journal of cardiology
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Review Meta Analysis
Amiodarone and cardiac arrest: Systematic review and meta-analysis.
The 2015 Guidelines for Resuscitation recommend amiodarone as the antiarrhythmic drug of choice in the treatment of resistant ventricular fibrillation or pulseless ventricular tachycardia. We reviewed the effects of amiodarone on survival and neurological outcome after cardiac arrest. ⋯ Amiodarone significantly improves survival to hospital admission. However there is no benefit of amiodarone in survival to discharge or neurological outcomes compared to placebo or other antiarrhythmics.
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Remote ischemic preconditioning (RIPC) has been associated with reduced risk of myocardial injury in patients undergoing cardiovascular surgery, but uncertainty about clinical outcomes remains, particularly in the light of 2 recent large randomized clinical trials (RCTs) which were neutral. We performed a meta-analysis to evaluate the efficacy of RIPC on clinically relevant outcomes in patients undergoing cardiovascular surgery. ⋯ RIPC did not decrease overall mortality, but was associated with less MI and acute renal failure and shorter hospitalizations in patients undergoing cardiac or vascular surgery.
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Dipeptidyl Peptidase 4 Inhibitors (DPP4-I) and Sodium-Glucose Linked coTransporter-2 Inhibitors (SGLT2-I) improve glycemic control in patients with type 2 diabetes mellitus (DM). However, only few studies were designed to assess the efficacy and safety of these drugs on cardiovascular (CV) events and mortality. The purpose of the current study was to evaluate the effects of DPP4-Is and SGLT2-Is on CV events and mortality by meta-analysis. ⋯ DPP4-Is show a safe CV profile as they do not affect mortality and CV events, including HF, in patients with type 2 DM. SGLT2-Is are associated with improved CV outcome and survival in DM patients.
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Review Meta Analysis
Culprit-lesion only versus complete multivessel percutaneous intervention in ST-elevation myocardial infarction: A systematic review and meta-analysis of randomized trials.
ST-segment elevation myocardial infarction (STEMI) in patients with concomitant multivessel (MV) coronary artery disease (CAD) is associated with poor outcomes. Percutaneous coronary intervention (PCI) of the culprit-lesion only (CLO) as compared with a MV PCI approach to revascularization remains uncertain. Our objective is to gain a better understanding of the efficacy and safety of CLO as compared with MV PCI in patients with STEMI by conducting an updated meta-analysis. ⋯ MV PCI significantly reduces the rate of MACE, CV mortality, and RRV without significant harm as compared to CLO PCI.
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To determine whether transcatheter aortic valve implantation (TAVI) improves (or impairs) follow-up overall survival compared with surgical aortic valve replacement (SAVR), we performed a meta-analysis of observational studies with a propensity-score analysis and another meta-analysis of randomized controlled trials (RCTs). ⋯ The arithmetic mean of 3-year survival rates was 71.3% after TAVI and 77.9% after SAVR. Compared with SAVR, TAVI appears to be associated with a significant increase in follow-up all-cause mortality.