Acta cardiologica
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Randomized Controlled Trial
Treatment practices and lipid profile of patients with acute coronary syndrome: results from a tertiary care hospital.
Background: Considering the increasing burden of cardiovascular risk factors and recent advances on the management of acute coronary syndromes (ACS), we studied the epidemiological characteristics and treatment strategies of patients presenting with ACS. We also evaluated the lipid profile and attainment of lipid goals in a 'real world' clinical setting. Methods: This was a substudy of IDEAL-LDL (Motivational interviewing to support low-density lipoprotein cholesterol (LDL-C) therapeutic goals and lipid-lowering therapy compliance in patients with acute coronary syndromes), a single-centre, prospective, randomised controlled trial. ⋯ Only 22.3% of these CAD patients had an optimal LDL-C of <70 mg/dl at admission. Conclusions: In hospitalised patients with ACS, management practices differed by ACS type and discharge medication was, mostly, in line with the latest guidelines. However, medication adherence and lipid lowering goals of secondary CAD prevention were largely unachieved.
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Randomized Controlled Trial
Efficacy of losartan as add-on therapy to prevent aortic growth and ventricular dysfunction in patients with Marfan syndrome: a randomized, double-blind clinical trial.
Marfan syndrome (MFS) is a multisystemic hereditary connective tissue disease. Aortic root aneurysms and dissections are the most common and life-threatening cardiovascular disorders affecting these patients. Other cardiac manifestations include mitral valve prolapse, ventricular dysfunction and arrhythmias. Medical treatment of cardiovascular features is ultimately aimed at slowing down aortic root growth rate and preventing dissection. Losartan has been proposed as a new therapeutic tool for this purpose. To which extent losartan affects cardiac function has not been studied previously. ⋯ Losartan on top of beta-blocker therapy has no additional effect on aortic growth or on cardiac function in patients with MFS. Our results are underpowered but are in line with the result from other groups. In order to have a better insight on whether a group of patients could benefit more from losartan therapy, the outcome of an on-going meta-analysis should be awaited.
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Randomized Controlled Trial Comparative Study
Rosuvastatin versus atorvastatin to prevent contrast induced nephropathy in patients undergoing primary percutaneous coronary intervention (ROSA-cIN trial).
We aimed to compare the incidence of contrast-induced nephropathy (CIN) between atorvastatin versus rosuvastatin in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary coronary angioplasty. ⋯ Atorvastatin and rosuvastatin had similar efficacy in preventing CIN in patients with STEMI undergoing P-PCI.
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Randomized Controlled Trial
Prophylactic intra-aortic balloon pump reduces C-reactive protein levels and early mortality in high-risk patients undergoing percutaneous coronary intervention.
Intra-aortic balloon pump (IABP) plays a pivotal role in the treatment of cardiogenic shock complicating acute myocardial infarction. However, the usefulness of prophylactic IABP support in high-risk patients during percutaneous coronary intervention (PCI) is still controversial, and its influence on the inflammatory response following PCI has not been well evaluated. In this study we sought to assess the impact of prophylactic IABP support upon C-reactive protein (CRP) level and clinical prognosis in high-risk patients undergoing PCI. ⋯ The use of a prophylactic IABP in high-risk patients before PCI could reduce the CRP level and reduce mortality during the early phase following PCI.
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Randomized Controlled Trial Comparative Study
Acute normovolaemic haemodilution with crystalloids in coronary artery bypass graft surgery: a preliminary survey of haemostatic markers.
Acute normovolaemic haemodilution (ANH) is a safe and cost-effective blood conservation strategy in procedures with great blood loss. It eliminates the risk of administrative errors and also contaminations that may occur whenever banked blood is used. Classically, haemodilution is regarded as causing coagulopathy. This study was designed to determine the effect of crystalloids on measured coagulation values and perioperative blood loss following ANH in patients undergoing elective coronary revascularization. ⋯ ANH reduced the need for PRBC and FFP by 58% and 74%, respectively. Regarding the increase in PT and decrease in Plt count, we concluded that performing ANH with saline solution (SS) in patients undergoing CABG surgery may cause a non-clinically significant change in coagulation state.