Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · May 2017
Review[Iron Deficiency in Chronic Heart Failure: Diagnostic Algorithm and Present-Day Therapeutic Options].
Iron deficiency (ID) occurs in up to 50% of patients with heart failure (HF). Even without presence of anaemia ID contributes to more severe symptoms, increased hospitalization and mortality. A number of randomized controlled trials demonstrated the clinical benefit of replenishment of iron stores with improvement of symptoms and fewer hospitalizations. ⋯ In this review a plain diagnostic algorithm for ID is suggested. Confounding factors for diagnosis and adequate treatment of ID in HF are discussed. A regular workup for iron deficiency parameters may benefit patients with heart failure by providing symptomatic improvements and fewer hospitalizations.
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Dtsch. Med. Wochenschr. · Mar 2017
Case Reports[Accumulation of Metformin-associated Lactic Acidosis].
Objective Lactic acidosis has been associated with the use of metformin since its introduction. The cause, however, is highly controversial. The incidence of metformin-associated lactic acidosis (MALA) is quoted at 3,0 to 16,7 cases per 100 000 patient-years according to current studies. ⋯ On day 7 of hospitalization, two patients had a normal and two patients an impaired renal function (stage III or IV, respectively). Conclusion In case of diarrhoea and vomiting in patients with type 2 diabetes under metformin-treatment, the active search for lactic acidosis is essential, independently of the previous renal function. An early diagnosis and therapy of MALA allows a good prognosis.
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Dtsch. Med. Wochenschr. · Mar 2017
[Analysis of Secondary Data to Determine the Prevalence of Cardiovascular High Risk Patients with Hypercholesterolemia and Refractory Course of Treatment].
Background Hypercholesterolemia plays a causal role in the development of cardiovascular diseases. Patients are affected differently. There is a lack of epidemiological data about the frequence and characteristics of patients in Germany, especially about those who do not respond sufficiently to high intensity statins with or without other lipid modifying therapies. ⋯ Due to adverse events or contraindications statins are often prescribed in submaximal doses. Therefore patients with statins at lower dose combined with another lipid lowering drug were also included in the analysis. For patients missing the LDL-C target of ≤ 130 mg/dl despite optimal lipid lowering therapy there is a high medical need for innovative therapies.