Heart, lung & circulation
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Heart, lung & circulation · Mar 2016
Review Meta AnalysisCardiac Troponin and its Relationship to Cardiovascular Outcomes in Community Populations - A Systematic Review and Meta-analysis.
The clinical relevance of minor elevations of cardiac troponin (cTn) in the general population remains uncertain. The objective of this systematic review was to examine the literature and evaluate the prevalence of raised cTn in asymptomatic, community populations and explore the strength of the relationship between cTn and cardiovascular mortality amongst those studied. ⋯ Elevated troponin in asymptomatic individuals in the community is associated with a tripling of risk of all-cause and cardiovascular mortality. Cardiac troponin T (cTnT) is generally not measured in this group of patients, but may potentially have utility in predicting risk in this population. Further research is required to assess if this risk is modifiable with usual primary prevention treatments.
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Heart, lung & circulation · Mar 2016
Review Meta AnalysisCardiac Troponin and its Relationship to Cardiovascular Outcomes in Community Populations - A Systematic Review and Meta-analysis.
The clinical relevance of minor elevations of cardiac troponin (cTn) in the general population remains uncertain. The objective of this systematic review was to examine the literature and evaluate the prevalence of raised cTn in asymptomatic, community populations and explore the strength of the relationship between cTn and cardiovascular mortality amongst those studied. ⋯ Elevated troponin in asymptomatic individuals in the community is associated with a tripling of risk of all-cause and cardiovascular mortality. Cardiac troponin T (cTnT) is generally not measured in this group of patients, but may potentially have utility in predicting risk in this population. Further research is required to assess if this risk is modifiable with usual primary prevention treatments.
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Heart, lung & circulation · Nov 2015
ReviewA Review of Carbon Dioxide Monitoring During Adult Cardiopulmonary Resuscitation.
Although high quality cardiopulmonary resuscitation is one of the most significant factors related to favourable outcome, its quality depends on many components, such as airway management, compression depth and chest recoil, hands-off time, and early defibrillation. The most common way of controlling the resuscitation efforts is monitoring of end-tidal carbon dioxide. ⋯ However, despite the abundant human and animal studies supporting the usefulness of end-tidal carbon dioxide, its optimal values during cardiopulmonary resuscitation remain controversial. In this review, the advantages and effectiveness of end-tidal carbon dioxide during cardiopulmonary resuscitation are discussed and specific target values are suggested based on the available literature.
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Heart, lung & circulation · Jul 2015
Review Meta AnalysisThe Role of Colchicine in Pericarditis--A Systematic Review and Meta-analysis of Randomised Trials.
Colchicine has been used in diverse clinical settings. Primary idiopathic pericarditis is complicated by recurrence in 15 to 30% of cases. Aspirin, non-steroidal anti-inflammatory drugs, colchicine and steroids are the commonly prescribed medications. We synthesised the available evidence from the randomised trials to assess the efficacy and safety of colchicine in primary and recurrent pericarditis. ⋯ Colchicine is effective in preventing both primary and recurrent episodes of pericarditis. The number needed to treat for preventing recurrent pericarditis was five. Gastrointestinal side-effects were the most common adverse events.
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Heart, lung & circulation · Jul 2015
ReviewPeri-operative Levosimendan in Patients Undergoing Cardiac Surgery: An Overview of the Evidence.
Levosimendan, a calcium sensitiser, has recently emerged as a valuable agent in the peri-operative management of cardiac surgery patients. Levosimendan is a calcium-sensitising ionodilator. By binding to cardiac troponin C and reducing its calcium-binding co-efficient, it enhances myofilament responsiveness to calcium and thus enhances myocardial contractility without increasing oxygen demand. ⋯ In addition to being used as post-operative rescue therapy for low cardiac output syndrome, a pre-operative levosimendan infusion in high risk patients with poor cardiac function may reduce inotropic requirements, the need for mechanical support, the duration of intensive care admissions as well as post-operative mortality. Indeed, it is these higher-risk patients who may experience a greater degree of benefit. Larger, multicentre randomised trials in cardiac surgery will help to elucidate the full potential of this agent.