Current Issue : October - December Volume : 2020 Issue Number : 4 Articles : 6 Articles
Whether the underlying risk of high bleeding risk (HBR) influences the relationship of high\nthrombotic risk (HTR) features with adverse events after drug-eluting stent implantation remains unclear. The\npurpose of this study was to evaluate (1) the prognostic effect of ESC guideline-endorsed HTR features on longterm\nclinical outcomes and (2) whether the outcomes of HTR versus non-HTR features vary by HBR status.\nMethods: Ten thousand one hundred sixty-seven consecutive patients who underwent percutaneous coronary\nintervention between January 2013 and December 2013 were prospectively enrolled in Fuwai PCI Registry. Patients\nwho are at HTR were defined as: diffuse multivessel disease in diabetic patients, chronic kidney disease, at least\nthree stents implanted, at least three stents lesions treated, bifurcation with two stents implanted, total stent...............
The ROX index (ratio of pulse oximetry/FIO2 to respiratory rate) has been validated to predict high\nflow nasal cannula therapy (HFNC) outcomes in patients with pneumonia. We evaluated a modified ROX index\nincorporating heart rate (HR) in patients initiated on HFNC for acute hypoxemic respiratory failure and as a\npreventative treatment following planned extubation.\nMethods: We performed a prospective observational cohort study of 145 patients treated with HFNC. ROX-HR\nindex was defined as the ratio of ROX index over HR (beats/min), multiplied by a factor of 100. Evaluation was\nperformed using area under the receiving operating characteristic curve (AUROC) and cutoffs assessed for prediction of\nHFNC failure: defined as the need for mechanical ventilation.\nResults: Ninety-nine (68.3%) and 46 (31.7%) patients were initiated on HFNC for acute hypoxemic respiratory failure\nand following a planned extubation, respectively. The majority (86.9%) of patients had pneumonia as a primary\ndiagnosis, and 85 (56.6%) patients were immunocompromised. Sixty-one (42.1%) patients required intubation (HFNC\nfailure). Amongst patients on HFNC for acute respiratory failure, HFNC failure was associated with a lower ROX and\nROX-HR index recorded at time points between 1 and 48 h. Within the first 12 h, both indices performed with the\nhighest AUROC at 10 h as follows:...................
Here we report a self-harming patient with a psychiatric disorder. A 73-year-old female patient\nwith 16-year coronary heart disease and a 4-year depression was admitted to our hospital for a coma. Two months\nearlier, the local hospital confirmed that the patient had a second-degree sinoatrial (SA) block (type 2) as well as\nbasal septal hypertrophy with the left ventricular outflow obstruction. Therefore, metoprolol sustained-release\ntablets 95 mg QD and diltiazem sustained-release tablets 90 mg QD was given as treatment after a pacemaker was\nimplanted. However, the patient had continued complaining about discomfort due to the pacemaker implanted\nafter being discharged from the hospital. Two months later, she attempted to commit suicide by removing her\npacemaker and taking 80 sleeping pills. After a series of treatments, the patient improved and was discharged\nwithout a pacemaker re-implantation. With continued anti-depression treatment and strengthen family supervision,\nthe patientâ??s condition is stable now.\nConclusions: A suicide attempt by intentionally removing the permanent pacemaker system was rarely reported. In\nbradycardia patients with a history of psychological or psychiatric disease, careful evaluation should be done before\nand after implantation of the pacemaker....
Left ventricular remodeling following ST-elevation myocardial infarction (STEMI) is associated with\npoor outcome, including heart failure (HF). Neprilysin inhibition leads to improved outcome in patients with altered\nleft ventricular ejection fraction (LVEF).\nMethods: We aimed to assess the association between serum levels of neprilysin and left ventricular (LV) volumes,\nfunction and remodeling in STEMI patients with successful myocardial reperfusion and no clinical sign of HF. Sixtyeight\npatients were admitted for STEMI and had both plasma neprilysin measurement at baseline and 3D\ntransthoracic echocardiogram at baseline and after a median follow-up of 7 months. We compared 3 groups:................
Quality improvement in the administration of extracorporeal cardiopulmonary resuscitation (ECPR)\nover time and its association with low-flow duration (LFD) and outcomes of cardiac arrest (CA) have been\ninsufficiently investigated. In this study, we hypothesized that quality improvement in efforts to shorten the\nduration of initiating ECPR had decreased LFD over the last 15 years of experience at an academic tertiary care\nhospital, which in turn improved the outcomes of in-hospital CA (IHCA).\nMethods: This was a single-center retrospective observational study of ECPR patients between January 2003 and\nDecember 2017. A rapid response system (RRS) and an extracorporeal membrane oxygenation (ECMO) program\nwere initiated in 2011 and 2013. First, the association of LFD per minute with the 90-day mortality and neurological\noutcome was analyzed using multiple logistic regression analysis. Then, the temporal changes in LFD were\ninvestigated.\nResults: Of 175 study subjects who received ECPR, 117 had IHCA. In the multivariate logistic regression, IHCA\npatients with shorter LFD experienced significantly increased 90-day survival and favorable neurological outcomes...............
Ventricular strain measurements vary depending on cardiac chamber (left ventricle [LV] or right\nventricle [RV]), type of strain (longitudinal, circumferential, or radial), ventricular level (basal, mid, or apical),\nmyocardial layer (endocardial or epicardial), and software used for analysis, among other demographic factors such\nas age and gender. Here, we present an analysis of ventricular strain taking all of these variables into account in a\ncohort of patients with no structural heart disease using a vendor-independent speckle-tracking software.................
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