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  • 1
    Online Resource
    Online Resource
    Comparison of Pulmonary Emboli Management Between Pulmonary Emboli Response Team and the Conventional Method: The First Study From Iran
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine Vol. 21, No. 2 ( 2022-06), p. 61-66
    Details
    In: Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 21, No. 2 ( 2022-06), p. 61-66
    Abstract: We aimed to evaluate the effectiveness of the Pulmonary Embolism Response Team (PERT) for intermediate-high risk and high-risk pulmonary embolism (PE) patients. Methods: This single-blind clinical trial was performed in 2019–2021, evaluating patients with intermediate-high risk and high risk of PE. Patients in the intervention group were managed by the PERT team, and treatment plans were implemented as soon as possible. Patients in the other group received conventional PE treatments based on the hospital protocols. We compared the primary outcome of short-term mortality between the 2 groups and secondary outcomes, including right ventricle indices, hospital length-of-stay, time to decision, 30-day and in-hospital bleeding. Results: Data of 74 patients were analyzed. We found no significant differences between the 2 groups regarding short-term mortality ( P = 0.642), bleeding, and other complications. However, the length-of-stay and time to decision were significantly lower in patients treated by the PERT team ( P 〈 0.001 for both). Further evaluations revealed that patients in the intervention group had a more significant reduction in the right ventricle size and systolic pulmonary pressure compared with the control group ( P = 0.015, P = 0.039, respectively). In addition, tricuspid annular plane systolic excursion and fractional area change increased more in the intervention group ( P = 0.023, P = 0.016, respectively). Conclusions: The PERT team led to significantly less time to make decisions, and it was able to select patients for advanced treatments more appropriately. Due to these facts, patients treated by PERT had significantly lower hospitalization duration and better right ventricle indices compared to controls.
    Type of Medium: Online Resource
    ISSN: 1535-2811
    URL: Article
    DOI: 10.1097/HPC.0000000000000279
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 2
    Online Resource
    Online Resource
    Perioperative Cardiac Troponin T and Risk of Postoperative Atrial Fibrillation in Coronary Artery Bypass Graft Surgery
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine Vol. 21, No. 1 ( 2022-03), p. 36-41
    Details
    In: Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 21, No. 1 ( 2022-03), p. 36-41
    Abstract: Postoperative atrial fibrillation (AF) is a common complication after cardiac surgery. We investigated whether perioperative cardiac troponin T (cTnT) is associated with the risk of AF after coronary artery bypass grafting (CABG). Methods: Two thousand four hundred twenty-one patients with isolated CABG were studied. High sensitivity cTnT (hs-cTnT) was assessed before and then at 80 hour and 24 hour after the operation. Logistic regression models were applied to investigate the association of perioperative hs-cTnT with postoperative AF. The ROC curve analysis was applied to determine the optimal cutoff values. Results: Postoperative AF was occurred in 356 (14.7%) patients. Age (adjusted odds ratio [ORs] 1.087–1.090), male gender (OR 1.390), left atrium size (ORs 1.055–1.111), on-pump coronary bypass (OR 1.561), and application of intra-aortic balloon pump (ORs 2.890–2.966) were independently associated with AF. Preoperative hs-cTnT was associated with AF in patients with off-pump coronary bypass (ORs 1.997–2.375). However, the area under the curve for preoperative hs-cTnT was 0.625 in this group. On-pump coronary bypass had major influence on postoperative hs-cTnT levels regardless of the occurrence of AF. Conclusions: Preoperative hs-cTnT level is associated with the risk of AF after isolated CABG in patients undergoing off-pump coronary bypass, but the accuracy of this biomarker is yet inadequate. Postoperative levels of hs-cTnT have no predictive value considering large influence by the surgical technique and the cardiac surgery itself. Therefore, perioperative hs-cTnT is not a clinically useful biomarker for predicting AF following CABG.
    Type of Medium: Online Resource
    ISSN: 1535-2811
    URL: Article
    DOI: 10.1097/HPC.0000000000000276
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 3
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    Online Resource
    The relationship between cardiological parameters and PCR in patients with coronavirus infection: A cross-sectional study
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Medicine Vol. 101, No. 50 ( 2022-12-16), p. e31935-
    Details
    In: Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 101, No. 50 ( 2022-12-16), p. e31935-
    Abstract: Cardiovascular injuries induced by SARS CoV-2 have been reported repeatedly in various studies. Therefore, it is necessary to understand cardiac complications at a low cost, quickly. This study aimed to determine the relationship between cardiological parameters and polymerase chain reaction (PCR) in patients with coronavirus infection. : Patients who were admitted to the emergency department due to the ongoing pandemic, all patients with similar symptoms to coronavirus disease 2019 infection were initially admitted to the respiratory emergency room and underwent subsequent evaluations to confirm or rule out SARS-COV2 infection symptoms were assessed for eligibility. Patient were categorized into 2 groups 1. Positive PCR and negative PCR groups. Binary logistic regression was performed to assess the effect of several factors on the likelihood of developing positive troponin, reduced ejection fraction (EF), and Positive brain natriuretic peptide (BNP). Among 195 patients included, 115 (58.9%) had positive PCR. Patient in the positive PCR and negative PCR were 58.04 ± 18.03 and 59.19 ± 15.38 years of age, respectively. Patients in the “positive PCR” were significantly less likely to have chronic kidney disease (6.69% vs 17.5%, P value: .022), consume calcium channel blockers (6.69% vs 18.75%, P value:0.012). At the univariable level, positive PCR was significantly associated with fewer odds for positive BNP (OR:0.46, P  = .019); nevertheless, the association was no longer significant after adjusting for confounders (adjusted OR:0.56, P  = .158). Unadjusted positive PCR results were not found to have a significant association with positive troponin or reduced EF. Likewise, multivariable regression revealed no association between positive PCR and positive troponin (aOR:1.28, P  = .529) and reduced EF (aOR:0.65, P  = .369). PCR positivity did not result in positive troponin and BNP and did not appear to decrease EF. In other words, serial troponin and BNP checks and initial echocardiography in coronavirus disease 2019 respiratory emergencies do not make significant differences in diagnostic and therapeutic management and inpatient outcomes of patients with positive or negative PCR and are not specific findings. Evidence suggests some coronavirus-induced cardiac complications will be manifested in the long term.
    Type of Medium: Online Resource
    ISSN: 1536-5964
    URL: Article
    DOI: 10.1097/MD.0000000000031935
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2049818-4
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  • 4
    Online Resource
    Online Resource
    Clinical Features and Prognoses of Middle-Aged Women With ST-Elevation Myocardial Infarction With a Focus on Spontaneous Coronary Artery Dissection
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine Vol. 21, No. 1 ( 2022-03), p. 18-23
    Details
    In: Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 21, No. 1 ( 2022-03), p. 18-23
    Abstract: Spontaneous coronary artery dissection (SCAD) has become an increasingly recognized cause of acute coronary syndrome, particularly in young women, over the last decade. The goal of this study was to determine the prognoses and characteristics of adult women with SCAD who presented with ST-elevation myocardial infarction (STEMI). Methods: This retrospective cohort study enrolled all adult women under the age of 60 who had undergone coronary artery angiography in the setting of STEMI. The patients were divided into 3 groups based on their angiographic characteristics: STEMI-SCAD (STEMI due to SCAD), STEMI-ATH (STEMI caused by an atherosclerotic lesion), and STEMI-others (STEMI due to other etiologies including Takotsubo cardiomyopathy and myopericarditis, as well as STEMI despite a normal epicardial coronary angiography). Results: Fifteen women out of 311 female patients aged below 60 years with STEMI were diagnosed with SCAD (4.8%). There were no significant differences in body mass index, hypertension, dyslipidemia, smoking status, opium addiction status, family history, previous percutaneous coronary intervention, coronary artery bypass grafting, and cerebrovascular accidents between the STEMI-SCAD and STEMI-ATH groups. Nevertheless, the STEMI-SCAD and STEMI-others groups were more likely to be younger, less likely to be diabetic, and less likely to have 3 cardiovascular risk factors or more than was the STEMI-ATH group. The left anterior descending artery was the most common culprit lesion in the STEMI-SCAD group (80%) and the other 2 groups. Out of the 311 patients, 7 patients died during the index hospitalization: 1 patient in the STEMI-SCAD group, 6 patients in the STEMI-ATH group, and 0 patients in the STEMI-others group. None of the patients in the STEMI-others group experienced any major adverse cardiac events during the follow-up. In the other 2 groups, the most experienced outcomes were myocardial infarction and in-hospital cardiac death, followed by target lesion revascularization and target vessel revascularization. Conclusions: STEMI-SCAD is one of the known causes of STEMI in young women. Still, despite the complexity of revascularization in our patients with STEMI-SCAD, they had more favorable prognoses in both conservative and revascularization management modalities than our patients with STEMI-ATH.
    Type of Medium: Online Resource
    ISSN: 1535-2811
    URL: Article
    DOI: 10.1097/HPC.0000000000000275
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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