Giornale italiano di cardiologia : organo ufficiale della Federazione italiana di cardiologia : organo ufficiale della Società italiana di chirurgia cardiaca
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G Ital Cardiol (Rome) · Oct 2014
Review[Pharmacogenetic algorithms for predicting the appropriate dose of vitamin K antagonists: are they still useful?].
The severity of side effects that may occur with vitamin K antagonists due to their narrow therapeutic window requires great attention in finding out the most appropriate dose for these drugs. Pharmacogenetic research has now considerably helped clarifying the relationships between genetic variants and sensitivity to such therapy, paving the ground to predictive algorithms that include clinical and genetic variables to establish the best doses to start and maintain an adequate anticoagulation. Pharmacogenetic algorithms indeed aim at identifying tailored regimens, reducing adverse drug reactions and subsequent hospitalizations, optimizing therapeutic efficacy and containing costs. Here we describe the results so far achieved in pharmacogenetic research with vitamin K antagonists, analyzing studies that have assessed the usefulness of such algorithms.
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G Ital Cardiol (Rome) · Oct 2014
Observational Study[Patients with heart failure in the last year of their life: the primary care perspective].
The care of end-stage patients with heart failure (HF) represents a substantial cost and a relevant workload for health professionals and caregivers. Studies performed in out-of-hospital settings are limited. We aimed to provide data about management in primary care and professional needs of general practitioners (GPs). ⋯ The care of HF patients is mostly home-based and provided by families and GPs. GPs often need simple and inexpensive cardiological and organizational support.
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G Ital Cardiol (Rome) · Oct 2014
Observational Study[Extracorporeal membrane oxygenation for the treatment of refractory cardiogenic shock in adults: strategies, results, and predictors of mortality].
The RotaFlow (Maquet, Jostra Medizintechnik AG, Hirrlingen, Germany) and Levitronix CentriMag (Levitronix LCC, Waltham, MA, USA) veno-arterial extracorporeal membrane oxygenation (ECMO) support systems have been investigated as treatment for refractory cardiogenic shock. ⋯ ECMO support provides encouraging results in different subsets of patients in cardiogenic shock. Blood lactate levels, creatine kinase-MB relative index and PRBCs transfused should be strictly monitored during veno-arterial ECMO running. Type of ECMO implantation, if peripheral or central, should be decided according to the specific patient subset.