Clinical research in cardiology : official journal of the German Cardiac Society
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Multicenter Study
Overweight is associated with improved survival and outcomes in patients with atrial fibrillation.
The aim of this study was to investigate the association of body mass index (BMI) with mortality and cardiovascular events in Chinese patients with atrial fibrillation (AF). ⋯ Obesity and overweight were not risk factors for 12-month mortality in Chinese AF patients. Overweight AF patients have better survival and outcomes than normal weight (BMI 18.5-24 kg/m(2)) and underweight patients.
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Review Meta Analysis
Intermittent levosimendan improves mid-term survival in chronic heart failure patients: meta-analysis of randomised trials.
Standard inotropic treatment is often necessary in end-stage heart failure but may be harmful. We performed a meta-analysis of randomized controlled trials to investigate the effect of repeated administration of levosimendan on survival in patients with chronic heart failure. ⋯ A large randomized trial is necessary to confirm the promising beneficial effects of intermittent levosimendan administration on the mid-term survival of patients with chronic heart failure.
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Observational Study
Elevated troponin in septic patients in the emergency department: frequency, causes, and prognostic implications.
According to the "Third Universal Definition of Myocardial Infarction", cardiac troponin (cTn) is defined to be elevated, if the value is above the 99th percentile of a normal reference population. Especially in emergency medicine, this leads to pathological values more often than before this definition has been founded. Severe sepsis and septic shock frequently cause a rise of cTn, but there is only limited data about its role in septic patients in the emergency department (ED). Therefore, we investigated the frequency, main causes, and prognostic relevance of elevated high-sensitive troponin T (hsTnT) in septic patients in the ED. ⋯ In the ED, sepsis is a relevant cause of elevated cTn, which underlines the role of sepsis as a differential diagnosis in non-ACS patients with positive cTn. A rise of cTn may be an indicator of poor outcome.
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Observational Study
Risk of atrial fibrillation, stroke, and death after radiofrequency catheter ablation of typical atrial flutter.
The purpose of this study was to assess the incidence, predictors, and prognostic clinical impact of atrial fibrillation (AF) over time after cavotricuspid isthmus (CTI) ablation of typical atrial flutter (AFL). ⋯ The transition to AF after CTI AFL ablation was high during a long-term follow-up period and maintained over time. Prior AF and COPD were the primary predictors of transition to AF after CTI AFL ablation. Patients who transitioned to AF had an increased risk of stroke and a more than twofold mortality rate. These clinical implications make it necessary to investigate AF after CTI ablation.
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Conflicting data exists regarding the frequency and significance of acute kidney injury (AKI) in ST segment elevation MI (STEMI) patients. The acute kidney injury network (AKIN) classification has been shown to predict mortality in various critically ill patients; however, limited information is available regarding its use and its clinical relevance among STEMI patients. ⋯ In STEMI patients undergoing primary PCI, AKI assessed by AKIN criteria is a frequent complication, associated with an increased risk of both short- and long-term mortality.