Clinical cardiology
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Clinical cardiology · Oct 2007
Blood transfusion and in-hospital outcomes in anemic patients with myocardial infarction undergoing percutaneous coronary intervention.
Studies have shown poor prognostic implications of anemia in patients with myocardial infarction (MI) and in patients undergoing percutaneous coronary intervention (PCI). The impact of blood transfusion in these populations remains controversial. The objective of this study was to examine the effect of transfusion on in-hospital mortality in anemic patients undergoing PCI for MI. ⋯ After adjustment for comorbidities and propensity for transfusion, blood transfusion was associated with a higher risk of in-hospital mortality (adjusted odds ratio = 2.02, 95% confidence interval 1.47-2.79, p < 0.0001). In anemic patients undergoing PCI for MI, transfusion was associated with an increased crude and adjusted rate of in-hospital mortality. A randomized controlled trial is needed to determine the value of transfusion and the ideal transfusion criteria.
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Clinical cardiology · Oct 2007
Impact of acute blood loss anemia and red blood cell transfusion on mortality after percutaneous coronary intervention.
The clinical impact of increasing levels of blood loss has been shown to increase morbidity and mortality after percutaneous coronary intervention (PCI). The impact of red blood cell (RBC) transfusion for severe bleeding is unknown. We systematically collected baseline and 8-h postprocedure hematocrit (HCT) values on patients undergoing PCI. ⋯ In a general PCI population, increasing levels of blood loss are associated with an increased incidence of major adverse cardiac events and in-hospital mortality. RBC transfusion in the setting of severe bleeding is associated with an increased risk of 1-year mortality. Transfusion of aged RBCs may also be detrimental in this setting.
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Clinical cardiology · May 2007
Comparative StudyTroponin, B-type natriuretic peptides and outcomes in severe heart failure: differences between ischemic and dilated cardiomyopathies.
Ischemic (ISCM) and idiopathic dilated (IDCM) cardiomyopathies have different responses to therapy and outcomes. Both may demonstrate elevations in troponin and B-type natriuretic peptides, but biomarker levels have not been reported to differ as a function of the etiology of heart failure (HF). Accordingly, we compared these biomarkers in patients with chronic HF. ⋯ Patients with acutely decompensated chronic HF have elevations in troponin and BNP. These elevations, as well as mortality are significantly higher in patients with ISCM compared to IDCM. The differential levels in biomarkers may be due to differences in disease pathogenesis, and fit with the adverse prognosis in these patients.
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Clinical cardiology · May 2007
Clinical TrialPortable enhanced external counterpulsation for acute coronary syndrome and cardiogenic shock: a pilot study.
Enhanced external counterpulsation (EECP) currently is used as an outpatient therapy for patients with refractory chronic angina. ⋯ EECP is safe and feasible for acute bedside therapy of critically ill patients with acute coronary syndrome and/or cardiogenic shock who are not candidates for IABP.