Clinical cardiology
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Clinical cardiology · Jun 2018
Review Meta AnalysisSole and combined vitamin C supplementation can prevent postoperative atrial fibrillation after cardiac surgery: A systematic review and meta-analysis of randomized controlled trials.
We undertook a systematic review and meta-analysis to evaluate the effect of vitamin C supplementation (vitamin C solely or as adjunct to other therapy) on prevention of postoperative atrial fibrillation (POAF) in patients after cardiac surgery. PubMed, Embase, Web of Science, and Cochrane Library were systematically searched to identify randomized controlled trials assessing the effect of vitamin C supplementation in adult patients undergoing cardiac surgery, and the meta-analysis was performed with a random-effects model. Thirteen trials involving 1956 patients were included. ⋯ The results remain stable and robust in subgroup and sensitivity analyses, and trial sequential analysis also confirmed that the evidence was sufficient and conclusive. Additionally, vitamin C could significantly decrease intensive care unit length of stay (weighted mean difference: -0.24 days, 95% CI: -0.45 to -0.03, P = 0.023), hospital length of stay (weighted mean difference: -0.95 days, 95% CI: -1.64 to -0.26, P = 0.007), and risk of adverse events (RR: 0.45, 95% CI: 0.21 to 0.96, P = 0.039). Use of vitamin C alone and as adjunct to other therapy can prevent POAF in patients undergoing cardiac surgery and should be recommended for patients receiving cardiac surgery for prevention of POAF.
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Clinical cardiology · Jun 2018
Multicenter Study Comparative Study Observational StudyStroke-prevention strategies in North American patients with atrial fibrillation: The GLORIA-AF registry program.
Antithrombotic prophylaxis with oral anticoagulation (OAC) substantially reduces stroke and mortality in patients with atrial fibrillation (AF). ⋯ In GLORIA-AF, 20% of the population comprising males with CHA2 DS2 -VASc ≥1 and females with CHA2 DS2 -VASc ≥2 did not receive OAC therapy. Patient characteristics associated with a lower likelihood of OAC prescription were use of antiplatelet drugs, paroxysmal pattern of AF, history of falls, and prior bleeding.
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Clinical cardiology · Jun 2018
Comparative StudyAchievement of multiple therapeutic targets for cardiovascular disease prevention: Retrospective analysis of real practice in Italy.
Pharmacological therapy in patients at high cardiovascular (CV) risk should be tailored to achieve recommended therapeutic targets. ⋯ Despite low prevalence and optimal medical therapy, individuals with high to very high SCORE risk did not achieve recommended therapeutic targets in a real-world practice.
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Clinical cardiology · Jun 2018
Serum albumin concentration as an independent prognostic indicator in patients with pulmonary arterial hypertension.
Serum albumin is a strong prognostic indicator for many disease processes, yet limited data exist regarding its prognostic relationship in pulmonary arterial hypertension (PAH). Our study aims to assess the relationship of hypoalbuminemia with disease severity and mortality in this population. ⋯ Lower serum albumin concentrations in patients with PAH are associated with higher mortality and can serve as a marker of disease severity in this patient population.
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Clinical cardiology · May 2018
Observational StudyThe prevalence of obstructive sleep apnea in patients with atrial fibrillation.
Obstructive sleep apnea (OSA) is a systemic disorder associated with significant cardiovascular complications. OSA may play a role in the initiation and worsening of atrial fibrillation (AF). This study aimed to determine the prevalence and clinical predictors of OSA in patients with AF. ⋯ OSA is common and often undetected in patients with AF, especially in nonobese and/or female patients. Patients may have a normal overall AHI but an abnormal AHI during rapid eye movement sleep. The clinical relevance and therapeutic implications in this subgroup should be further investigated. The clinical features of OSA are not reliable predictors of OSA in patients with AF. A low threshold for detection of OSA, with sleep studies, in these patients may be merited.