International journal of cardiology
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Randomized Controlled Trial Multicenter Study Comparative Study
The predictive value of C-reactive protein on recurrence of atrial fibrillation after cardioversion with or without treatment with atorvastatin.
The aim of this study was to investigate whether high-sensitivity C-reactive protein (hsCRP) levels prior to cardioversion (CV) predict recurrence of atrial fibrillation (AF) in patients randomized to treatment with either atorvastatin or placebo 30 and 180 days after CV. ⋯ HsCRP was associated with AF recurrence one and six months after successful CV of persistent AF. However, the association at one month was significant only after adjusting for atorvastatin treatment.
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Although controversial, using prophylactic intra-aortic balloon pump (IABP) in patients undergoing high-risk percutaneous coronary intervention (PCI) has been reported to be effective by numerous registry studies. However, conflicting findings were observed in observational studies (Obs.) and randomised controlled trials (RCTs). ⋯ The results suggest that PCI plus P-IABP support does not result in reduced in-hospital mortality or MACCE nor in significant higher access-site complications or stroke incidence compared with PCI alone in patients at high risk for peri-procedural PCI complications.
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Human exposure to high altitude is increasing, through inhabitation of areas of high altitude, expansion of tourism into more remote areas, and air travel exposing passengers to typical altitudes equivalent to 8005 ft (2440 m). With ascent to high altitude, a number of acute and chronic physiological changes occur, influencing all systems of the human body. When considering that cardiac arrest is the second most common cause of death in the mountains and that up to 60% of the elderly have significant heart disease or other health problems, these changes are of particular importance as they may have a significant impact on resuscitation efforts. ⋯ As no randomized trials evaluating the effects of physiological changes after ascent to high altitude on cardiopulmonary resuscitation were identified, our search was expanded to include all studies addressing important aspects on high altitude physiology which could have a potential impact on the resuscitation of cardiac arrest victims. The aim of this review is to discuss the major physiological changes occurring after ascent to high altitude and their potential effects on cardiopulmonary resuscitation. Based on the available data, specific suggestions are proposed regarding resuscitation at high altitude.
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Multicenter Study Observational Study
Fibrinogen function is impaired in whole blood from patients with cyanotic congenital heart disease.
Patients with cyanotic congenital heart disease (CCHD) have haemostatic abnormities associated with bleeding and thrombo-embolic events. The haemostatic abnormalities are not fully understood, but recent studies indicate that elevated haematocrit and fibrinogen function may be of importance. The aim of this study was to characterise the haemostatic profile and examine the potential role of haematocrit on clot formation and strength in CCHD patients. Furthermore to examine whether CCHD patients with history of haemoptysis have diminished fibrinogen function compared to those without haemoptysis. ⋯ Patients with CCHD are hypocoagulable mainly due to impaired fibrinogen function. Despite a low platelet count, platelet function does not seem to be severely affected in CCHD patients. Haemostasis, and especially fibrinogen function, is negatively affected by elevated haematocrit, and fibrinogen function is diminished in CCHD patients with haemoptysis.
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Randomized Controlled Trial
20-Hour preprocedural hydration is not superior to 5-hour preprocedural hydration in the prevention of contrast-induced increases in serum creatinine and cystatin C.
Although intravenous hydration with isotonic saline is the standard therapy for the prevention of contrast-induced nephropathy (CIN), there is still insufficient evidence concerning the optimal timing to initiate preprocedural intravenous hydration with isotonic saline. ⋯ 20 h-HS is not superior to 5h-HS in the prevention of the contrast-induced increases in serum creatinine and cystatin C in patients with renal insufficiency undergoing an elective coronary procedure.