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- Nessler, Jadwiga, et al.
(författare)
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Serum biomarkers and clinical outcomes in heart failure patients treated de novo with carvedilol
- 2013
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Ingår i: Cardiology Journal. - 1898-018X. ; 20:2, s. 144-151
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Tidskriftsartikel (refereegranskat)abstract
- Background: The role of inflammatory and hemodynamic stress biomarkers in heart failure (HF) patients treated de novo with beta-blockers has been poorly studied. Methods: A total of 86 patients (age 56 +/- 9 years, 81 men) with left ventricular ejection fraction (LVEF) < 40% and previously not treated with beta-blockers were initiated on carvedilol. At baseline and 12 months later we performed echocardiography, cardiopulmonary exercise testing, and determined serum levels of B-type natriuretic peptide (BNP), endothelin-1 (ET-1), C-reactive protein (CRP), interleukin-6, and tumor necrosis factor alpha (TNF-alpha). Patients were followed up over a total period of 9 +/- 3 years from baseline. Results: Increased baseline CRP and its on-treatment decrease were associated with improvement of LVEF (est. coefficient per one SD: 1.6; 95% CI: -0.05,3.28; p = 0.056, and -1.80; -3.43, -0.18; p = 0.030, respectively) and diminishing of LV end-systolic volume index [mL/m(2)] (-6.83; -11.32; -2.34; p = 0.003, and 5.85; 1.23; -10.46; p = 0.014, respectively). Higher baseline ET-1 and on-treatment increase in TNF-alpha predicted frequent admissions (>1) for cardiac complications (odds ratio per one SD: 1.98; 95% CI: 1.09-3.59; p = 0.025, and 2.07, 1.12-3.84, p = 0.021, respectively) whereas higher baseline BNP was asociated with increased mortality (hazard ratio per one SD: 2.09, 95% CI: 1.26-3.45; p = 0.004). Conclusions: Serum biomarkers may have different roles in prediction of clinical outcomes among HF patients treated de novo with carvedilol. (Cardiol J 2013; 20, 2: 144-151)
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- Zysko, Dorota, et al.
(författare)
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History of syncope predicts loss of consciousness after head trauma: Retrospective study
- 2014
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Ingår i: Cardiology Journal. - 1898-018X. ; 21:6, s. 674-678
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Tidskriftsartikel (refereegranskat)abstract
- Background: Head trauma may present as transient loss of consciousness (TLOC) currently classified as traumatic in origin, in contrast to non-traumatic forms, such as syncope. Whether past history of syncope predisposes to loss of consciousness after head injury has been poorly studied. Methods: A retrospective analysis of data obtained from 818 consecutive patients admitted to Emergency Departments was conducted. Face-to-face semi-structured interviews were performed, where patients' past history of syncope and head injury were explored. Head injury events were stratified as high-or low-energy trauma. Data regarding past syncopal events were explored in regard to number, age at the first occurrence, and syncope circumstances. Multivariate logistic regression model was applied to assess the relationship between loss of consciousness during head injury and past history of syncope. Results: Both past history of non-traumatic TLOC (odds ratio [OR] 3.78; 95% confidence interval [CI] 2.13-6.68, p < 0.001) and high-energy mechanism (OR 3.84; 95% CI 2.35-6.28, p < 0.001) predicted TLOC after head trauma. This relationship was even stronger when past episodes of TLOC were limited to those typical for reflex syncope (OR 4.34; 95% CI 2.34-7.89, p < 0.001). Further, the number of non-traumatic TLOC episodes in the patient's history was also predictive of TLOC after head injury (OR per 1 episode: 1.24; 95% CI 1.04-1.48, p = 0.015). Conclusions: Syncope in a patient's history predicts loss of consciousness after head injury. The clinical importance of this finding merits further investigation.
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