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1.
Medicine (Baltimore) ; 103(8): e36933, 2024 Feb 23.
Article in English | MEDLINE | ID: mdl-38394539

ABSTRACT

BACKGROUND: Acute heart failure (AHF) is one of the most common cardiovascular diseases. Early diagnosis and prognosis are essential, as they can eventually lead to a fatal condition. Recently, brain natriuretic peptide (BNP) has been recognized as one of the most popular biomarkers for AHF. Changes in glomerular filtration rate (GFR) are often observed in AHF. METHODS: We searched PubMed, Google Scholar, and ScienceDirect between March and June 2023. Original case control studies written in English that assessed levels oh BNP in AHF were included. Systematic reviews, letters to editor, correspondence, comprehensive reviews, and duplicated studies were excluded. Funnel plots were constructed to assess publication bias. RESULTS: A total of 9 studies were selected and we obtained the mean difference (MD) of BNP level to be 2.57 (95% CI: 1.35, 3.78), and GFR to be -15.52, (95% CI: -23.35, -7.70) in AHF patients. Sensitivity analyses supported the robustness of the outcome. CONCLUSION: Results indicated that BNP was a promising prognostic biomarker of AHF, whereas GFR was found to be negatively correlated with AHF.


Subject(s)
Heart Failure , Natriuretic Peptide, Brain , Humans , Glomerular Filtration Rate , Acute Disease , Prognosis , Biomarkers , Heart Failure/diagnosis , Heart Failure/complications , Peptide Fragments
2.
Am J Cardiol ; 195: 9-16, 2023 05 15.
Article in English | MEDLINE | ID: mdl-36989606

ABSTRACT

Currently, guidelines recommend the uptake of high-dose statins before and after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome. However, the association of high-dose statins with the incidence of the no-reflow phenomenon remains unclear. This study aimed to review the evidence of preprocedural high-dose statin therapy to reduce no-reflow incidence after PCI. PubMed, Embase, and Google Scholar were searched from inception until May 2022 for studies comparing high-dose statins with low-dose or no statin therapy before PCI. Studies reporting the no-reflow phenomenon were shortlisted. The National Institutes of Health tool for randomized and cohort studies was used to assess the quality of included studies. A random-effects model was used to derive odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). A total of 11 studies were included, with a population of 4,294 patients. The use of high-dose statins before PCI significantly reduced postprocedural no-reflow (OR 0.51, 95% CI 0.35 to 0.74, p = 0.0005, I2 = 32%). A total of 7 studies included patients who underwent PCI without previous use of statins. A significant decrease in overall no-reflow events was observed with high-intensity statin treatment versus low-intensity statin/placebo (OR 0.55, 95% CI 0.34 to 0.88, p = 0.01, I2 = 25%) among patients who were statin naive. Acute high-dose statin therapy before PCI significantly reduces the hazard of post-PCI no-reflow events in patients with acute coronary syndrome. Our results encourage the routine use of statins before PCI.


Subject(s)
Acute Coronary Syndrome , Hydroxymethylglutaryl-CoA Reductase Inhibitors , No-Reflow Phenomenon , Percutaneous Coronary Intervention , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Acute Coronary Syndrome/drug therapy , Acute Coronary Syndrome/surgery , Percutaneous Coronary Intervention/adverse effects , No-Reflow Phenomenon/etiology , No-Reflow Phenomenon/prevention & control , Cohort Studies
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