ABSTRACT
The rise of cardiac troponin post-percutaneous coronary intervention (PCI) is associated with a high risk of long-term cardiovascular events. Previous studies have shown that curcuminoids decreased myocardial injury post-coronary bypass graft surgery through anti-oxidant and anti-inflammatory effects. We sought to examine whether curcuminoids could prevent PCI-related myocardial injury. One-hundred enrolled patients receiving elective PCI were randomized to obtain curcuminoids or placebo 4 g/day at least 1 day before and after the scheduled PCI. Cardiac troponin-T and 12-lead electrocardiogram were evaluated before PCI and at 24 and 48 h post-PCI. The definitions of PCI-related myocardial injury and myocardial infarction were in line with the third universal definition of myocardial infarction. Baseline characteristics of patients and procedures did not differ between the curcuminoids and placebo groups. The mean age was 63.9 ± 10.8 years. The incidence of PCI-related myocardial injury was not different between curcuminoids and placebo groups (32% vs. 38%, P = .675). The peak high-sensitive cardiac troponin T levels after PCI were not different between the curcuminoids and placebo groups (201.0 ± 547.0 ng/L vs. 187.0 ± 703.9 ng/L respectively, P = .912). Further, the high-sensitive C-reactive protein levels post-PCI were similar in patients receiving curcuminoids and placebo (7.2 ± 18.8 mg/dL vs. 6.6 ± 17.5 mg/dL, respectively, P = .873). We found that short-term treatment with curcuminoids did not reduce the occurrence of PCI-related myocardial injury. We did not observe the role of anti-oxidative and anti-inflammatory effects of curcuminoids in the PCI-related myocardial injury.
Subject(s)
Diarylheptanoids/administration & dosage , Myocardial Infarction/prevention & control , Percutaneous Coronary Intervention/adverse effects , Postoperative Complications/prevention & control , Aged , C-Reactive Protein/metabolism , Female , Humans , Male , Middle Aged , Myocardial Infarction/etiology , Myocardial Infarction/metabolism , Postoperative Complications/etiology , Postoperative Complications/metabolism , Prospective Studies , Treatment OutcomeABSTRACT
Objective: To evaluate the effects of an educational board game on heart failure (HF) patients' knowledge and self-care behavior. Methods: In this randomized controlled study with a follow-up of 3 months, 76 patients with HF with reduced ejection fraction, who had been enrolled in our multidisciplinary HF program, were divided into two groups. During their follow-up appointment at the HF clinic usually 2 weeks after discharge, the interventional group participated in an HF educational board game conducted in Thai language, while the control group received the usual care including standard education. The primary outcome was the change of score achieved in the specialized HF knowledge and self-care behavior assessment. Results: In the intervention group, the knowledge and self-care behavior significantly improved (all P < 0.001), whereas both scores were unchanged in the control group (P = 0.09 and P = 0.21). Mean score change for knowledge and self-care behavior showed greater improvement in the intervention group when compared with the control group (P < 0.002 and P < 0.006). Conclusion: Participation in an interactive educational board game resulted in an increase in the HF patients' knowledge and self-care behavior. Practice Implications: An interactive educational board game may be used as an alternative educational tool in HF patients.
Subject(s)
Games, Recreational/psychology , Heart Failure/therapy , Knowledge , Self Care , Adult , Aged , Female , Health Education/methods , Heart Failure/psychology , Humans , Male , Middle Aged , Surveys and Questionnaires , ThailandABSTRACT
Background: Beta-blockers have been shown to decrease mortality and morbidity in heart failure with reduced ejection fraction (HFrEF) patients. However, the side effects are also dose-related, leading to the underdosing. Cost constraint may be one of the limitations of appropriate beta-blocker use; this can be improved with generic drugs. However, the effects in real life practice have not been investigated. Methods and results: This study aimed to compare the efficacy and safety of generic and brand beta-blockers in HFrEF patients. We performed a retrospective cohort analysis in HFrEF patients who received either generic or brand beta-blocker in Chiang Mai Heart Failure Clinic. The primary endpoint was the proportion of patients who received at least 50% target dose of beta-blocker between generic and brand beta-blockers. Adverse events were secondary endpoints. 217 patients (119 and 98 patients received generic and brand beta-blocker, respectively) were enrolled. There were no differences between groups regarding age, gender, etiology of heart failure, New York Heart Association (NYHA) functional class, left ventricular ejection fraction (LVEF), rate of receiving angiotensin converting enzyme inhibitor (ACEI), angiotensin recepter blocker (ARB), or spironolactone. Patients receiving brand beta-blockers had lower resting heart rate at baseline (74.9 and 84.2 bpm, p = .001). Rate of achieved 50% target dose and target daily dose did not differ between groups (40.4 versus 44.5% and 48.0 versus 55.0%, p > .05, respectively). Rate of side effects was not different between groups (32.3 versus 29.5%, p > .05) and the most common side effect was hypotension. Conclusion: This study demonstrated that beta-blocker tolerability was comparable between brand and generic formulations. Generic or brand beta-blockers should be prescribed to HFrEF patients who have no contraindications.
