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Borghi C, Domienik-Karłowicz J, Tykarski A, Filipiak KJ, Jaguszewski MJ, Narkiewicz K, Barylski M, Mamcarz A, Wolf J, Mancia G. Expert consensus for the diagnosis and treatment of patients with hyperuricemia and high cardiovascular risk: 2023 update. Cardiol J 2023; 31:1-14. [PMID: 38155566 PMCID: PMC10919576 DOI: 10.5603/cj.98254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Affiliation(s)
- Claudio Borghi
- Department of Medical and Surgical Sciences, University of Bologna, Italy
| | - Justyna Domienik-Karłowicz
- Department of Internal Medicine and Cardiology with the Center for Diagnosis and Treatment of Venous Thromboembolism, Medical University of Warsaw, Poland.
| | - Andrzej Tykarski
- Department of Hypertensiology, Angiology and Internal Medicine, University of Medical Sciences, Poznan, Poland
| | - Krzysztof J Filipiak
- Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
- Department of Hypertensiology, Angiology and Internal Medicine, University of Medical Sciences, 61-701 Poznań, Poland
| | | | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdansk, Poland
| | - Marcin Barylski
- Department of Internal Medicine and Cardiac Rehabilitation, Medical University of Lodz, Poland
| | - Artur Mamcarz
- 3rd Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Medical University of Gdansk, Poland
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2
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Denegri A, Szarpak L, Pruc M, Jaguszewski MJ. Spontaneous coronary artery dissection and Takotsubo syndrome. Eur J Intern Med 2023; 117:137-139. [PMID: 37586984 DOI: 10.1016/j.ejim.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/03/2023] [Accepted: 08/05/2023] [Indexed: 08/18/2023]
Affiliation(s)
- Andrea Denegri
- Department of Cardiology, Parma University Hospital, Parma, Italy
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, One Baylor Plaza - BCM285, Houston, TX 77030, USA.
| | - Michal Pruc
- Department of Public Health, International Academy of Ecology and Medicine, Kyiv, Ukraine
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Pruc M, Jannasz I, Swieczkowski D, Procyk G, Gasecka A, Rafique Z, Chirico F, Bragazzi NL, Jaguszewski MJ, Wysocki J, Szarpak L. Diagnostic value of soluble urokinase-type plasminogen activator receptor in patients with acute coronary syndrome: A systematic review and meta-analysis. Cardiol J 2023:VM/OJS/J/96228. [PMID: 37772350 DOI: 10.5603/cj.96228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/19/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND In contemporary clinical practice, there is an increasing need for new clinically relevant biomarkers potentially optimizing management strategies in patients with suspected acute coronary syndrome (ACS). This study aimed to determine the diagnostic utility of soluble urokinase-type plasminogen activator receptor (suPAR) levels in individuals with suspected ACS. METHODS A literature search was performed in Web of Science, PubMed, Scopus, and the Cochrane Central Register of Controlled Trials databases, for studies comparing suPAR levels among patients with and without ACS groups. The methodological quality of the included papers was assessed using the Newcastle-Ottawa Scale (NOS). A fixed-effects model was used if I² < 50%; otherwise, the random-effects model was performed. RESULTS Five studies with 3417 participants were included in the meta-analysis. Pooled analysis showed that mean suPAR levels in the ACS group were statistically significantly higher than in the control group (3.56 ± 1.38 vs. 2.78 ± 0.54 ng/mL, respectively; mean difference: 1.04; 95% confidence interval: 0.64-1.44; I² = 99%; p < 0.001). CONCLUSIONS In the context of acute coronary syndrome, suPAR is a potential biomarker for the early identification of medical conditions in individuals who are being treated in emergency rooms.
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Affiliation(s)
- Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Public Health, International Academy of Ecology and Medicine, Kyiv, Ukraine
| | - Iwona Jannasz
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology, and Rehabilitation, Warsaw, Poland
| | - Damian Swieczkowski
- Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, Poland
| | - Grzegorz Procyk
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Francesco Chirico
- Post-Graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Nicola Luigi Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Canada
| | | | - Jaroslaw Wysocki
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States.
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
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Stolarczyk Ł, Gilis-Malinowska N, Jaguszewski MJ, Gutiérrez-Chico JL. Inside Cardiology Journal: After Journal Citation Reports 2022 have been published. Cardiol J 2023; 30:499-501. [PMID: 37691534 PMCID: PMC10508082 DOI: 10.5603/cj.97141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023] Open
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Safiejko K, Smereka J, Pruc M, Ladny JR, Jaguszewski MJ, Filipiak KJ, Yakubtsevich R, Szarpak L. Efficacy and safety of hypertonic saline solutions fluid resuscitation on hypovolemic shock: A systematic review and meta-analysis of randomized controlled trials. Cardiol J 2022; 29:966-977. [PMID: 33140397 PMCID: PMC9788734 DOI: 10.5603/cj.a2020.0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Fluid resuscitation is a fundamental intervention in patients with hypovolemic shock resulting from trauma. Appropriate fluid resuscitation in trauma patients could reduce organ failure, until blood components are available, and hemorrhage is controlled. We conducted a systematic review and meta-analysis assessing the effect of hypertonic saline/dextran or hypertonic saline for fluid resuscitation on patient outcomes restricted to adults with hypovolemic shock. METHODS We conducted a search of electronic information sources, including PubMed, Embase, Web of Science, Cochrane library and bibliographic reference lists to identify all randomized controlled trials (RCTs) investigating outcomes of crystalloids versus colloids in patients with hypovolemic shock. We calculated the risk ratio (RR) or mean difference (MD) of groups using fixed or random-effect models. RESULTS Fifteen studies including 3264 patients met our inclusion criteria. Survival to hospital discharge rate between research groups varied and amounted to 71.2% in hypertonic saline/dextran group vs. 68.4% for isotonic/normotonic fluid (normal saline) solutions (odds ratio [OR] = 1.19; 95% confidence interval [CI] 0.97-1.45; I2 = 48%; p = 0.09). 28- to 30-days survival rate for hypertonic fluid solutions was 72.8% survivable, while in the case of isotonic fluid (normal saline) - 71.4% (OR = 1.13; 95% CI 0.75-1.70; I2 = 43%; p = 0.56). CONCLUSIONS This systematic review and meta-analysis, which included only evidence from RCTs hypertonic saline/dextran or hypertonic saline compared with isotonic fluid did not result in superior 28- to 30-day survival as well as in survival to hospital discharge. However, patients with hypotension who received resuscitation with hypertonic saline/dextran had less overall mortality as patients who received conventional fluid.
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Affiliation(s)
- Kamil Safiejko
- Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Michal Pruc
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jerzy R. Ladny
- Polish Society of Disaster Medicine, Warsaw, Poland,Clinic of Emergency Medicine and Disaster, Medical University Bialystok, Poland
| | | | | | - Ruslan Yakubtsevich
- Department of Anesthesiology and Intensive Care, Grodno State Medical University, Grodno, Belarus
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland,Polish Society of Disaster Medicine, Warsaw, Poland,Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
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6
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Bielski K, Böttiger BW, Pruc M, Gasecka A, Sieminski M, Jaguszewski MJ, Smereka J, Gilis-Malinowska N, Peacock FW, Szarpak L. Outcomes of audio-instructed and video-instructed dispatcher-assisted cardiopulmonary resuscitation: a systematic review and meta-analysis. Ann Med 2022; 54:464-471. [PMID: 35107406 PMCID: PMC8812740 DOI: 10.1080/07853890.2022.2032314] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The present meta-analysis of clinical and simulation trials aimed to compare video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (V-DACPR) with conventional audio-instructed dispatcher-assisted bystander cardiopulmonary resuscitation (C-DACPR). METHODS We searched PubMed, Embase, Web of Science, Cochrane Collaboration databases and Scopus from inception until June 10, 2021. The primary outcomes were the prehospital return of spontaneous circulation (ROSC), survival to hospital discharge, and survival to hospital discharge with a good neurological outcome for clinical trials, and chest compression quality for simulation trials. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) indicated the pooled effect. The analyses were performed with the RevMan 5.4 and STATA 14 software. RESULTS Overall, 2 clinical and 8 simulation trials were included in this meta-analysis. In clinical trials, C-DACPR and V-DACPR were characterised by, respectively, 11.8% vs. 24.3% of prehospital ROSC (OR = 0.46; 95% CI: 0.30, 0.69; I2 = 66%; p < .001), 10.7% vs. 22.3% of survival to hospital discharge (OR = 0.46; 95% CI: 0.30, 0.70; I2 = 69%; p < .001), and 6.3% vs. 16.0% of survival to hospital discharge with a good neurological outcome (OR = 0.39; 95% CI: 0.23, 0.67; I2 = 73%; p < .001). In simulation trials, chest compression rate per minute equalled 91.3 ± 22.6 for C-DACPR and 107.8 ± 12.6 for V-DACPR (MD = -13.40; 95% CI: -21.86, -4.95; I2 = 97%; p = .002). The respective values for chest compression depth were 38.7 ± 14.3 and 41.8 ± 12.5 mm (MD = -2.67; 95% CI: -8.35, 3.01; I2 = 98%; p = .36). CONCLUSIONS As compared with C-DACPR, V-DACPR significantly increased prehospital ROSC and survival to hospital discharge. Under simulated resuscitation conditions, V-DACPR exhibited a higher rate of adequate chest compressions than C-DACPR.Key messagesBystander cardiopulmonary resuscitation parameters significantly depend on the dispatcher's support and the manner of the support provided.Video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation can increase the rate of prehospital return of spontaneous circulation and survival to hospital discharge.Video-instructed dispatcher-assisted bystander cardiopulmonary resuscitation improves the quality of chest compressions compared with dispatcher-assisted resuscitation without video instruction.
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Affiliation(s)
- Karol Bielski
- Institute of Outcomes Research, Polonia University, Czestochowa, Poland.,Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland
| | - Bernd W Böttiger
- Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Michal Pruc
- Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland
| | - Aleksandra Gasecka
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands.,First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | | | - Jacek Smereka
- Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland.,Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | | | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, United States
| | - Lukasz Szarpak
- Polish Society of Disaster Medicine, Research Unit, Warsaw, Poland.,Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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7
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Azizi M, Mahfoud F, Weber MA, Sharp ASP, Schmieder RE, Lurz P, Lobo MD, Fisher NDL, Daemen J, Bloch MJ, Basile J, Sanghvi K, Saxena M, Gosse P, Jenkins JS, Levy T, Persu A, Kably B, Claude L, Reeve-Stoffer H, McClure C, Kirtane AJ, Mullin C, Thackeray L, Chertow G, Kahan T, Dauerman H, Ullery S, Abbott JD, Loening A, Zagoria R, Costello J, Krathan C, Lewis L, McElvarr A, Reilly J, Cash M, Williams S, Jarvis M, Fong P, Laffer C, Gainer J, Robbins M, Crook S, Maddel S, Hsi D, Martin S, Portnay E, Ducey M, Rose S, DelMastro E, Bangalore S, Williams S, Cabos S, Rodriguez Alvarez C, Todoran T, Powers E, Hodskins E, Paladugu V, Tecklenburg A, Devireddy C, Lea J, Wells B, Fiebach A, Merlin C, Rader F, Dohad S, Kim HM, Rashid M, Abraham J, Owan T, Abraham A, Lavasani I, Neilson H, Calhoun D, McElderry T, Maddox W, Oparil S, Kinder S, Radhakrishnan J, Batres C, Edwards S, Garasic J, Drachman D, Zusman R, Rosenfield K, Do D, Khuddus M, Zentko S, O'Meara J, Barb I, Foster A, Boyette A, Wang Y, Jay D, Skeik N, Schwartz R, Peterson R, Goldman JA, Goldman J, Ledley G, Katof N, Potluri S, Biedermann S, Ward J, White M, Mauri L, Sobieszczky P, Smith A, Aseltine L, Stouffer R, Hinderliter A, Pauley E, Wade T, Zidar D, Shishehbor M, Effron B, Costa M, Semenec T, Roongsritong C, Nelson P, Neumann B, Cohen D, Giri J, Neubauer R, Vo T, Chugh AR, Huang PH, Jose P, Flack J, Fishman R, Jones M, Adams T, Bajzer C, Mathur A, Jain A, Balawon A, Zongo O, Bent C, Beckett D, Lakeman N, Kennard S, D’Souza RJ, Statton S, Wilkes L, Anning C, Sayer J, Iyer SG, Robinson N, Sevillano A, Ocampo M, Gerber R, Faris M, Marshall AJ, Sinclair J, Pepper H, Davies J, Chapman N, Burak P, Carvelli P, Jadhav S, Quinn J, Rump LC, Stegbauer J, Schimmöller L, Potthoff S, Schmid C, Roeder S, Weil J, Hafer L, Agdirlioglu T, Köllner T, Böhm M, Ewen S, Kulenthiran S, Wachter A, Koch C, Fengler K, Rommel KP, Trautmann K, Petzold M, Ott C, Schmid A, Uder M, Heinritz U, Fröhlich-Endres K, Genth-Zotz S, Kämpfner D, Grawe A, Höhne J, Kaesberger B, von zur Mühlen C, Wolf D, Welzel M, Heinrichs G, Trabitzsch B, Cremer A, Trillaud H, Papadopoulos P, Maire F, Gaudissard J, Sapoval M, Livrozet M, Lorthioir A, Amar L, Paquet V, Pathak A, Honton B, Cottin M, Petit F, Lantelme P, Berge C, Courand PY, Langevin F, Delsart P, Longere B, Ledieu G, Pontana F, Sommeville C, Bertrand F, Feyz L, Zeijen V, Ruiter A, Huysken E, Blankestijn P, Voskuil M, Rittersma Z, Dolmans H, Kroon A, van Zwam W, Vranken J, de Haan. C, Renkin J, Maes F, Beauloye C, Lengelé JP, Huyberechts D, Bouvie A, Witkowski A, Januszewicz A, Kądziela J, Prejbisj A, Hering D, Ciecwierz D, Jaguszewski MJ, Owczuk R. Effects of Renal Denervation vs Sham in Resistant Hypertension After Medication Escalation: Prespecified Analysis at 6 Months of the RADIANCE-HTN TRIO Randomized Clinical Trial. JAMA Cardiol 2022; 7:1244-1252. [PMID: 36350593 PMCID: PMC9647563 DOI: 10.1001/jamacardio.2022.3904] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Importance Although early trials of endovascular renal denervation (RDN) for patients with resistant hypertension (RHTN) reported inconsistent results, ultrasound RDN (uRDN) was found to decrease blood pressure (BP) vs sham at 2 months in patients with RHTN taking stable background medications in the Study of the ReCor Medical Paradise System in Clinical Hypertension (RADIANCE-HTN TRIO) trial. Objectives To report the prespecified analysis of the persistence of the BP effects and safety of uRDN vs sham at 6 months in conjunction with escalating antihypertensive medications. Design, Setting, and Participants This randomized, sham-controlled, clinical trial with outcome assessors and patients blinded to treatment assignment, enrolled patients from March 11, 2016, to March 13, 2020. This was an international, multicenter study conducted in the US and Europe. Participants with daytime ambulatory BP of 135/85 mm Hg or higher after 4 weeks of single-pill triple-combination treatment (angiotensin-receptor blocker, calcium channel blocker, and thiazide diuretic) with estimated glomerular filtration rate (eGFR) of 40 mL/min/1.73 m2 or greater were randomly assigned to uRDN or sham with medications unchanged through 2 months. From 2 to 5 months, if monthly home BP was 135/85 mm Hg or higher, standardized stepped-care antihypertensive treatment starting with aldosterone antagonists was initiated under blinding to treatment assignment. Interventions uRDN vs sham procedure in conjunction with added medications to target BP control. Main Outcomes and Measures Six-month change in medications, change in daytime ambulatory systolic BP, change in home systolic BP adjusted for baseline BP and medications, and safety. Results A total of 65 of 69 participants in the uRDN group and 64 of 67 participants in the sham group (mean [SD] age, 52.4 [8.3] years; 104 male [80.6%]) with a mean (SD) eGFR of 81.5 (22.8) mL/min/1.73 m2 had 6-month daytime ambulatory BP measurements. Fewer medications were added in the uRDN group (mean [SD], 0.7 [1.0] medications) vs sham (mean [SD], 1.1 [1.1] medications; P = .045) and fewer patients in the uRDN group received aldosterone antagonists at 6 months (26 of 65 [40.0%] vs 39 of 64 [60.9%]; P = .02). Despite less intensive standardized stepped-care antihypertensive treatment, mean (SD) daytime ambulatory BP at 6 months was 138.3 (15.1) mm Hg with uRDN vs 139.0 (14.3) mm Hg with sham (additional decreases of -2.4 [16.6] vs -7.0 [16.7] mm Hg from month 2, respectively), whereas home SBP was lowered to a greater extent with uRDN by 4.3 mm Hg (95% CI, 0.5-8.1 mm Hg; P = .03) in a mixed model adjusting for baseline and number of medications. Adverse events were infrequent and similar between groups. Conclusions and Relevance In this study, in patients with RHTN initially randomly assigned to uRDN or a sham procedure and who had persistent elevation of BP at 2 months after the procedure, standardized stepped-care antihypertensive treatment escalation resulted in similar BP reduction in both groups at 6 months, with fewer additional medications required in the uRDN group. Trial Registration ClinicalTrials.gov Identifier: NCT02649426.
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Affiliation(s)
- Michel Azizi
- Université Paris Cité, F-75006 Paris, France,Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Hypertension Department and DMU CARTE, F-75015 Paris, France,INSERM, CIC1418, F-75015 Paris, France
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Saarland University Hospital, Homburg/Saar, Germany,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge
| | - Michael A. Weber
- Division of Cardiovascular Medicine, State University of New York, Downstate Medical Center, New York
| | - Andrew S. P. Sharp
- University Hospital of Wales, Cardiff and University of Exeter, Exeter, United Kingdom
| | - Roland E. Schmieder
- Nephrology and Hypertension, University Hospital Erlangen, Friedrich Alexander University, Erlangen, Germany
| | - Philipp Lurz
- Heart Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Melvin D. Lobo
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | - Joost Daemen
- Erasmus MC, University Medical Center Rotterdam, Department of Cardiology, Rotterdam, the Netherlands
| | - Michael J. Bloch
- Department of Medicine, University of Nevada School of Medicine, Vascular Care, Renown Institute of Heart and Vascular Health, Reno
| | - Jan Basile
- Division of Cardiovascular Medicine, Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston
| | | | - Manish Saxena
- Barts NIHR Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | | | | | - Terry Levy
- Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc and Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium
| | - Benjamin Kably
- Assistance Publique–Hôpitaux de Paris, Hôpital Européen Georges-Pompidou, Department of Pharmacology, Paris, France
| | | | | | | | - Ajay J. Kirtane
- Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Danny Do
- for the RADIANCE-HTN Investigators
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Jay Giri
- for the RADIANCE-HTN Investigators
| | | | - Thu Vo
- for the RADIANCE-HTN Investigators
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8
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Nieborek A, Ladny JR, Jaguszewski MJ, Denegri A, Sikora A, Pucylo S, Gasecka A, Pruc M, Savytsky I, Szarpak L. Should targeted temperature management be used in cardiogenic shock patients? Systematic review and meta-analysis. Cardiol J 2022:VM/OJS/J/91254. [PMID: 36200546 DOI: 10.5603/cj.a2022.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 08/30/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Therapeutic hypothermia, or targeted temperature management (TTM), is a strategy of reducing the core body temperature of survivors of sudden cardiac arrest, cardiogenic shock (CS) or stroke. Therefore, a systematic literature review and meta-analysis were performed to tackle the question about whether the implementation of TTM is actually beneficial for patients with CS. METHODS Study was designed as a systematic review and meta-analysis. PubMed, Cochrane Library, Web of Science and Scopus were searched from these databases inception to July 17, 2022. Eligible studies were those comparing TTM and non-TTM treatment in CS patients. Data were pooled with the Mantel-Haenszel method. RESULTS Thirty-day mortality was reported in 3 studies. Polled analysis of 30-day mortality was 44.2% for TTM group and 48.9% for non-TTM group (risk ratio: 0.90; 95% confidence interval: 0.75 to 1.08; p = 0.27). Other mortality follow-up periods showed also no statistically significant differences (p > 0.05). The occurrence of adverse events in the studied groups also did not show statistically significant differences between TTM and non-TTM groups (p > 0.05 for myocardial infarction, stent thrombosis, sepsis, pneumonia, stroke or bleeding events). CONCLUSIONS The present analysis shows no significant benefit of TTM in patients with CS. Moreover, no statistically significant increase of the incidence of adverse effects was found. However, further randomized studies with higher sample size and greater validity are needed to determine if TTM is worth implementing in CS patients.
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Affiliation(s)
- Adam Nieborek
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jerzy R Ladny
- Clinic of Emergency Medicine, Medical University Bialystok, Poland
| | | | - Andrea Denegri
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Italy
| | - Aleksandra Sikora
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Szymon Pucylo
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Aleksandra Gasecka
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Ivan Savytsky
- European School of Medicine, International European University, Kyiv, Ukraine
| | - Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States.
- Reseach Unit, Maria Sklodowska-Curie Bialysok Oncology Center, Bialystok, Poland.
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9
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Fialek B, Pruc M, Smereka J, Jas R, Rahnama-Hezavah M, Denegri A, Szarpak A, Jaguszewski MJ, Peacock FW, Szarpak L. Diagnostic value of lactate dehydrogenase in COVID-19: A systematic review and meta-analysis. Cardiol J 2022; 29:751-758. [PMID: 35762075 PMCID: PMC9550334 DOI: 10.5603/cj.a2022.0056] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/06/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This meta-analysis outlines the role of elevated lactate dehydrogenase (LDH) levels in assessing the severity of coronavirus disease 2019 (COVID-19). METHODS The current study was designed as a systematic review and meta-analysis. Embase, Pub- Med, Web of Science, Scopus and Cochrane Central Register of Controlled Trials were searched to identify the usefulness of LDH as a marker of COVID-19 severity. All extracted data were analyzed using RevMan V.5.4 or STATA V.14 software. RESULTS A total of 264 records were selected for this meta-analysis. Pooled analysis showed that LDH levels were statistically significantly lower in the group of survivors compared to patients who died in hospital (standardized mean differences [SMD] = -3.10; 95% confidence interval [CI]: -3.40 to -2.79; I2 = 99%; p < 0.001). Lower LDH levels were observed in non-severe groups compared to severe course of COVID-19 (SMD = -2.38; 95% CI: -2.61 to -2.14; I2 = 99%; p < 0.001). The level of LDH was statistically significantly lower in the severe group compared to the critical group (SMD = -1.48; 95% CI: -2.04 to -0.92; I2 = 98%; p < 0.001). Patients who did not require treatment in the intensive care unit (ICU) showed significantly lower levels of LDH compared to patients who required treatment in the ICU (SMD = -3.78; 95% CI: -4.48 to -3.08; I2 = 100%; p < 0.001). CONCLUSIONS This meta-analysis showed that elevated LDH was associated with a poor outcome in COVID-19.
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Affiliation(s)
- Bartosz Fialek
- Rheumatology Department, Marshal Jozef Pilsudski Memorial Hospital, Plonsk, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jacek Smereka
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Rafal Jas
- Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | | | | | - Agnieszka Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | | | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, United States
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, Houston, TX, United States.
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10
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Szarpak L, Szwed P, Gasecka A, Rafique Z, Pruc M, Filipiak KJ, Jaguszewski MJ. Milrinone or dobutamine in patients with heart failure: evidence from meta-analysis. ESC Heart Fail 2022; 9:2049-2050. [PMID: 35384369 PMCID: PMC9065811 DOI: 10.1002/ehf2.13812] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/05/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Maria Sklodowska‐Curie Medical AcademyWarsaw03‐411Poland
- Maria Sklodowska‐Curie Bialystok Oncology CenterBialystokPoland
| | - Piotr Szwed
- 1st Chair and Department of CardiologyMedical University of WarsawWarsawPoland
| | - Aleksandra Gasecka
- 1st Chair and Department of CardiologyMedical University of WarsawWarsawPoland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency MedicineBaylor College of MedicineHoustonTXUSA
| | - Michal Pruc
- Polish Society of Disaster MedicineWarsawPoland
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11
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Blek N, Szwed P, Putowska P, Nowicka A, Drela WL, Gasecka A, Ladny JR, Merza Y, Jaguszewski MJ, Szarpak L. The diagnostic and prognostic value of copeptin in patients with acute ischemic stroke and transient ischemic attack: A systematic review and meta-analysis. Cardiol J 2022; 29:610-618. [PMID: 35621091 PMCID: PMC9273240 DOI: 10.5603/cj.a2022.0045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Stroke is the second main cause of mortality and the third leading cause of mortality and permanent disability combined. Many potential biomarkers have been described to contribute to the diagnosis, prognosis of outcomes, and risk stratification after stroke. Copeptin is an inactive peptide that is produced in an equimolar ratio to arginine vasopressin in response to the activation of the endogenous stress system. Methods The present study is a systematic review and meta-analysis to assess plasma copeptin concentrations, diagnostic and prognostic values for risk stratification after acute ischemic stroke and transient ischemic attack. Results Mean copeptin level in stroke vs. non-stroke groups varied and amounted to 19.8 ± 17.4 vs. 9.7 ± 6.6 pmol/L, respectively (mean differences [MD]: 12.75; 95% confidence interval [CI]: 5.00 to 20.49; p < 0.001), in good vs. poor outcome 12.0 ± 3.6 vs. 29.4 ± 14.5 (MD: −8.13; 95% CI: −8.37 to −7.88; p < 0.001) and in survive vs. non-survive stroke patients: 13.4 ± 3.2 vs. 33.0 ± 12.3, respectively (MD: −13.43; 95% CI: −17.82 to −9.05; p < 0.001). Conclusions The above systematic review and meta-analysis suggests that monitoring the copeptin levels may help predict the long-term prognosis of ischemic stroke efficiently. Determining the copeptin level may help individualize the management of ischemic stroke patients, keep stroke risk lower, reduce post-stroke complications, including patient death, and minimize healthcare costs.
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Affiliation(s)
- Natasza Blek
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland. .,Department of Neurology, Wolski Hospital, Warsaw, Poland.
| | - Piotr Szwed
- Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Paulina Putowska
- Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Adrianna Nowicka
- Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Wiktoria L Drela
- Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Aleksandra Gasecka
- Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Jerzy R Ladny
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
| | | | | | - Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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12
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Szarpak L, Pruc M, Maslyukov A, Glamcevski MT, Gilis-Malinowska N, Jaguszewski MJ. Genesis of arrhythmia in the course of COVID-19. Cardiol J 2022; 29:535-536. [PMID: 35514088 PMCID: PMC9170308 DOI: 10.5603/cj.a2022.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 04/23/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States.,Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Anatoliy Maslyukov
- School of Medicine, International European University, Kyiv, Ukraine.,Department of Biomedical Sciences, Odessa International Medical University, Odessa, Ukraine
| | - Mihajlo T Glamcevski
- School of Medicine, International European University, Kyiv, Ukraine.,Royal University of Phnom Penh, Penh, Cambodia
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13
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Karbowska E, Swieczkowski D, Gasecka A, Pruc M, Safiejko K, Ladny JR, Kopiec T, Jaguszewski MJ, Filipiak KJ, Rafique Z, Szarpak L. Statins and the risk of pancreatic cancer: A systematic review and meta-analysis of 2,797,186 patients. Cardiol J 2022:VM/OJS/J/88590. [PMID: 35373328 DOI: 10.5603/cj.a2022.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Statin use in many studies is related to the improvement of a patients' condition including reducing the risk of various malignancies. Herein, is a systematic review and meta-analysis to examine the evidence on the association between statin therapy and the risk of the occurrence of pancreatic cancer, mainly in terms of decreased risk of developing pancreatic cancer among patients using statin therapy in the long-term perspective. METHODS PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from database inception to December 1st, 2021. Random effect models were used to estimate summary odds ratios (OR) and the corresponding 95% confidence intervals (CI). RESULTS A total of 26 studies comprising 2,797,186 patients were included. Polled analysis showed that pancreatic cancer occurrence in statin vs. no-statin group varied and amounted to 0.4% vs. 0.6% (RR = 0.83; 95% CI: 0.72-0.96; I² = 84%; p = 0.01). CONCLUSIONS In summary, the present analysis shows that overall statins use is significantly associated with a reduction in risk of pancreatic cancer. However, these results were not confirmed for the randomized controlled trial subgroup. Further prospective studies are needed to confirm the current results.
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Affiliation(s)
- Eryka Karbowska
- Department of CT and MR Radiology, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
| | - Damian Swieczkowski
- Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, Gdańsk, Poland
| | - Aleksandra Gasecka
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Soceity of Disaster Medicine, Warsaw, Poland
| | - Kamil Safiejko
- Colorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
| | - Jerzy R Ladny
- Department of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Tomasz Kopiec
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | | | - Krzysztof J Filipiak
- Institute of Clinical Science, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
- Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA;.
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14
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Affiliation(s)
- Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Fiza Najeeb
- School of Medicine, International European University, Kyiv, Ukraine
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15
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Michalski TA, Figatowski T, Jaguszewski MJ. ST-segment elevation myocardial infarction after COVID-19 reinfection: The disseminated thrombotic process. Cardiol J 2022; 28:989-990. [PMID: 34985121 PMCID: PMC8747836 DOI: 10.5603/cj.2021.0142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/31/2021] [Accepted: 08/09/2021] [Indexed: 12/02/2022] Open
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16
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Piepiorka-Broniecka M, Michalski TA, Figatowski T, Wojtowicz A, Jurowiecki J, Stanska A, Rogowski J, Jaguszewski MJ. NOAC versus warfarin in the treatment of atrial fibrillation during the first three months after bioprosthetic aortic valve replacement. Cardiol J 2021; 29:355-357. [PMID: 34897639 PMCID: PMC9007476 DOI: 10.5603/cj.a2021.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 10/22/2021] [Accepted: 10/28/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
| | | | | | - Andrzej Wojtowicz
- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Poland
| | - Jaroslaw Jurowiecki
- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Poland
| | - Aleksandra Stanska
- Division of Quality of Life Research, Department of Psychology, Medical University of Gdansk, Poland
| | - Jan Rogowski
- Department of Cardiac and Vascular Surgery, Medical University of Gdansk, Poland
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17
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Szarpak L, Filipiak KJ, Skwarek A, Pruc M, Rahnama M, Denegri A, Jachowicz M, Dawidowska M, Gasecka A, Jaguszewski MJ, Iskrzycki L, Rafique Z. Outcomes and mortality associated with atrial arrhythmias among patients hospitalized with COVID-19: A systematic review and meta-analysis. Cardiol J 2021; 29:33-43. [PMID: 34897631 PMCID: PMC8890412 DOI: 10.5603/cj.a2021.0167] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 11/27/2021] [Accepted: 11/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in the adult population. Herein, is a systematic review with meta-analysis to determine the impact of AF/atrial flutter (AFL) on mortality, as well as individual complications in patients hospitalized with the coronavirus disease 2019 (COVID-19). Methods A systematic search of the SCOPUS, Medline, Web of Science, CINAHL and Cochrane databases was performed. The a priori primary outcome of interest was in-hospital mortality. A random-effects model was used to pool study results. Results Nineteen studies which included 33,296 patients were involved in this meta-analysis. In-hospital mortality for AF/AFL vs. no-AF/AFL groups varied and amounted to 32.8% vs. 14.2%, respectively (risk ratio [RR]: 2.18; 95% confidence interval [CI]: 1.79–2.65; p < 0.001). In-hospital mortality in new onset AF/AFL compared to no-AFAFL was 22.0% vs. 18.8% (RR: 1.86; 95% CI: 1.54–2.24; p < 0.001). Intensive care unit (ICU) admission was required for 17.7% of patients with AF/AFL compared to 10.8% for patients without AF/AFL (RR: 1.94; 95% CI: 1.04–3.62; p = 0.04). Conclusions The present study reveals that AF/AFL is associated with increased in-hospital mortality and worse outcomes in patients with COVID-19 and may be used as a negative prognostic factor in these patients. Patients with AF/AFL are at higher risk of hospitalization in ICU. The presence of AF/AFL in individuals with COVID-19 is associated with higher risk of complications, such as bleeding, acute kidney injury and heart failure. AF/AFL may be associated with unfavorable outcomes due to the hemodynamic compromise of cardiac function itself or hyperinflammatory state typical of these conditions.
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Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Poland. .,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland. .,Outcomes Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Krzysztof J Filipiak
- Institute of Clinical Medicine, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Aleksandra Skwarek
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Michal Pruc
- Outcomes Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Mansur Rahnama
- Chair and Department of Oral Surgery, Medical University of Lublin, Lublin, Poland
| | - Andrea Denegri
- Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena Italy
| | - Marta Jachowicz
- Students Research Club, Maria Sklodowska-Curie Medical Academy in Warsaw, Poland
| | - Malgorzata Dawidowska
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Lukasz Iskrzycki
- Department of Emergency Medical Service, Medical University of Wroclaw, Wroclaw, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
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18
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Szarpak L, Pruc M, Filipiak KJ, Popieluch J, Bielski A, Jaguszewski MJ, Gilis-Malinowska N, Chirico F, Rafique Z, Peacock FW. Myocarditis: A complication of COVID-19 and long-COVID-19 syndrome as a serious threat in modern cardiology. Cardiol J 2021; 29:178-179. [PMID: 34811716 PMCID: PMC8890406 DOI: 10.5603/cj.a2021.0155] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/14/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
- Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Krzysztof J Filipiak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Julia Popieluch
- Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Andrzej Bielski
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Polonia University, Czestochowa, Poland
| | | | | | - Francesco Chirico
- Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, Italian State Police, Milan, Italy
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
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19
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Szarpak L, Jaguszewski MJ, Pruc M, Rafique Z. Myocardial injury: a future challenge for long-COVID-19 complications. Eur Heart J Qual Care Clin Outcomes 2021; 7:618. [PMID: 34549296 DOI: 10.1093/ehjqcco/qcab067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/10/2021] [Accepted: 09/18/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Solidarnosci 12 Av.; 03-411 Warsaw, Poland.,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
| | | | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Solidarnosci 12 Av.; 03-411 Warsaw, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
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20
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Szarpak L, Filipiak KJ, Gasecka A, Gawel W, Koziel D, Jaguszewski MJ, Chmielewski J, Gozhenko A, Bielski K, Wroblewski P, Savytskyi I, Szarpak L, Rafique Z. Vitamin D supplementation to treat SARS-CoV-2 positive patients. Evidence from meta-analysis. Cardiol J 2021; 29:188-196. [PMID: 34642923 PMCID: PMC9007480 DOI: 10.5603/cj.a2021.0122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/06/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Vitamin D is a likely candidate for treatment as its immune modulating characteristics have effects on coronavirus disease 2019 (COVID-19) patients. It was sought herein, to summarize the studies published to date regarding the vitamin D supplementation to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients. METHODS A systematic review and meta-analysis were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The primary outcome were 14-day and in-hospital mortality reported as an odds ratio (OR) with the associated 95% confidence interval (CI). RESULTS Eight articles were included in the review with a combined total of 2,322 individual patients, 786 in the vitamin D supplementation group and 1,536 in the control group. The use of vitamin D compared to the group without vitamin D supplementation was associated with a lower 14-day mortality (18.8% vs. 31.3%, respectively; OR = 0.51; 95% CI: 0.12-2.19; p = 0.36), a lower in-hospital mortality (5.6% vs. 16.1%; OR = 0.56; 95% CI: 0.23-1.37; I2 = 74%; p = 0.20), the rarer intensive care unit admission (6.4% vs. 23.4%; OR = 0.19; 95% CI: 0.06-0.54; I2 = 77%; p = 0.002) as well as rarer mechanical ventilation (6.5% vs. 18.9%; OR = 0.36; 95% CI: 0.16-0.80; I2 = 0.48; p = 0.01). CONCLUSIONS Vitamin D supplementation in SARS-CoV-2 positive patients has the potential to positively impact patients with both mild and severe symptoms. As several high-quality randomized control studies have demonstrated a benefit in hospital mortality, vitamin D should be considered a supplemental therapy of strong interest. Should vitamin D prove to reduce hospitalization rates and symptoms outside of the hospital setting, the cost and benefit to global pandemic mitigation efforts would be substantial.
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Affiliation(s)
- Luiza Szarpak
- Institute of Outcomes Research, Polonia University, Czestochowa, Poland
- Outcomes Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Krzysztof J Filipiak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Aleksandra Gasecka
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Wladyslaw Gawel
- Outcomes Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Surgery, The Silesian Hospital in Opava, Czech Republic
| | | | | | | | | | - Karol Bielski
- Outcomes Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
- Emergency Medical Service and Medical Transport Dispatcher, Warsaw, Poland
| | - Pawel Wroblewski
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | | | - Lukasz Szarpak
- Outcomes Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.
- Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, TX, United States
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21
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Nucera G, Chirico F, Rafique Z, Gilis-Malinowska N, Gasecka A, Litvinova N, Wang B, Ilesanmi O, Pruc M, Jaguszewski MJ, Szarpak L. Need to update cardiological guidelines to prevent COVID-19 related myocardial infarction and ischemic stroke. Cardiol J 2021; 29:174-175. [PMID: 34642925 PMCID: PMC8890413 DOI: 10.5603/cj.a2021.0120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Gabriella Nucera
- Department of Emergency, Fatebenefratelli Hospital, ASST Fatebenefratelli and Sacco, Milan, Italy
| | - Francesco Chirico
- Post-graduate School of Occupational health, Università Cattolica del Sacro Cuore, Rome, Italy. .,Health Service Department, Italian State Police, Ministry of the Interior, Milan, Italy.
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | | | - Aleksandra Gasecka
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Nataliia Litvinova
- European Medical School, International European University, Kiev, Ukraine
| | - Benjamin Wang
- UC Davis Graduate School of Management, Davis, CA, USA
| | - Olayinka Ilesanmi
- Department of Community Medicine, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria.,Department of Community Medicine, College of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Michal Pruc
- Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland.,Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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22
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Bielski K, Smereka J, Chmielewski J, Pruc M, Chirico F, Gasecka A, Litvinova N, Jaguszewski MJ, Nowak-Starz G, Rafique Z, Peacock FW, Szarpak L. Meta-analysis of chest compression-only versus conventional cardiopulmonary resuscitation by bystanders for adult with out-of-hospital cardiac arrest. Cardiol J 2021; 30:606-613. [PMID: 34622436 PMCID: PMC10508072 DOI: 10.5603/cj.a2021.0115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND According to the guidelines of cardiopulmonary resuscitation (CPR) conducted by bystanders, two methods of CPR are feasible: standard CPR (sCPR) with mouth-to-mouth ventilations and continuous chest compression-only CPR (CCC) without rescue breathing. The goal herein, was to evaluate the effect of sCPR (30:2) and CCC on resuscitation outcomes in patients with out-of-hospital cardiac arrest (OHCA) patients. METHODS This study was a systematic review and meta-analysis. Using standardized criteria, Pub- Med, Web of Science, Scopus, EMBASE and Cochrane Collaboration were searched for trials assessing the effect of sCPR vs. CCC on resuscitation outcomes after adult OHCA. Random-effects model meta-analysis was applied to calculate the mean deviation (MD), odds ratio (OR) and 95% confidence interval (CI). RESULTS Overall, 3 randomized controlled trials and 12 non-randomized trials met the inclusion criteria. Survival to hospital discharge with sCPR was 10.2% compared to 9.3% in the CCC group (OR = 1.04; 95% CI: 0.93-1.16; p = 0.46). Survival to hospital discharge with good neurological outcome measured with the cerebral performance category (CPC 1 or 2) was 6.5% for sCPR vs. 5.8% for CCC (OR = 1.00; 95% CI: 0.84-1.20; p = 0.98). Prehospital return of spontaneous circulation (ROSC) in sCPR and CCC groups was 15.9% and 14.8%, respectively (OR = 1.13; 95% CI: 0.91-1.39; p = 0.26). Survival to hospital admission with ROSC occurred in 29.5% of the sCPR group compared to 28.4% in CCC group (OR = 1.20; 95% CI: 0.89-1.63; p = 0.24). CONCLUSIONS This systematic review and meta-analysis concluded that there were no significant differences in the resuscitation outcomes between the use of standard cardiopulmonary resuscitation and chest compression only.
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Affiliation(s)
- Karol Bielski
- Institute of Outcomes Research, Polonia Academy, Czestochowa, Poland
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jacek Smereka
- Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Emergency Medical Service, Medical University of Wroclaw, Poland
| | | | - Michal Pruc
- Polish Society of Disaster Medicine, Warsaw, Poland
- Institute of Outcomes Research, Polonia Academy, Czestochowa, Poland
| | - Francesco Chirico
- Postgraduate School of Occupational Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, State Police, Ministry of Interior, Milan, Italy
| | - Aleksandra Gasecka
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, the Netherlands
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
| | - Nataliia Litvinova
- European Medical School, International European University, Kiev, Ukraine
| | | | - Grazyna Nowak-Starz
- Collegium Medicum Institute of Health Sciences, Kochanowski University, Kielce, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, TX, United States
| | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine Houston, TX, United States
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
- Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
- Polish Society of Disaster Medicine, Warsaw, Poland.
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23
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Szarpak L, Jaguszewski MJ, Pruc M, Malysz M, Gasecka A, Rafique Z. Safety and efficacy of clopidogrel versus ticagrelor in acute coronary syndrome in the prehospital setting. Am J Emerg Med 2021; 56:351-352. [PMID: 34635386 DOI: 10.1016/j.ajem.2021.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland; Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland; Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland.
| | | | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
| | - Marek Malysz
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
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24
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Jaguszewski MJ, Gasecka A, Hering D, Filipiak KJ, Szarpak L, Fijałkowski M, Gruchała M. Levosimendan improves the acute course of takotsubo syndrome: a pooled analysis. ESC Heart Fail 2021; 8:4360-4363. [PMID: 34342162 PMCID: PMC8497347 DOI: 10.1002/ehf2.13486] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/11/2021] [Accepted: 06/07/2021] [Indexed: 01/31/2023] Open
Affiliation(s)
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Dagmara Hering
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland.,Maria Sklodowska-Curie Białystok Oncology Center, Białystok, Poland
| | - Marcin Fijałkowski
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
| | - Marcin Gruchała
- 1st Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland
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25
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Kaminska H, Szarpak L, Kosior D, Wieczorek W, Szarpak A, Al-Jeabory M, Gawel W, Gasecka A, Jaguszewski MJ, Jarosz-Chobot P. Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis. Acta Diabetol 2021; 58:1101-1110. [PMID: 33778910 PMCID: PMC8005367 DOI: 10.1007/s00592-021-01701-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/03/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND The novel coronavirus disease 2019 (COVID-19) has spread worldwide since the beginning of 2020, placing the heavy burden on the health systems all over the world. The population that particularly has been affected by the pandemic is the group of patients suffering from diabetes mellitus. Having taken the public health in considerations, we have decided to perform a systematic review and meta-analysis of diabetes mellitus on in-hospital mortality in patients with COVID-19. METHODS A systematic literature review (MEDLINE, EMBASE, Web of Science, Scopus, Cochrane) including all published clinical trials or observational studies published till December 10, 2020, was performed using following terms "diabetes mellitus" OR "diabetes" OR "DM" AND "survival" OR "mortality" AND "SARS-CoV-2" OR "COVID-19". RESULTS Nineteen studies were included out of the 7327 initially identified studies. Mortality of DM patients vs non-DM patients was 21.3 versus 6.1%, respectively (OR = 2.39; 95%CI: 1.65, 3.64; P < 0.001), while severe disease in DM and non-DM group varied and amounted to 34.8% versus 22.8% (OR = 1.43; 95%CI: 0.82, 2.50; P = 0.20). In the DM group, the complications were observed far more often when compared with non-DM group, both in acute respiratory distress (31.4 vs. 17.2%; OR = 2.38; 95%CI:1.80, 3.13; P < 0.001), acute cardiac injury (22.0% vs. 12.8%; OR = 2.59; 95%CI: 1.81, 3.73; P < 0.001), and acute kidney injury (19.1 vs. 10.2%; OR = 1.97; 95%CI: 1.36, 2.85; P < 0.001). CONCLUSIONS Based on the findings, we shall conclude that diabetes is an independent risk factor of the severity of COVID-19 in-hospital settings; therefore, patients with diabetes shall aim to reduce the exposure to the potential infection of COVID-19.
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Affiliation(s)
- Halla Kaminska
- Department of Pediatrics and Children's Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Silesia, Poland
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Bialystok Oncology Center, Ogrodowa 12 str., 15-027, Bialystok, Poland.
- Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Dariusz Kosior
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
- Department of Cardiology and Hypertension With Electrophysiological Lab, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Wojciech Wieczorek
- Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | | | - Wladyslaw Gawel
- Department of Surgery, The Silesian Hospital in Opava, Opava, Czech Republic
| | - Aleksandra Gasecka
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
- Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Center, Amsterdam, The Netherlands
- 1St Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Przemyslawa Jarosz-Chobot
- Department of Pediatrics and Children's Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Silesia, Poland
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26
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Szarpak L, Rafique Z, Gasecka A, Chirico F, Gawel W, Hernik J, Kaminska H, Filipiak KJ, Jaguszewski MJ, Szarpak L. A systematic review and meta-analysis of effect of vitamin D levels on the incidence of COVID-19. Cardiol J 2021; 28:647-654. [PMID: 34308537 PMCID: PMC8428943 DOI: 10.5603/cj.a2021.0072] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/04/2021] [Accepted: 06/04/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a disease primarily affecting the respiratory tract, however due to the nature of the pathogenesis it is able to affect the whole body. So far, no causative treatment has been found and the main strategy when dealing with COVID-19 relies on widespread vaccination programs and symptomatic treatment. Vitamin D due to its ability to modulate the immunological system has been proposed as a factor playing role in the organism response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Therefore, we decided to perform this meta-analysis which aimed to establish a connection between vitamin D status and COVID-19 infection. METHODS Study was designed as a systematic review and meta-analysis. PubMed, EMBASE, Web of Science, Cochrane Collaboration Databases and Scopus electronic databases were searched for relevant studies from database inception to May 10th, 2021. Mean differences (MDs) with their 95% confidence intervals (CI) were calculated. RESULTS Thirteen studies providing data for 14,485 participants met the inclusion criteria. Mean vitamin D levels in SARS-CoV-2 negative patients was 17.7 ± 6.9 ng/mL compared to SARS-CoV-2 positive patients 14.1 ± 8.2 ng/mL (MD = 3.93; 95% CI 2.84-5.02; I2 = 99%; p < 0.001). CONCLUSIONS Low serum vitamin D levels are statistically significantly associated with the risk of COVID-19 infection. Supplementation of vitamin D especially in the deficiency risk groups is indicated.
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Affiliation(s)
- Luiza Szarpak
- Institute of Outcomes R esearch, Polonia University, Czestochowa, Poland
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland
- Department of Cardiology, University Medical Center Utrecht, The Netherlands
| | - Francesco Chirico
- Post-graduate School of Occupational Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Health Service Department, Italian State Police, Ministry of the Interior, Milano, Italy
| | - Wladyslaw Gawel
- Department of Surgery, The Silesian Hospital in Opava, Czech Republic
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jacek Hernik
- Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Halla Kaminska
- Polish Society of Disaster Medicine, Warsaw, Poland
- Department of Pediatrics and Children's Diabetology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Zabrze, Poland
| | | | | | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.
- Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.
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27
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Meyer-Szary J, Gasecka A, John I, Jaguszewski MJ, Peacock FW, Gilis-Malinowska N, Szarpak L. Outcomes associated with lidocaine and amiodarone administration in pediatric in-hospital cardiac arrest. Cardiol J 2021; 28:783-785. [PMID: 34240400 DOI: 10.5603/cj.a2021.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/08/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Jaroslaw Meyer-Szary
- Department of Pediatric Cardiology and Congenital Heart Diseases, Medical University of Gdansk, Poland, Poland.
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | - Ivo John
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
| | | | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | | | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Poland.,Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland
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28
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Szarpak L, Pruc M, Gasecka A, Jaguszewski MJ, Michalski T, Peacock FW, Smereka J, Pytkowska K, Filipiak KJ. Should we supplement zinc in COVID-19 patients? Evidence from meta-analysis. Pol Arch Intern Med 2021; 131:802-807. [PMID: 34180610 DOI: 10.20452/pamw.16048] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Preliminary retrospective reports showed that zinc supplementation may decrease mortality in COVID-19 patients, postulating the potential therapeutic efficacy of zinc in the management of the disease. OBJECTIVES We sought to summarize the studies published to date regarding the antiviral activity of zinc in COVID-19 patients. PATIENTS AND METHODS A meta-analysis was performed to compare the outcomes of hospitalized patients receiving zinc supplementation and those treated with standard care. The primary outcome was survival to hospital discharge. Secondary outcomes were in-hospital mortality and length of stay in hospital or intensive care unit (ICU). RESULTS Data relating to 1474 patients included in four studies were analyzed. Survival to hospital discharge was 56.8% in the zinc group, compared to 75.9% in the non-zinc group (P=0.88). In-hospital mortality was 22.3% in the zinc group, compared to 13.6% for the standard care group (P=0.16). Length of hospital stay was 7.7(3.7) days in the zinc group and 7.2(3.9) days in the standard treatment group (P<0.001). Length of ICU stay was 4.9(1.7) days in the zinc group and 5.8(1.9) days in the standard care group (P=0.009). CONCLUSIONS Zinc supplementation did not have any beneficial impact on the course of COVID-19 evaluated as survival to hospital discharge and in-hospital mortality. The zinc-supplemented group had longer hospital and ICU lengths of stay. There is at present no evidence-based data to support routine zinc supplementation in COVID-19 patients.
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Affiliation(s)
- Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
- Maria Sklodowska-Curie Bialystok Oncology Center, Białystok, Poland
| | - Michal Pruc
- Polish Society of Disaster Medicine, Raszyn, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
| | | | - Tomasz Michalski
- 1st Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas, United States
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wrocław, Poland
| | | | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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29
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Olszewska-Parasiewicz J, Szarpak Ł, Rogula S, Gąsecka A, Szymańska U, Kwiatkowska M, Jaguszewski MJ, Sierpiński R, Zaczyński A, Wierzba W, Kosior DA. Statins in COVID-19 Therapy. Life (Basel) 2021; 11:life11060565. [PMID: 34208435 PMCID: PMC8234902 DOI: 10.3390/life11060565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 01/08/2023] Open
Abstract
Inhibitors of 3-hydroxy-3methylgultaryl-coenzyme A reductase (statins) are one of the main groups of drugs used in preventing and treating cardiovascular diseases worldwide. They are widely available, cheap, and well-tolerated. Based on statins’ pleiotropic properties, including improvement of endothelial dysfunction, antioxidant properties, atherosclerotic plaque stabilization, and inhibition of inflammatory responses, it can be hypothesized that the use of statins, at least as an adjuvant in antiviral therapy, may be justified. All these effects might be especially beneficial in patients with COVID-19, suffering from endothelial dysfunction, microvascular and macrovascular thrombosis, and cytokine storm. Here, we review the recent data regarding the pathophysiology of SARS-CoV-2 activity in host cells, proposed COVID-19 therapy, the pleiotropic activity of statins, and statins in clinical trials in respiratory infections. According to the guidelines of the European and American Cardiac Societies, in patients with cardiovascular disease or high cardiovascular risk with concomitant COVID-19 it is recommended to continue statin treatment. However, the initiation of statin therapy de novo in COVID-19 treatment should only be done as part of a clinical trial.
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Affiliation(s)
- Justyna Olszewska-Parasiewicz
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Łukasz Szarpak
- Maria Sklodowska-Curie Białystok Oncology Centre, Ogrodowa 12, 15-027 Białystok, Poland
- Maria Sklodowska-Curie Medical Academy in Warsaw, Solidarnosci 12, 03-411 Warsaw, Poland
- Correspondence:
| | - Sylwester Rogula
- Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (A.G.)
| | - Aleksandra Gąsecka
- Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (A.G.)
| | - Urszula Szymańska
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Maria Kwiatkowska
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Milosz J. Jaguszewski
- Department of Cardiology, Medical University of Gdańsk, Dębinki 7, 80-952 Gdańsk, Poland;
| | - Radosław Sierpiński
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland;
| | - Artur Zaczyński
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Waldemar Wierzba
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
- UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, Felińskego 15, 01-513 Warsaw, Poland
| | - Dariusz A. Kosior
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
- Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
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30
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Rogula S, Błażejowska E, Gąsecka A, Szarpak Ł, Jaguszewski MJ, Mazurek T, Filipiak KJ. Inclisiran-Silencing the Cholesterol, Speaking up the Prognosis. J Clin Med 2021; 10:jcm10112467. [PMID: 34199468 PMCID: PMC8199585 DOI: 10.3390/jcm10112467] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/29/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
The reduction of circulating low-density lipoprotein-cholesterol (LDL-C) is a primary target in cardiovascular risk reduction due to its well-established benefits in terms of decreased mortality. Despite the use of statin therapy, 10%–20% of high- and very-high-risk patients do not reach their LDL-C targets. There is an urgent need for improved strategies to manage dyslipidemia, especially among patients with homozygous familial hypercholesterolemia, but also in patients with established cardiovascular disease who fail to achieve LDL goals despite combined statin, ezetimibe, and PCSK9 inhibitor (PCSK9i) therapy. Inclisiran is a disruptive, first-in-class small interfering RNA (siRNA)-based therapeutic developed for the treatment of hypercholesterolemia that inhibits proprotein convertase subtilisin–kexin type 9 (PCSK9) synthesis, thereby upregulating the number of LDL receptors on the hepatocytes, thus lowering the plasma LDL-C concentration. Inclisiran decreases the LDL-C levels by over 50% with one dose every 6 months, making it a simple and well-tolerated treatment strategy. In this review, we summarize the general information regarding (i) the role of LDL-C in atherosclerotic cardiovascular disease, (ii) data regarding the role of PCSK9 in cholesterol metabolism, (iii) pleiotropic effects of PCSK9, and (iv) the effects of PCSK9 silencing. In addition, we focus on inclisiran, in terms of its (i) mechanism of action, (ii) biological efficacy and safety, (iii) results from the ORION trials, (iv) benefits of its combination with statins, and (v) its potential future role in atherosclerotic cardiovascular disease.
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Affiliation(s)
- Sylwester Rogula
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (E.B.); (T.M.); (K.J.F.)
| | - Ewelina Błażejowska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (E.B.); (T.M.); (K.J.F.)
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (E.B.); (T.M.); (K.J.F.)
- Correspondence: ; Tel.: +48-22-599-19-59
| | - Łukasz Szarpak
- Maria Sklodowska-Curie Białystok Oncology Centre, Ogrodowa 12, 15-027 Białystok, Poland;
- Maria Sklodowska-Curie Medical Academy in Warsaw, Solidarności 12, 03-411 Warsaw, Poland
| | - Milosz J. Jaguszewski
- 1st Department of Cardiology, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland;
| | - Tomasz Mazurek
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (E.B.); (T.M.); (K.J.F.)
| | - Krzysztof J. Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (E.B.); (T.M.); (K.J.F.)
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31
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Navarese EP, Lansky AJ, Kereiakes DJ, Kubica J, Gurbel PA, Gorog DA, Valgimigli M, Curzen N, Kandzari DE, Bonaca MP, Brouwer M, Umińska J, Jaguszewski MJ, Raggi P, Waksman R, Leon MB, Wijns W, Andreotti F. Cardiac mortality in patients randomised to elective coronary revascularisation plus medical therapy or medical therapy alone: a systematic review and meta-analysis. Eur Heart J 2021; 42:4638-4651. [PMID: 34002203 PMCID: PMC8669551 DOI: 10.1093/eurheartj/ehab246] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/28/2021] [Accepted: 04/13/2021] [Indexed: 01/09/2023] Open
Abstract
Aims The value of elective coronary revascularisation plus medical therapy over medical therapy alone in managing stable patients with coronary artery disease is debated. We reviewed all trials comparing the two strategies in this population. Methods and results From inception through November 2020, MEDLINE, EMBASE, Google Scholar, and other databases were searched for randomised trials comparing revascularisation against medical therapy alone in clinically stable coronary artery disease patients. Treatment effects were measured by rate ratios (RRs) with 95% confidence intervals, using random-effects models. Cardiac mortality was the pre-specified primary endpoint. Spontaneous myocardial infarction (MI) and its association with cardiac mortality were secondary endpoints. Further endpoints included all-cause mortality, any MI, and stroke. Longest follow-up data were abstracted. The study is registered with PROSPERO (CRD42021225598). Twenty-five trials involving 19 806 patients (10 023 randomised to revascularisation plus medical therapy and 9783 to medical therapy alone) were included. Compared with medical therapy alone, revascularisation yielded a lower risk of cardiac death [RR 0.79 (0.67–0.93), P < 0.01] and spontaneous MI [RR 0.74 (0.64–0.86), P < 0.01]. By meta-regression, the cardiac death risk reduction after revascularisation, compared with medical therapy alone, was linearly associated with follow-up duration [RR per 4-year follow-up: 0.81 (0.69–0.96), P = 0.008], spontaneous MI absolute difference (P = 0.01) and percentage of multivessel disease at baseline (P = 0.004). Trial sequential and sensitivity analyses confirmed the reliability of the cardiac mortality findings. All-cause mortality [0.94 (0.87–1.01), P = 0.11], any MI (P = 0.14), and stroke risk (P = 0.30) did not differ significantly between strategies. Conclusion In stable coronary artery disease patients, randomisation to elective coronary revascularisation plus medical therapy led to reduced cardiac mortality compared with medical therapy alone. The cardiac survival benefit after revascularisation improved with longer follow-up times and was associated with fewer spontaneous MIs.
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Affiliation(s)
- Eliano P Navarese
- Interventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.,Faculty of Medicine, University of Alberta, Edmonton, Canada.,SIRIO MEDICINE research network, Poland
| | | | - Dean J Kereiakes
- Christ Hospital and Lindner Research Center, Cincinnati, OH, USA
| | - Jacek Kubica
- Interventional Cardiology and Cardiovascular Medicine Research, Department of Cardiology and Internal Medicine, Nicolaus Copernicus University, Bydgoszcz, Poland.,SIRIO MEDICINE research network, Poland
| | - Paul A Gurbel
- Sinai Center for Thrombosis Research and Drug Development, Sinai Hospital of Baltimore, Baltimore, MD, USA
| | - Diana A Gorog
- Faculty of Medicine, National Heart and Lung Institute, Imperial College, London, UK.,Cardiology Department, East and North Hertfordshire NHS Trust, Stevenage, UK
| | - Marco Valgimigli
- Department of Cardiology, Inselspital Universitätsspital, Bern, Switzerland
| | - Nick Curzen
- University Hospital Southampton NHS Foundation Trust, Southampton, UK.,University of Southampton, Southampton, UK
| | - David E Kandzari
- Department of Interventional Cardiology, Piedmont Heart Institute, Atlanta, GA, USA
| | - Marc P Bonaca
- CPC Clinical Research, University of Colorado School of Medicine, USA
| | - Marc Brouwer
- Department of Cardiology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Julia Umińska
- Department of Geriatrics, Nicolaus Copernicus University, Bydgoszcz, Poland
| | | | - Paolo Raggi
- Faculty of Medicine, University of Alberta, Edmonton, Canada
| | - Ron Waksman
- Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA
| | - Martin B Leon
- Division of Cardiovascular Medicine, Columbia University Irving Medical Center, New York, NY, USA.,Cardiovascular Research Foundation, New York, NY, USA
| | - William Wijns
- The Lambe Institute for Translational Medicine and Curam, National University of Ireland Galway and Saolta University Healthcare Group, Galway, Ireland
| | - Felicita Andreotti
- Direzione Scientifica, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy.,Cardiovascular Medicine, Catholic University Medical School, Rome, Italy
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Szarpak L, Borkowska M, Peacock FW, Rafique Z, Gasecka A, Smereka J, Pytkowska K, Jachowicz M, Iskrzycki L, Gilis-Malinowska N, Jaguszewski MJ. Characteristics and outcomes of in-hospital cardiac arrest in COVID-19. A systematic review and meta-analysis. Cardiol J 2021; 28:503-508. [PMID: 33942278 DOI: 10.5603/cj.a2021.0043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/18/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The purpose herein, was to perform a systematic review of interventional outcome studies in patients with in-hospital cardiac arrest before and during the coronavirus disease 2019 (COVID-19) pandemic period. METHODS A meta-analysis was performed of publications meeting the following PICOS criteria: (1) participants, patients > 18 years of age with cardiac arrest due to any causes; (2) intervention, cardiac arrest in COVID-19 period; (3) comparison, cardiac arrest in pre-COVID-19 period; (4) outcomes, detailed information for survival; (5) study design, randomized controlled trials, quasi-randomized or observational studies comparing cardiac arrest in COVID-19 and pre-COVID-19 period for their effects in patients with cardiac arrest. RESULTS Survival to hospital discharge for the pre-pandemic and pandemic period was reported in 3 studies (n =1432 patients) and was similar in the pre-pandemic vs. the pandemic period, 35.6% vs. 32.1%, respectively (odds ratio [OR] 1.72; 95% confidence interval [CI] 0.81-3.65; p = 0.16; I2 = 72%). Return of spontaneous circulation was reported by all 4 studies and were also similar in the pre and during COVID-19 periods, 51.9% vs. 48.7% (OR 1.27; 95% CI 0.78-2.07; p = 0.33; I2 = 71%), respectively. Pooled analysis of cardiac arrest recurrence was also similar, 24.9% and 17.9% (OR 1.60; 95% CI 0.99-2.57; p = 0.06; I2 = 32%) in the pre and during COVID-19 cohorts. Survival with Cerebral Performance Category 1 or 2 was higher in pre vs. during pandemic groups (27.3 vs. 9.1%; OR 3.75; 95% CI 1.26-11.20; p = 0.02). Finally, overall mortality was similar in the pre vs. pandemic groups, 65.9% and 67.2%, respectively (OR 0.67; 95% CI 0.33-1.34; p = 0.25; I2 = 76%). CONCLUSIONS Compared to the pre-pandemic period, in hospital cardiac arrest in COVID-19 patients was numerically higher but had statistically similar outcomes.
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Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland.,Maria Sklodowska-Curie Białystok Oncology Center, Bialystok, Poland
| | | | - Frank W Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, United States
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.,Department of Cardiology, University Medical Center Utrecht, The Netherlands
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Katarzyna Pytkowska
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Marta Jachowicz
- Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
| | - Lukasz Iskrzycki
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
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Szarpak L, Ruetzler K, Figatowski T, Pruc M, Gasecka A, Jaguszewski MJ. Efficacy and safety of prasugrel and clopidogrel in st-segment elevation myocardial infarction in prehospital setting. Am J Emerg Med 2021; 53:254-255. [PMID: 33934923 DOI: 10.1016/j.ajem.2021.04.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/15/2021] [Accepted: 04/15/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland; Polish Society of Disaster Medicine, Warsaw, Poland; Maria Sklodowska-Curie Białystok Oncology Centre, Białystok, Poland.
| | - Kurt Ruetzler
- Departments of General Anesthesiology and Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Tomasz Figatowski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Michal Pruc
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Aleksandra Gasecka
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands; 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Szarpak L, Michalski TA, Smereka J, Gasecka A, Pruc M, Jaguszewski MJ. Efficacy and safety of ticagrelor use in pre-hospital setting. Am J Emerg Med 2021; 52:265-266. [PMID: 33966923 DOI: 10.1016/j.ajem.2021.04.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/06/2021] [Accepted: 04/13/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland; Polish Society of Disaster Medicine, Warsaw, Poland; Maria Sklodowska-Curie Białystok Oncology Centre, Białystok, Poland.
| | - Tomasz A Michalski
- 1st Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra Gasecka
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands; 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Michal Pruc
- Polish Society of Disaster Medicine, Warsaw, Poland
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35
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Szarpak L, Rafique Z, Gasecka A, Jaguszewski MJ, Filipiak KJ. Tirofiban in emergency conditions: Systematic review. Am J Emerg Med 2021; 51:422-423. [PMID: 33824023 DOI: 10.1016/j.ajem.2021.03.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/22/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland; Maria Sklodowska-Curie Białystok Oncology Centre, Białystok, Poland; Polish Society of Disaster Medicine, Warsaw, Poland.
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Aleksandra Gasecka
- Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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36
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Al-Jeabory M, Gasecka A, Wieczorek W, Mayer-Szary J, Jaguszewski MJ, Szarpak L. Efficacy and safety of tranexamic acid in pediatric trauma patients: Evidence from meta-analysis. Am J Emerg Med 2021; 49:404-405. [PMID: 33722435 DOI: 10.1016/j.ajem.2021.02.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 01/20/2023] Open
Affiliation(s)
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland; Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Wojciech Wieczorek
- Polish Society of Disaster Medicine, Warsaw, Poland; Department of Emergency Medicine, Medical University of Warsaw, Warsaw, Poland
| | | | - Milosz J Jaguszewski
- Department of Paediatric Cardiology and Congenital Heart Diseases, Medical University of Gdansk, Gdansk, Poland
| | - Lukasz Szarpak
- Polish Society of Disaster Medicine, Warsaw, Poland; Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland; Maria Sklodowska-Cure Bialystok Oncology Centre, Białystok, Poland.
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37
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Al-Jeabory M, Szarpak L, Attila K, Simpson M, Smereka A, Gasecka A, Wieczorek W, Pruc M, Koselak M, Gawel W, Checinski I, Jaguszewski MJ, Filipiak KJ. Efficacy and Safety of Tranexamic Acid in Emergency Trauma: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:1030. [PMID: 33802254 PMCID: PMC7958951 DOI: 10.3390/jcm10051030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 12/01/2022] Open
Abstract
In trauma patients, bleeding can lead to coagulopathy, hemorrhagic shock, and multiorgan failure, and therefore is of fundamental significance in regard to early morbidity. We conducted a meta-analysis to evaluate the efficacy and safety of tranexamic acid (TXA) in civil and military settings and its impact on in-hospital mortality (survival to hospital discharge or 30-day survival), intensive care unit and hospital length of stay, incidence of adverse events (myocardial infarct and neurological complications), and volume of blood product transfusion. The systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic review of the literature using PubMed, Scopus, EMBASE, Web of Science, and the Cochrane Central Register and Controlled Trials (CENTRAL) database was conducted from inception to 10 January 2021. In-hospital mortality was reported in 14 studies and was 15.5% for the TXA group as compared with 16.4% for the non-TXA group (OR = 0.81, 95% CI 0.62-1.06, I2 = 83%, p = 0.12). In a civilian TXA application, in-hospital mortality in the TXA and non-TXA groups amounted to 15.0% and 17.1%, respectively (OR = 0.69, 95% CI 0.51-0.93, p = 0.02, I2 = 78%). A subgroup analysis of the randomized control trial (RCT) studies showed a statistically significant reduction in in-hospital mortality in the TXA group (14.3%) as compared with the non-TXA group (15.7%, OR = 0.89, 95% CI 0.83-0.96, p = 0.003, I2 = 0%). To summarize, TXA used in civilian application reduces in-hospital mortality. Application of TXA is beneficial for severely injured patients who undergoing shock and require massive blood transfusions. Patients who undergo treatment with TXA should be monitored for clinical signs of thromboembolism, since TXA is a standalone risk factor of a thromboembolic event and the D-dimers in traumatic patients are almost always elevated.
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Affiliation(s)
- Mahdi Al-Jeabory
- Outcomes Research Unit, Polish Society of Disaster Medicine, P.O. Box 78, 05-090 Raszyn, Poland
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, Poland
| | - Kecskes Attila
- NATO Centre of Excellence for Military Medicine, 1555 Budapest, Hungary
| | | | - Adam Smereka
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
- Department of Cardiology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Wojciech Wieczorek
- Department of Emergency Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Michal Pruc
- Outcomes Research Unit, Polish Society of Disaster Medicine, P.O. Box 78, 05-090 Raszyn, Poland
| | - Maciej Koselak
- Maria Sklodowska-Curie Medical Academy in Warsaw, 03-411 Warsaw, Poland
| | - Wladyslaw Gawel
- Department of Surgery, The Silesian Hospital in Opava, 746 01 Opava, Czech Republic
| | - Igor Checinski
- Department of Emergency Medical Service, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Milosz J Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland
| | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-091 Warsaw, Poland
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38
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Gasecka A, Pruc M, Kukula K, Gilis-Malinowska N, Filipiak KJ, Jaguszewski MJ, Szarpak L. Post-COVID-19 heart syndrome. Cardiol J 2021; 28:353-354. [PMID: 33645626 DOI: 10.5603/cj.a2021.0028] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 02/22/2021] [Indexed: 01/12/2023] Open
Affiliation(s)
- Aleksandra Gasecka
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland. .,Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Michał Pruc
- Polish Society of Disaster Medicine, Warsaw, Poland
| | - Katarzyna Kukula
- Polish Society of Disaster Medicine, Warsaw, Poland.,Maria Sklodowska-Curie Medical Academy in Warsaw, Poland
| | | | | | | | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Poland.,Maria Sklodowska-Curie Białystok Oncology Center, Białystok, Poland
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39
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Jaguszewski MJ, Gasecka A, Filipiak KJ, Szarpak L. Levosimendan or dobutamine in patients with low cardiac output syndrome: Results from meta-analysis. Int J Cardiol 2021; 333:145. [PMID: 33639185 DOI: 10.1016/j.ijcard.2021.02.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/08/2021] [Accepted: 02/18/2021] [Indexed: 10/22/2022]
Affiliation(s)
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland; Department of Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland; Maria Sklodowska-Curie Białystok Oncology Centre, Białystok, Poland
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40
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Szarpak L, Gasecka A, Opiełka M, Gilis-Malinowska N, Filipiak KJ, Jaguszewski MJ. Copeptin level differentiates takotsubo cardiomyopathy from acute myocardial infarction. Biomarkers 2021; 26:75-76. [PMID: 33433256 DOI: 10.1080/1354750x.2021.1875503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Lukasz Szarpak
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland.,Białystok Oncology Centre, Białystok, Poland
| | - Aleksandra Gasecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.,Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mikołaj Opiełka
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Krzysztof J Filipiak
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
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Szarpak L, Zaczynski A, Kosior D, Bialka S, Ladny JR, Gilis-Malinowska N, Smereka J, Kanczuga-Koda L, Gasecka A, Filipiak KJ, Jaguszewski MJ. Evidence of diagnostic value of ferritin in patients with COVID-19. Cardiol J 2020; 27:886-887. [PMID: 33346371 DOI: 10.5603/cj.a2020.0171] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- Lukasz Szarpak
- Maria Skłodowska-Curie Medical Academy in Warsaw, Poland. .,Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland.. .,Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland..
| | - Artur Zaczynski
- Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland
| | - Dariusz Kosior
- Department of Cardiology and Hypertension with Electrophysiological Lab, Central Clinical Hospital of the Ministry of the Interior and Administration in Warsaw, Warsaw, Poland.,Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Szymon Bialka
- Department of Anaesthesiology and Intensive Care, Medical University of Silesia, Katowice, Poland
| | - Jerzy R Ladny
- Polish Society of Disaster Medicine, Warsaw, Poland.,Chair of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland
| | | | - Jacek Smereka
- Polish Society of Disaster Medicine, Warsaw, Poland.,Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | | | - Aleksandra Gasecka
- First Chair and Department of Cardiology, Medical University of Warsaw, Poland
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Świeczkowski D, Zdanowski S, Merks P, Szarpak Ł, Vaillancourt R, Jaguszewski MJ. The plague of unexpected drug recalls and the pandemic of falsified medications in cardiovascular medicine as a threat to patient safety and global public health: A brief review. Cardiol J 2020; 29:133-139. [PMID: 33346374 PMCID: PMC8890415 DOI: 10.5603/cj.a2020.0168] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/19/2020] [Accepted: 11/20/2020] [Indexed: 11/25/2022] Open
Abstract
Valsartan, losartan, and irbesartan, are widely used in the treatment strategies of cardiovascular medicine diseases, including hypertension and heart failure. Recently, many formulations for the aforementioned diseases contained active pharmaceutical ingredients and had been abruptly recalled from the market due to safety concerns mainly associated with unwanted impurities — nitrosamines, which are highly carcinogenic substances accidentally produced during manufacturing. Along with cardiovascular medications, formulations containing ranitidine were also recalled from the market. This poses a particular threat to public health due to the non-prescription status of these drugs. Regulatory authorities, including the Food and Drug Administration and European Medicines Agency among others, have taken action to minimize patient risk and improve the manufacturing quality as well as re-checking current guidelines and recommendations. While these steps are necessary to avoid further recalls, authorities should remember the growing concerns of patients regarding the safety and efficacy of pharmacotherapy. Apart from the genuine manufacturing mistakes mentioned above, falsified and counterfeit medications should be at the heart of global attention. The lack of a well-accepted definition of falsified/counterfeit medications has impeded political and scientific efforts to mitigate risk of this phenomenon. Falsified Medicines Directive should be considered the most pivotal legislation recently enacted to harmonize international cooperation. In summary, one should remember that only international and direct collaboration between patients, stakeholders, and authorities be considered a remedy for a pandemic of falsified medicines and plague of unexpected recalls due to safety concerns.
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Affiliation(s)
- Damian Świeczkowski
- First Department of Cardiology, Medical University of Gdansk, Poland, Dębinki Street 7, 80-211, Gdańsk, Poland.
| | - Szymon Zdanowski
- Department of Anaesthesiology and Intensive Therapy, Medical University of Gdansk, Mariana Smoluchowskiego 17, 80-214, Gdańsk, Poland
| | - Piotr Merks
- Medical Department, Cardinal Stefan Wyszyński University in Warsaw, Wóycickiego Street 1/3, 01 - 938 Warsaw, Poland
| | - Łukasz Szarpak
- Bialystok Oncology Center, Ogrodowa 12 Str., 15-027 Bialystok, Poland
| | - Régis Vaillancourt
- Children's Hospital of Eastern Ontario, 401, Smith Road, Ottawa, K1H 8L1, Canada
| | - Milosz J Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Poland, Dębinki Street 7, 80-211, Gdańsk, Poland
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Ludwin K, Safiejko K, Smereka J, Nadolny K, Cyran M, Yakubtsevich R, Jaguszewski MJ, Filipiak KJ, Szarpak L, Rodríguez-Núñez A. Systematic review and meta-analysis appraising efficacy and safety of adrenaline for adult cardiopulmonary resuscitation. Cardiol J 2020; 28:279-292. [PMID: 33140398 DOI: 10.5603/cj.a2020.0133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND There is a beneficial effect of adrenaline during adult cardiopulmonary resuscitation (CPR) from cardiac arrest but there is also uncertainty about its safety and effectiveness. The aim of this study was to evaluate the use of adrenaline versus non-adrenaline CPR. METHODS PubMed, ScienceDirect, Embase, CENTRAL (Cochrane Central Register of Controlled Trials) and Google Scholar databases were searched from their inception up to 1st July 2020. Two reviewers independently assessed eligibility and risk of bias, with conflicts resolved by a third reviewer. Risk ratio (RR) or mean difference of groups were calculated using fixed or random-effect models. RESULTS Nineteen trials were identified. The use of adrenaline during CPR was associated with a significantly higher percentage of return of spontaneous circulation (ROSC) compared to non-adrenaline treatment (20.9% vs. 5.9%; RR = 1.87; 95% confidence interval [CI] 1.37-2.55; p < 0.001). The use of adrenaline in CPR was associated with ROSC at 19.4% and for non-adrenaline treatment - 4.3% (RR = 3.23; 95% CI 1.89-5.53; p < 0.001). Survival to discharge (or 30-day survival) when using adrenaline was 6.8% compared to non-adrenaline treatment (5.5%; RR = 0.99; 95% CI 0.76-1.30; p = 0.97). However, the use of adrenaline was associated with a worse neurological outcome (1.6% vs. 2.2%; RR = 0.57; 95% CI 0.42-0.78; p < 0.001). CONCLUSIONS This review suggests that resuscitation with adrenaline is associated with the ROSC and survival to hospital discharge, but no higher effectiveness was observed at discharge with favorable neurological outcome. The analysis showed higher effectiveness of ROSC and survival to hospital discharge in non-shockable rhythms. But more multicenter randomized controlled trials are needed in the future.
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Affiliation(s)
- Kobi Ludwin
- Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Jacek Smereka
- Polish Society of Disaster Medicine, Warsaw, Poland.,Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Klaudiusz Nadolny
- Department of Emergency Medical Service, Higher School of Strategic Planning in Dabrowa Gornicza, Dabrowa Gornicza, Poland.,Faculty of Medicine, Katowice School of Technology, Katowice, Poland
| | - Maciej Cyran
- Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland
| | - Ruslan Yakubtsevich
- Department of Anesthesiology and Intensive Care Grodno State Medical University, Grodno, Belarus
| | | | - Krzysztof J Filipiak
- First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Lukasz Szarpak
- Bialystok Oncology Center, Bialystok, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland. .,Maria Sklodowska-Curie Medical Academy in Warsaw, Warsaw, Poland.
| | - Antonio Rodríguez-Núñez
- Pediatric Intensive Care Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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Borkowska MJ, Smereka J, Safiejko K, Nadolny K, Maslanka M, Filipiak KJ, Jaguszewski MJ, Szarpak L. Out-of-hospital cardiac arrest treated by emergency medical service teams during COVID-19 pandemic: A retrospective cohort study. Cardiol J 2020; 28:15-22. [PMID: 33140396 DOI: 10.5603/cj.a2020.0135] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/02/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a challenge for medical personnel, especially in the current COVID-19 pandemic, where medical personnel should perform resuscitation wearing full personal protective equipment. This study aims were to assess the characteristics and outcomes of adults who suffered an OHCA in the COVID-19 pandemic treated by emergency medical service (EMS) teams. METHODS All EMS-attended OHCA adults over than 18 years in the Polish EMS registry were analyzed. The retrospective EMS database was conducted. EMS interventions performed between March 1, and April 30, 2020 were retrospectively screened. RESULTS In the study period EMS operated 527 times for OHCA cases. The average age of patients with OHCA was 67.8 years. Statistically significantly more frequently men were involved (64.3%). 298 (56.6%) of all OHCA patients had resuscitation attempted by EMS providers. Among resuscitated patients, 73.8% were cardiac etiology. 9.4% of patients had return of spontaneous circulation, 27.2% of patients were admitted to hospital with ongoing chest compression. In the case of 63.4% cardiopulmonary resuscitation was ineffective and death was determined. CONCLUSIONS The present study found that OHCA incidence rate in the Masovian population (central region of Poland) in March-April 2020 period was 12.2/100,000 adult inhabitants. Return of spontaneous circulation in EMS was observed only in 9.4% of resuscitated patients. The presence of shockable rhythms was associated with better prognosis. The prehospital mortality, even though it was high, did not differ from those reported by other studies.
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Affiliation(s)
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | | | - Klaudiusz Nadolny
- Faculty of Medicine, Katowice School of Technology, Katowice, Poland.,Department of Emergency Medical Service, Strategic Planning University of Dabrowa Gornicza, Dabrowa Gornicza, Poland
| | - Maciej Maslanka
- Polish Society of Disaster Medicine, Warsaw, Poland.,Maria Skłodowska-Curie Medical Academy in Warsaw, Poland
| | - Krzysztof J Filipiak
- First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Lukasz Szarpak
- Białystok Oncology Center, Białystok, Poland. .,Polish Society of Disaster Medicine, Warsaw, Poland.
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Safiejko K, Smereka J, Filipiak KJ, Szarpak A, Dabrowski M, Ladny JR, Jaguszewski MJ, Szarpak L. Effectiveness and safety of hypotension fluid resuscitation in traumatic hemorrhagic shock: a systematic review and meta-analysis of randomized controlled trials. Cardiol J 2020; 29:463-471. [PMID: 32648249 PMCID: PMC9170316 DOI: 10.5603/cj.a2020.0096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/06/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Although the resuscitation of an adult trauma patient has been researched and written about for the past century, the ideal fluid strategy to infuse during the initial resuscitation period remains unresolved. This work was aimed at assessing the effect of hypotensive versus conventional resuscitation strategies in traumatic hemorrhagic shock patients on mortality, and the need for blood transfusions including adverse events. METHODS This systematic review and meta-analysis were performed following the PRISMA guidelines. Electronic databases were searched for randomized controlled trials (RCT) comparing the effect of hypotension versus conventional fluid resuscitation for traumatic hemorrhagic shock patients. Two reviewers independently performed the screening, data extraction, and bias assessment. The data analysis was completed using the Cochrane Collaboration's software RevMan 5.4. RESULTS Data from 28 RCTs on 4503 patients were included in the final meta-analysis. Patients receiving hypotension fluid resuscitation compared with conventional fluid resuscitation experienced less mortality (12.5% vs. 21.4%; RR = 0.58; 95% CI: 0.51-0.66; p < 0.001), fewer adverse events (10.8% vs. 13.4%; RR = 0.70; 95% CI: 0.59-0.83; p < 0.001), including fever acute respiratory distress syndrome (7.8% vs. 16.8%) or multiple organ dysfunction syndrome (8.6% vs. 21.6%). CONCLUSIONS This meta-analysis showed that hypotensive fluid resuscitation significantly reduced the mortality of hypovolemic shock patients. Findings are low in certainty and should be interpreted with caution. Therefore, there is an urgent need for larger, multicenter, randomized trials to confirm these findings.
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Affiliation(s)
- Kamil Safiejko
- Comprehensive Cancer Center in Bialystok, Bialystok, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Krzysztof J Filipiak
- First Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Agnieszka Szarpak
- Maria Skłodowska-Curie Madical Academy in Warsaw, Warsaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Marek Dabrowski
- Chair and Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
| | - Jerzy R Ladny
- Clinic of Emergency Medicine, Medical University of Bialystok, Bialystok, Poland; Polish Society of Disaster Medicine, Warsaw, Poland.,Polish Society of Disaster Medicine, Warsaw, Poland
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Majer J, Jaguszewski MJ, Frass M, Leskiewicz M, Smereka J, Ładny JR, Robak O, Szarpak Ł. Does the use of cardiopulmonary resuscitation feedback devices improve the quality of chest compressions performed by doctors? A prospective, randomized, cross-over simulation study. Cardiol J 2018; 26:529-535. [PMID: 30155865 DOI: 10.5603/cj.a2018.0091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 08/24/2018] [Accepted: 07/22/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of the study was to compare the quality of chest compressions (CCs) carried out with and without the use of the TrueCPR device during simulated cardiopulmonary resuscitations conducted by trainee doctors. METHODS The study was a prospective, randomized, cross-over simulation study. The study involved 65 trainee doctors who were tasked with performing a 2-min cycle of uninterrupted CCs under conditions of a simulated cardiopulmonary resuscitation of adults. CC were carried out in two scenarios: with and without TrueCPR chest compression support. Participants did not have experience in the use of CCs prior to this study. RESULTS The depth of compressions in regard to CC techniques were varied by 45 mm (IQR 43-48) for manual CC and 53 mm (IQR 51-55) for the TrueCPR device (p < 0.001). The incidence of CCs with and without TrueCPR was: 112 (IQR 103-113) vs. 129 (IQR 122-135) compressions (p = 0.002). The degree of complete chest relaxation with the TrueCPR device was 95% (IQR 76-99) and without the device, 33% (IQR 29-38) (p < 0.001). CONCLUSIONS In the simulation study performed, the use of the TrueCPR device resulted in a significant improvement in the quality of CCs in relation to frequency and depth of CCs and correctness of chest relaxation.
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Affiliation(s)
| | | | - Michael Frass
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Marcin Leskiewicz
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek Smereka
- Department of Emergency Medical Service, Wroclaw Medical University, Wroclaw, Poland
| | - Jerzy R Ładny
- Department of Emergency Medicine and Disaster, Medical University Bialystok, Bialystok, Poland
| | - Oliver Robak
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
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Opolski MP, Jaguszewski MJ, Spiewak M, Witkowski A. Optical Coherence Tomography for Guiding Plaque Stabilization in a Patient With Myocardial Infarction and Massive Coronary Thrombosis. J Invasive Cardiol 2018; 30:E59-E60. [PMID: 29958180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
An OCT-guided watchful-waiting strategy is used to avoid the invasive treatment of the LMCA in a very young patient with massive coronary thrombosis.
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Affiliation(s)
- Maksymilian P Opolski
- Department of Interventional Cardiology and Angiology, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland.
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Jaguszewski MJ, Cortes C, Daucher H, Schincariol M, Halejcio M, Besuch P, Gutiérrez-Chico JL. Very late stent thrombosis in everolimus-eluting stent with predisposing mechanical factors: Differential features. Cardiol J 2018; 24:345-349. [PMID: 28831778 DOI: 10.5603/cj.2017.0089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 05/09/2017] [Accepted: 05/12/2017] [Indexed: 11/25/2022] Open
Abstract
no abstract.
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Affiliation(s)
| | | | | | | | | | | | - Juan Luis Gutiérrez-Chico
- Klinikum Frankfurt (Oder), Interventional Cardiology, Germany; Institute of Cardiovascular Translational Research of Atlantic (ICTRA), Berlin, Germany.
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Swieczkowski D, Merks P, Gruchala M, Jaguszewski MJ. The role of the pharmacist in the care of patients with cardiovascular diseases. Kardiol Pol 2016; 74:1319-1326. [PMID: 27714709 DOI: 10.5603/kp.a2016.0136] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022]
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