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He S, Wang S, Xu T, Wang S, Qi M, Chen Q, Lin L, Wu H, Gan P. Role of Thiamine Supplementation in the Treatment of Chronic Heart Failure: An Updated Meta-Analysis of Randomized Controlled Trials. Clin Cardiol 2024; 47:e24309. [PMID: 38940395 PMCID: PMC11212003 DOI: 10.1002/clc.24309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains uncertain. HYPOTHESIS Receiving supplementary thiamine may not confer benefits to patients with CHF. METHODS A comprehensive search was conducted across the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases up until May 2023 to identify articles investigating the effects of thiamine supplementation in CHF patients. Predefined criteria were utilized for selecting data on study characteristics and results. RESULTS Seven randomized, double-blind, controlled trials (five parallel trials and two crossover trials) involving a total of 274 patients were enrolled. The results of the meta-analysis pooling these studies did not reveal any significant effect of thiamine treatment compared with placebo on left ventricular ejection fraction (WMD = 1.653%, 95% CI: -1.098 to 4.405, p = 0.239, I2 = 61.8%), left ventricular end-diastolic volume (WMD = -6.831 mL, 95% CI: -26.367 to 12.704, p = 0.493, I2 = 0.0%), 6-min walking test (WMD = 16.526 m, 95% CI: -36.582 to 69.634, p = 0.542, I2 = 66.3%), N-terminal pro-B type natriuretic peptide (WMD = 258.150 pg/mL, 95% CI: -236.406 to 752.707, p = 0.306, I2 = 21.6%), or New York Heart Association class (WMD = -0.223, 95% CI: -0.781 to 0.335, p = 0.434, I2 = 87.1%). However, it effectively improved the status of thiamine deficiency (TD). CONCLUSIONS Our meta-analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.
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Affiliation(s)
- Shuai He
- Department of Hand and Foot SurgeryTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Shasha Wang
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Tingli Xu
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Shuwei Wang
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Minfang Qi
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Qingqing Chen
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Lu Lin
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Huijuan Wu
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
| | - Pengcheng Gan
- Department of Intensive Care RehabilitationTaizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical UniversityTaizhouZhejiangChina
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Cobilinschi C, Andrei CA, Grinţescu IM, Mirea L. Metabolic failure due to thiamine deficiency during critical illness. Curr Opin Clin Nutr Metab Care 2024; 27:155-162. [PMID: 38205831 DOI: 10.1097/mco.0000000000001017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
PURPOSE OF REVIEW Thiamine is a crucial component in cellular energy metabolism, serving as a cofactor for multiple enzymatic processes and also having a role in regulating neuronal and neuromuscular transmission. Also it exerts antioxidant proprieties. The objective of this review is to consolidate and assess the most recent research concerning the consequences of insufficient thiamine levels for critically ill patients and to examine thiamine-related interventions. RECENT FINDINGS Recent studies have unveiled a noteworthy association between thiamine deficiency and unfavorable consequences, such as heightened morbidity and fatality rates. The aforementioned deficiency exhibits a significant presence in medical situations such as starvation and alcohol use disorder, but also in patients during critical illness. Thiamine deficiency can have significant metabolic implications resulting in compromised energy generation and organ dysfunction, warranting prompt recognition and management. SUMMARY Thiamine deficiency may not be recognized in critical care. Timely identification and management are imperative to mitigate adverse outcomes and improve patient prognosis. Thiamine may offer benefits for specific patient groups at higher risk of deficiency. Future studies should focus to establish optimal dosing, timing, and monitoring strategies on understanding the pathophysiological changes associated with thiamine deficiency in ICU patients and clarify its role in improving clinical outcomes.
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Affiliation(s)
- Cristian Cobilinschi
- Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest
- Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Cosmin-Andrei Andrei
- Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest
- Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Ioana Marina Grinţescu
- Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest
- Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Liliana Mirea
- Department of Anesthesiology and Intensive Care, Clinical Emergency Hospital Bucharest
- Department of Anesthesiology and Intensive Care II, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
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Naseem MA, Qadeer A, Zain A. Comment on: Physician Radiation Exposure during Endomyocardial Biopsy and Right Heart Catheterization. Curr Probl Cardiol 2023; 48:101930. [PMID: 37422034 DOI: 10.1016/j.cpcardiol.2023.101930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Affiliation(s)
| | - Ahsan Qadeer
- King Edward Medical University, Lahore, Pakistan
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Zain A, Naseem MA, Qadeer A. Comment on: Blood Coagulation Disorders in Heart Failure: From Basic Science to Clinical Perspectives. Curr Probl Cardiol 2023; 48:101929. [PMID: 37422044 DOI: 10.1016/j.cpcardiol.2023.101929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Ahmad Zain
- Services Institute of Medical Sciences, Pakistan.
| | | | - Ahsan Qadeer
- King Edward Medical University, Lahore, Pakistan
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Qadeer A, Naseem MA, Zain A. Comment on: Soluble Urokinase Plasminogen Activator Receptor Levels and Outcomes in Patients With Heart Failure. Curr Probl Cardiol 2023; 48:101946. [PMID: 37422030 DOI: 10.1016/j.cpcardiol.2023.101946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Ahsan Qadeer
- King Edward Medical University, Lahore, Pakistan.
| | | | - Ahmad Zain
- Services Institute of Medical Sciences, Pakistan
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Mansoor M, Shakil F, Jalal U, Shahid F, Jamal M, Ali AS, Abbasi FA, Hijazi H, Imran H, Hirani S, Javaid A, Abu Bakar A, Shah AA, Varrassi G, Khatri M, Kumar S. Comparison of the Efficacy of Cisplatin/Paclitaxel Versus Carboplatin/Paclitaxel in Improving Survival and Quality of Life in the Advanced Ovarian Cancer Patient Population: A Systematic Review and Meta-Analysis of Randomized Control Trials. Cureus 2023; 15:e51011. [PMID: 38264391 PMCID: PMC10803949 DOI: 10.7759/cureus.51011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 12/23/2023] [Indexed: 01/25/2024] Open
Abstract
Ovarian cancer, being one of the prevalent gynecological cancers, warrants a therapy that's both effective and well tolerated. After extensive drug testing, combination regimens with paclitaxel plus platinum-based agents such as cisplatin/carboplatin and taxanes, have shown promising results for advanced ovarian cancer. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to compare the efficacy of two treatment regimens for advanced ovarian cancer: cisplatin/paclitaxel and carboplatin/paclitaxel. PubMed (Medline), Science Direct, and Cochrane Library were searched from inception to March 2023. The meta-analysis included patients with histologically verified International Federation of Gynaecology and Obstetrics (FIGO) stages IIB to IV ovarian carcinoma who received either carboplatin/paclitaxel or cisplatin/paclitaxel. The primary outcomes were progression-free survival (PFS), overall survival (OS), quality of life (QOL), complete response rate (CRR), and partial response rate (PRR). The revised Cochrane Risk of Bias Tool 2.0 was used to assess the quality of the RCTs The five RCTs chosen for this statistical analysis consisted of a total of 2239 participants, with 1109 receiving paclitaxel/cisplatin for treatment and the remaining 1130 receiving carboplatin/paclitaxel. Among all included outcomes, these reported significant findings: QoL (p-value=0.0002), thrombocytopenia (p=<0.00001), neurological toxicity (p-value=0.003), nausea/vomiting (p-value=<0.00001), myalgia/arthralgia (p-value=0.02), and febrile neutropenia (p-value=0.01). We concluded that the carboplatin/paclitaxel doublet endows a better quality of life (QOL) to patients along with significantly fewer gastrointestinal and neurological toxicities when compared with the cisplatin/paclitaxel combination. However, the myelosuppressive effects of carboplatin/paclitaxel remain a point of concern and may require clinical management.
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Affiliation(s)
- Marium Mansoor
- Medicine and Surgery, Allama Iqbal Medical College, Lahore, PAK
| | - Firzah Shakil
- Allergy and Immunology, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Urba Jalal
- Medical School, Allama Iqbal Medical College, Lahore, PAK
| | - Fatimah Shahid
- Medical School, Rawalpindi Medical University, Rawalpindi, PAK
| | - Maira Jamal
- Pediatrics, Hamdard College of Medicine and Dentistry, Karachi, PAK
| | - Alishba S Ali
- Medical School, Rawalpindi Medical University, Rawalpindi, PAK
| | - Fatima A Abbasi
- Cardiology, Shifa International Hospital Islamabad, Islamabad, PAK
| | - Hamna Hijazi
- Medical School, Khyber Medical College, Peshawar, PAK
| | - Hamza Imran
- Medical School, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Sapna Hirani
- Medical School, Peoples University of Medical and Health Science, Nawabshah, PAK
| | - Aima Javaid
- Medical School, Fatimah Jinnah Medical University, Lahore, PAK
| | - Ahshum Abu Bakar
- Medical School, Shalamar Medical and Dental College, Lahore, PAK
| | - Abdul Ahad Shah
- Medical School, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | | | - Mahima Khatri
- Medicine and Surgery, Dow University of Health Sciences, Civil Hospital Karachi, Karachi, PAK
| | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
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Onumajuru C, Aloh M. Comment on: Sudden Cardiac Death in Heart Failure: A 20-Year Perspective From a Mediterranean Cohort. Curr Probl Cardiol 2023; 48:101972. [PMID: 37473951 DOI: 10.1016/j.cpcardiol.2023.101972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Cindy Onumajuru
- Department of Medicine, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana.
| | - Macdonald Aloh
- Department of Medicine, Fort Valley State University, Fort Valley, GA
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Israel OF, Akubuiro C. Comment on: A Roadmap to Reinvigorating Training Pathways Focused on the Care of Patients With Heart Failure: Shifting From Failure to Function. Curr Probl Cardiol 2023; 48:101976. [PMID: 37473945 DOI: 10.1016/j.cpcardiol.2023.101976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
Affiliation(s)
| | - Chiderah Akubuiro
- Trinity Medical Sciences University, Ribishi, St. Vincent and the Grenadines
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Israel OF, Akubuiro C. Comment on: A New Norm for Early-Career Advanced Heart Failure Clinicians. Curr Probl Cardiol 2023; 48:101977. [PMID: 37473934 DOI: 10.1016/j.cpcardiol.2023.101977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/16/2023] [Indexed: 07/22/2023]
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Fnu A. Comment On: The Association of Multidimensional Sleep Health With Adiposity in Heart Failure With Preserved Ejection Fraction. Curr Probl Cardiol 2023; 48:101898. [PMID: 37392976 DOI: 10.1016/j.cpcardiol.2023.101898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/03/2023]
Affiliation(s)
- Aparna Fnu
- Department of Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, Sindh, Pakistan.
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Kumar M. Comment on: Does Thiamine Supplementation Affect Heart Failure? A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Curr Probl Cardiol 2023; 48:101900. [PMID: 37406953 DOI: 10.1016/j.cpcardiol.2023.101900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Munesh Kumar
- Department of Medicine, Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan.
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12
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Aparna F. Comment on: Excess of Heart Failure-Related Deaths During the 2020 COVID-19 Pandemic in the United States. Curr Probl Cardiol 2023; 48:101906. [PMID: 37399860 DOI: 10.1016/j.cpcardiol.2023.101906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/05/2023]
Affiliation(s)
- Fnu Aparna
- Department of Meidicine, Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan.
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13
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Punshi VK, Punshi AK. Comment on: Time from Admission to Right Heart Catheterization in Cardiogenic Shock Patients. Curr Probl Cardiol 2023; 48:101899. [PMID: 37394205 DOI: 10.1016/j.cpcardiol.2023.101899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/27/2023] [Indexed: 07/04/2023]
Abstract
The study article "Time from Admission to Right Heart Catheterization in Cardiogenic Shock Patients" was recently published in your prestigious Journal. We are writing to offer a constructive review of the article. Even while we value the authors' attempts to shed light on this vital topic, a few issues deserve more attention.
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Ikram J, Zahid A. Comment on: Congestion in AMI-Cardiogenic Shock: Rethinking Treatment Goals. Curr Probl Cardiol 2023; 48:101948. [PMID: 37422048 DOI: 10.1016/j.cpcardiol.2023.101948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
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Zahid A, Ikram J. Comment on: Incident Heart Failure With Mildly Reduced Ejection Fraction: Frequency, Characteristics, and Outcomes. Curr Probl Cardiol 2023; 48:101947. [PMID: 37422039 DOI: 10.1016/j.cpcardiol.2023.101947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Ayesha Zahid
- Department of Medicine, Rehman Medical institute, Peshawar, Pakistan.
| | - Jibran Ikram
- Department of Medicine, Rehman Medical institute, Peshawar, Pakistan
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Jyotsna F, Ikram J, Nageeta F, Komal F, Anjlee F, Patel H, Nassri T, Kumari M, Kumar R, Shah SU, Kashif M, Varrassi G, Kumar S, Patel T. Unlocking the Potential of Immunotherapy in Cardiovascular Disease: A Comprehensive Review of Applications and Future Directions. Cureus 2023; 15:e42790. [PMID: 37664375 PMCID: PMC10469982 DOI: 10.7759/cureus.42790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Immunotherapy has emerged as a pioneering therapeutic approach that harnesses the immune system's abilities to combat diseases, particularly in the field of oncology where it has led to significant advancements. However, despite its significant impact in the field of oncology, the potential of immunotherapy in the context of cardiovascular disease (CVD) has not been thoroughly investigated. The purpose of this narrative review is to address the existing knowledge and potential uses of immunotherapy in the field of cardiovascular disease (CVD), with the intention of filling the existing gap in understanding. Furthermore, the review thoroughly examines the future prospects of this swiftly advancing field, providing insights into the aspects that necessitate further investigation and addressing the forthcoming challenges. The review is organized into four distinct sections to enhance comprehension. The first section introduces immunotherapy, presenting the fundamental concepts and principles. The second section explores the immunomodulatory mechanisms in cardiovascular disease (CVD), with a specific focus on the intricate interplay between the immune system and the development of cardiovascular pathogenesis. The utilization of immunotherapy in specific cardiovascular conditions will be examined, investigating the application of immunotherapy in the context of different cardiovascular diseases. The future prospects and challenges in immunotherapy for cardiovascular diseases will be discussed, highlighting the potential areas for future research and addressing the barriers that must be overcome to effectively implement immunotherapeutic interventions in the management of cardiovascular diseases.
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Affiliation(s)
- Fnu Jyotsna
- Medicine, Dr. B.R. Ambedkar Medical College & Hospital, Mohali, IND
| | - Jibran Ikram
- Orthopaedics and Trauma, Rehman Medical Institute, Peshawar, PAK
| | - Fnu Nageeta
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Fnu Komal
- Medicine, Chandka Medical College, Larkana, PAK
| | - Fnu Anjlee
- Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK
| | - Harshkumar Patel
- Internal Medicine, PDU (Pandit Dindayal Upadhyay) Medical College, Rajkot, IND
| | - Taleb Nassri
- Medicine, Heart and Vascular Institute, Dearborn, USA
| | - Meena Kumari
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Rajesh Kumar
- Business Intelligence and Data Analytics, Westcliff University, Irvine, USA
| | | | - Maham Kashif
- Medicine, Khawaja Muhammad Safdar Medical College, Wazirabad, PAK
| | | | - Satesh Kumar
- Medicine and Surgery, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Tirath Patel
- Medicine, American University of Antigua, St. John, ATG
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Fnu K, Fnu N, Fnu N. Comment on: Effect of Flu Vaccination on Severity and Outcome of Heart Failure Decompensations. Curr Probl Cardiol 2023:101949. [PMID: 37422032 DOI: 10.1016/j.cpcardiol.2023.101949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 07/04/2023] [Indexed: 07/10/2023]
Abstract
We evaluated the study "[Effect of Flu Vaccination on Severity and Outcome of Heart Failure Decompensations" by Miró et al. [1]. This insightful paper explores the potential influence of flu vaccination on the severity and outcomes of heart failure decompensations, illuminating a crucial connection between cardiovascular health and preventing infectious diseases. We want to start by praising the author for selecting such an important and timely subject for discussion. Millions worldwide suffer from heart failure, a severe public health issue. This unique gives essential insights into cardiology and presents a viable route for enhancing patient outcomes by examining the potential connection between flu vaccine and heart failure decompensations.
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Affiliation(s)
| | - Neha Fnu
- Ghulam Muhammad Medical College, Sukkur, +92-3270225366.
| | - Neha Fnu
- Jinnah Sindh Medical University, Karachi.
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