1
|
Affiliation(s)
- Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| | - Henry W West
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK.,Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, OX3 9DU, UK
| |
Collapse
|
2
|
Norrish G, Ding T, Field E, McLeod K, Ilina M, Stuart G, Bhole V, Uzun O, Brown E, Daubeney PEF, Lota A, Linter K, Mathur S, Bharucha T, Kok KL, Adwani S, Jones CB, Reinhardt Z, Omar RZ, Kaski JP. A validation study of the European Society of Cardiology guidelines for risk stratification of sudden cardiac death in childhood hypertrophic cardiomyopathy. Europace 2020; 21:1559-1565. [PMID: 31155643 PMCID: PMC6788212 DOI: 10.1093/europace/euz118] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [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: 10/18/2018] [Accepted: 04/05/2019] [Indexed: 01/15/2023] Open
Abstract
AIMS Sudden cardiac death (SCD) is the most common cause of death in children with hypertrophic cardiomyopathy (HCM). The European Society of Cardiology (ESC) recommends consideration of an implantable cardioverter-defibrillator (ICD) if two or more clinical risk factors (RFs) are present, but this approach to risk stratification has not been formally validated. METHODS AND RESULTS Four hundred and eleven paediatric HCM patients were assessed for four clinical RFs in accordance with current ESC recommendations: severe left ventricular hypertrophy, unexplained syncope, non-sustained ventricular tachycardia, and family history of SCD. The primary endpoint was a composite outcome of SCD or an equivalent event (aborted cardiac arrest, appropriate ICD therapy, or sustained ventricular tachycardia), defined as a major arrhythmic cardiac event (MACE). Over a follow-up period of 2890 patient years (median 5.5 years), MACE occurred in 21 patients (7.5%) with 0 RFs, 19 (16.8%) with 1 RFs, and 3 (18.8%) with 2 or more RFs. Corresponding incidence rates were 1.13 [95% confidence interval (CI) 0.7-1.73], 2.07 (95% CI 1.25-3.23), and 2.52 (95% CI 0.53-7.35) per 100 patient years at risk. Patients with two or more RFs did not have a higher incidence of MACE (log-rank test P = 0.34), with a positive and negative predictive value of 19% and 90%, respectively. The C-statistic was 0.62 (95% CI 0.52-0.72) at 5 years. CONCLUSIONS The incidence of MACE is higher for patients with increasing numbers of clinical RFs. However, the current ESC guidelines have a low ability to discriminate between high- and low-risk individuals.
Collapse
Affiliation(s)
- Gabrielle Norrish
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London, UK.,Institute of Cardiovascular Sciences University College London, London, UK.,ERN GUARD-HEART (European Reference Network for Rare and Complex Diseases of the Heart)
| | - Tao Ding
- Department of Statistical Science, University College London, London, UK
| | - Ella Field
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London, UK.,Institute of Cardiovascular Sciences University College London, London, UK.,ERN GUARD-HEART (European Reference Network for Rare and Complex Diseases of the Heart)
| | - Karen McLeod
- Department of Paediatric Cardiology, Royal Hospital for Children, Glasgow, UK
| | - Maria Ilina
- Department of Paediatric Cardiology, Royal Hospital for Children, Glasgow, UK
| | - Graham Stuart
- Department of Paediatric Cardiology, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Vinay Bhole
- Department of Paediatric Cardiology, Birmingham Women and Children's NHS Foundation Trust, Birmingham, UK
| | - Orhan Uzun
- Department of Paediatric Cardiology, University Hospital of Wales, Cardiff, UK
| | - Elspeth Brown
- Department of Paediatric Cardiology, Leeds Teaching Hospital NHS Trust, Leeds, UK
| | - Piers E F Daubeney
- Department of Paediatric Cardiology, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, UK
| | - Amrit Lota
- Department of Paediatric Cardiology, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, UK
| | - Katie Linter
- Department of Paediatric Cardiology, University Hospitals of Leicester, Leicester, UK
| | - Sujeev Mathur
- Department of Paediatric Cardiology, Evelina London Children's Hospital, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Tara Bharucha
- Department of Paediatric Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Khoon Li Kok
- Department of Paediatric Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Satish Adwani
- Department of Paediatric Cardiology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Caroline B Jones
- Department of Paediatric Cardiology, Alder Hey Children's Hospital, Liverpool, UK
| | - Zdenka Reinhardt
- Department of Paediatric Cardiology, The Freeman Hospital, Newcastle, UK
| | - Rumana Z Omar
- Department of Statistical Science, University College London, London, UK
| | - Juan Pablo Kaski
- Centre for Inherited Cardiovascular Diseases, Great Ormond Street Hospital, Great Ormond Street, London, UK.,Institute of Cardiovascular Sciences University College London, London, UK.,ERN GUARD-HEART (European Reference Network for Rare and Complex Diseases of the Heart)
| |
Collapse
|
3
|
Abstract
INTRODUCTION COVID-19 is the disease caused by an infection of the SARS-CoV-2 virus, previously known as 2019 Novel Coronavirus (2019-nCoV) respiratory disease. World Health Organization (WHO) declared the official name as COVID-19 in February 2020 and in 11th March 2020 declared COVID-19 as Global Pandemic. In June 6th 2020, over 7 million cases registered in the world, recovered 3.4 million and death over 402.000. AIM The aim of this study is to retreive published papers about COVID-19 infection deposited in PubMed data base and analyzed current results of investigations regarding morbidity and mortality rates as consequences of COVID-19 infection and opinions of experts about treatment of afected patients with COVID-19 who have Cardiovascular diseases (CVDs). METHODS It's used method of descriptive analysis of the published papers with described studies about Corona virus connected with CVDs. RESULTS After searching current scientific literature (on PubMed till today is deposited more than 1.000 papers about COVID-19 with consequences in almost every medical disciplines), we have acknowledged that till today not any Evidence Based Medicine (EBM) study in the world. Also, there are no unique proposed ways of treatments and drugs to protect patients, especially people over 65 years old, who are very risk group to be affected with COVID-19, including patients with CVDs. Vaccine against COVID-19 is already produced and being in phases of testing in praxis in treatment of COVID-19 at affected patients, but the opinions of experts and common people whole over the world about vaccination are full of controversis. CONCLUSION Frequent hand washing, avoiding crowds and contact with sick people, and cleaning and disinfecting frequently touched surfaces can help prevent coronavirus infections are the main proposal of WHO experts in current Guidelines, artefacts stored on a web site. Those preventive measures at least can help to everybody, including also the patients who have evidenced CVDs in their histories of illness. Authors analyzed most important dilemmas about all aspects of CVDs, including etipathogenesis, treatment with current drugs and use of potential discovered vaccines against COVID-19 infection, described in scientific papers deposited in PubMed data base.
Collapse
Affiliation(s)
- Vjekoslav Gerc
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Izet Masic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Nizama Salihefendic
- Department of Emergency Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Muharem Zildzic
- Academy of Medical Sciences of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| |
Collapse
|
4
|
Kennon S, Archbold A. Expert Opinion: Guidelines for the Management of Patients with Aortic Stenosis Undergoing Non-cardiac Surgery: Out of Date and Overly Prescriptive. Interv Cardiol 2017; 12:133-136. [PMID: 29588742 DOI: 10.15420/icr.2017:20:2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Patients with severe aortic stenosis who require non-cardiac surgery present a difficult clinical problem. The most recent clinical practice guidelines from the American College of Cardiology/American Heart Association and the European Society of Cardiology for the perioperative cardiovascular assessment and management of patients undergoing noncardiac surgery were both published in 2014. These guidelines are reviewed in the light of recently published randomised controlled trial data regarding the efficacy of transcatheter aortic valve implantation to treat aortic stenosis.
Collapse
Affiliation(s)
- Simon Kennon
- Barts Heart Centre, St Bartholomew's Hospital, London, UK
| | | |
Collapse
|