scholarly journals Evaluation of Efficacy and Tolerability of Perindopril 8 mg in Bangladeshi Hypertensive Patients: Results from an Open-label, Observational, Multi-center Study (CONTROL)

2012 ◽  
Vol 5 (1) ◽  
pp. 44-50
Author(s):  
MN Islam ◽  
AAS Majumder ◽  
RS Mahmud ◽  
M Sadequzzaman ◽  
MA Bashar ◽  
...  
Keyword(s):  
Stage Ii ◽  
Uncontrolled Hypertension ◽  
Newly Diagnosed ◽  
Open Label ◽  
Hypertensive Patients ◽  
Group I ◽  
The Mean ◽  
Group Ii ◽  
Multi Center Study ◽  
Center Study

Background: The CONTROL (COversyl in Newly diagnosed stage-II & unconTROlled hypertensivepatients triaL) was performed with an objective to evaluate the blood pressure (BP) lowering efficacyand tolerability of Perindopril 8mg in newly diagnosed stage II patients and uncontrolledhypertensive patients among Bangladeshi population.Methods: This was an open-label, observational, multi-center study conducted in consultationcenters for out-patients located in different cities of Bangladesh. Adults, aged above 18 years withnewly diagnosed stage-II hypertension or uncontrolled hypertension, were recruited. Patients weretreated with Perindopril 4mg daily for first 1 week, afterwards uptitrated to Perindopril 8 mg dailyand continued treatment for 12 weeks. Patients were followed-up at week-1, week-4, week-8 andweek-12.Results: In total, 245 patients were enrolled. Among them, 88 were newly diagnosed stage-II (Group-I) and 157 were uncontrolled (Group-II) hypertensive patients. Male and female distribution was57% and 43% respectively. Mean age of patients was 54.5 ±11.7 years.After 12 weeks treatment, there was a significant reduction in BP from baseline (p<0.001) in overallpopulation as well as in Group I and in Group II. In overall population, the mean BP reduction was-31/-15 mmHg (from 163.7/96.8 mmHg to 132.4/81.7 mmHg. In Group I, the reduction was -33/-16mmHg (from 166.5/98.2 mmHg to 133.4/82.0 mmHg) and in Group II, -30/-14 mmHg (from 159.3/95.6 mmHg to 129.1/81.6 mmHg).10 patients (4.1%) had to discontinue the treatment due to adverse effects. Dry cough (2%) andhypotension (1.2%) were the main cause of discontinuation. Perindopril 8mg was well tolerated asindicated by the high proportion of physicians (81%) reporting ‘good’ to ‘excellent’ tolerability atweek 12.Conclusion: This study suggests that Perindopril 8mg is effective and safe in the treatment ofhypertension in Bangladeshi patients. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12272 Cardiovasc. j. 2012; 5(1): 44-50

Assessment of Acute Kidney Injury in Patients Undergoing Elective Coronary Angiography and Percutaneous Coronary Intervention

2012 ◽  
Vol 5 (1) ◽  
pp. 37-43
Author(s):  
ABMM Alam ◽  
M Moniruzzaman ◽  
MB Alam ◽  
N Islam ◽  
F Khatoon ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Contrast Media ◽  
Creatinine Level ◽  
Ace Inhibitor ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Group I ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Group Ii

Background: CIN has gained increased attention in the clinical setting, particularly during cardiac intervention but also in many other radiological procedures in which iodinated contrast media are used. There is at present good clinical evidence from well-controlled randomized studies that CIN is a common cause of acute renal dysfunction.Methodology: This was a prospective study conducted among the patients who underwent coronary angiography and percutaneous coronary intervention in the Department of Cardiology, Dhaka Medical College Hospital during January 2010 to December 2010. A total of 111 patients age range from 25 to 75 years were included in the study. Serum creatinine level at baseline and at the end of 48 hours was done in all these patients. Study population was divided into two groups according to development of acute kidney injury (AKI). Group-I = AKI, Group II = Not developed AKI. Results: AKI developed 11.7% of the study patient. DM and Preexisting renal insufficiency were significantly higher in group I patients. HTN was (61.5% Vs 44.9%) higher in group I but not significantly. History of ACE inhibitor/ARB, NSAID intake and LVEF <40% were significantly higher in group I patients. The mean±SD volume of CM (Contrast Media) were 156.9±44.8 ml and 115.4±30.0 ml in group I and group II respectively, which was significant. The mean±SD of serum creatinine after 48-72 hours of CAG/PCI was 1.4±0.37 mg/dl and 1.1±0.2 mg/dl in group I and group II respectively. The serum creatinine level increased significantly (p<0.05) after 48-72 hours of CAG/PCI in group I. In group II, S. creatinine level increased but not significant (p>0.05). Impaired renal function was found 76.9% and 2.0% in group I and group II respectively. DM, HTN, preexisting renal insufficiency, ACE inhibitor/ARB, NSAIDs, contrast volume (>150 ml), eGFR (<60 ml/min/ 1.73m2) and LVEF (<40%) are significantly (p0.05) associated for CIN development.Conclusion: CIN is an iatrogenic but preventable disorder results from the administration of contract media. Although rare in the general population, CIN occurs frequently in patients with underlying renal dysfunction and diabetes. In patients with pre angiographic normal renal function, the prevalence is low but in pre-existing renal impairment it may pose a serious threat. Thus risk factors are synergistic in their ability to predispose to the development of CIN. A careful risk-benefit analysis must always be performed prior to the administration of contrast media to patients at risk for CIN. DOI: http://dx.doi.org/10.3329/cardio.v5i1.12227 Cardiovasc. j. 2012; 5(1): 37-43

scholarly journals The Efficacy of Anti-Arrhythmic Drugs in Children With Idiopathic Frequent Symptomatic or Asymptomatic Premature Ventricular Complexes With or Without Asymptomatic Ventricular Tachycardia: a Retrospective Multi-Center Study

2021 ◽  
Author(s):  
Robin A. Bertels ◽  
Janneke A. E. Kammeraad ◽  
Anna M. Zeelenberg ◽  
Luc H. Filippini ◽  
Ingmar Knobbe ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Beta Blockers ◽  
Control Group ◽  
Premature Ventricular Complexes ◽  
Percentage Points ◽  
Asymptomatic Children ◽  
Group A ◽  
The Mean ◽  
Multi Center Study ◽  
Center Study

AbstractThe aim of the study is to compare the efficacy of flecainide, beta-blockers, sotalol, and verapamil in children with frequent PVCs, with or without asymptomatic VT. Frequent premature ventricular complexes (PVCs) and asymptomatic ventricular tachycardia (VT) in children with structurally normal hearts require anti-arrhythmic drug (AAD) therapy depending on the severity of symptoms or ventricular dysfunction; however, data on efficacy in children are scarce. Both symptomatic and asymptomatic children (≥ 1 year and < 18 years of age) with a PVC burden of 5% or more, with or without asymptomatic runs of VT, who had consecutive Holter recordings, were included in this retrospective multi-center study. The groups of patients receiving AAD therapy were compared to an untreated control group. A medication episode was defined as a timeframe in which the highest dosage at a fixed level of a single drug was used in a patient. A total of 35 children and 46 medication episodes were included, with an overall change in PVC burden on Holter of -4.4 percentage points, compared to -4.2 in the control group of 14 patients. The mean reduction in PVC burden was only significant in patients receiving flecainide (− 13.8 percentage points; N = 10; p = 0.032), compared to the control group and other groups receiving beta-blockers (− 1.7 percentage points; N = 18), sotalol (+ 1.0 percentage points; N = 7), or verapamil (− 3.9 percentage points; N = 11). The efficacy of anti-arrhythmic drug therapy on frequent PVCs or asymptomatic VTs in children is very limited. Only flecainide appears to be effective in lowering the PVC burden.

The role of epicardial fat tissue in atrial fibrillation onset in patients with hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Tarzimanova ◽  
V.I Podzolkov ◽  
M.V Pisarev ◽  
R.G Gataulin ◽  
K.A Oganesian
Keyword(s):  
Atrial Fibrillation ◽  
Plasma Concentration ◽  
Sinus Rhythm ◽  
Epicardial Fat ◽  
Funding Source ◽  
Fat Tissue ◽  
Hypertensive Patients ◽  
Group I ◽  
Epicardial Fat Tissue ◽  
Group Ii

Abstract Aim To study the influence of epicardial fat tissue (EFT) on atrial fibrillation (AF) occurrence in hypertensive patients. Materials and methods The study included 195 patients with hypertension aged from 38 to 72 years (mean age was 61.5±1.8 years). All patients were divided into two groups: group I included 95 hypertensive patients with paroxysmal AF; 100 patients with hypertension in sinus rhythm were enrolled into group II. Echocardiography was performed to evaluate the thickness of EFT in a parasternal long-axis view. The EFT volume was assessed with computed tomography (CT) scan. The plasma concentration of tissue inhibitor of metalloproteinase-1 (TIMP-1) and metalloproteinase-9 (MMP-9) was measured to evaluate the myocardial fibrosis process. Results There was no significant difference between the studied groups of patients in body mass index: 34.43±1.2 kg/m2 in group I vs 31.97±1.67 kg/m2 in the group II. Waist circumference was significantly higher in group I in comparison with the group II patients: 118.9±3.3 cm vs 110.2±1.4 cm, respectively (p=0.038). EFT thickness was significantly higher in patients with paroxysmal AF (11.6±0.8 mm) in comparison with the patients in sinus rhythm (8.6±0.4 mm) (p&lt;0.001). In group I patients a significant increase of EFT volume (4.6±0.4) in comparison with II group (3.5±0.25) (p=0.002) was noted. A significant positive correlation was revealed in hypertensive patients with paroxysmal AF between EFT volume and left atrial (LA) volume (r=0.7, p=0.022). Also, the plasma concentrations of TIMP-1 and MMP-1 were significantly higher in patients with paroxysmal AF and hypertension. There was a strong positive correlation between EFT volume and plasma concentration of TIMP-1 (r=0.72; p=0.01) and between the EFT volume and the LA volume (r=0.7, p=0.022) in group I patients. Multivariate regression analysis revealed the significant influence of increased EFT thickness more than 10 mm (prevalence ratio (PR) 4.1; 95% CI 1.1; 15.6) and EFT volume more than 6 ml (PR 3.7; 95% CI 1.0; 14.2) on AF occurrence. Conclusion Increased EFT thickness (more than 10 mm) and EFT volume (more than 6 ml) are predictors of AF onset in hypertensive patients. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The complex subject of the Department

scholarly journals Sex Differences in the Medical Utilization for Ischemic Heart Disease Among Newly Diagnosed Hypertensive Korean Patients (P04-170-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Jiae Shin ◽  
Dongwoo Ham ◽  
Seoeun Ahn ◽  
Hee-Young Paik ◽  
Hyojee Joung
Keyword(s):  
Medical Care ◽  
Medical Cost ◽  
Medical Utilization ◽  
Care Utilization ◽  
Newly Diagnosed ◽  
Care Providers ◽  
Men And Women ◽  
Hypertensive Patients ◽  
Medical Care Utilization ◽  
The Mean

Abstract Objectives This study aimed to investigate sex differences in the medical utilization for ischemic heart disease (IHD) among newly diagnosed hypertensive patients using a cohort data of South Korea. Methods We analyzed the National Sample Cohort version 2.0 of the National Health Insurance Service. Newly diagnosed hypertensive patients aged 40–84 were extracted from the baseline population, who received health examinations during 2003–2006 without pre-existing type 2 diabetes or circulatory diseases. Propensity score was applied to match men to women with the same ratio of body mass index (BMI) and fasting blood glucose (FBG) among the patients. Men and women (each 10, 110) were selected for analyses and followed until the end of 2015. Person-year was defined as the period from the diagnosis of hypertension to the incidence of IHD. Associations between IHD and the medical care utilization such as the mean of medical care visit, the mean medical cost, and the type and the location of medical care providers were investigated using Cox proportional hazard model. Hazard ratios (HR) of IHD according to medical care utilization were adjusted for age, income, BMI, FBG, smoking, and alcohol consumption. Results Incidence rates (per 1000 person-years) of IHD were 43.1 in men and 43.0 in women. The mean follow-up period was 5.2 person-years. The HRs of IHD were significantly higher in the subjects with a high mean medical cost (T3) (men, HR = 1.39, 95% CI 1.25–1.54; women, HR = 1.33, 95% CI 1.20–1.48) than in those with a low mean medical cost (T1). However, the subjects visiting medical care providers more (T3) had lower HRs than those visiting less (T1) (men, HR = 0.80, 95% CI 0.72–0.89; women, HR = 0.79, 95% CI 0.71–0.88). Conclusions Hypertensive patients in Korea showed an increased risk of IHD when they paid medical cost more and visited medical care less per person-year in both men and women. Funding Sources This research was supported by Support Program for Women in Science, Engineering and Technology through the National Research Foundation of Korea funded by the Korea government (MSIT). (No.2016H1C3A1903202). Supporting Tables, Images and/or Graphs

scholarly journals A prospective study on effectiveness of drotaverine in acceleration of labor

2019 ◽  
Vol 2 (3) ◽  
pp. 137-141
Author(s):  
Padma Raj Dhungana ◽  
Rajesh Adhikari ◽  
Prem Raj Pageni ◽  
Apsara Koirala ◽  
Anand Nepal
Keyword(s):  
Prospective Study ◽  
Drug Administration ◽  
Active Phase ◽  
Delivery Mode ◽  
Normal Delivery ◽  
Group I ◽  
Vacuum Delivery ◽  
Drotaverine Hydrochloride ◽  
The Mean ◽  
Group Ii

Background: Labor is a naturally occurring physiological process associated with uterine contractions, effacement, dilatation of cervix and descent of presenting part. Drotaverine hydrochloride is a non-anticholinergic isoquinoline derivative which acts by elevating intracellular cyclic Adenosine Mono Phosphate (cAMP) and cyclic Guanosine Mono Phosphate (cGMP) promoting smooth muscle relaxation. Materials and Method: This was a hospital based prospective study on effectiveness of Drotaverine Hydrochloride on enhancing dilatation of cervix and acceleration of active phase of labor. The sample size was 100. Fifty cases of women in active phase of labor received injection drotaverine hydrochloride 40 mg (group i) and fifty cases of women did not receive any drug (group ii) among those at term with singleton pregnancy and vertex presentation. Variables like maternal age, interval between administration of drug and delivery, mode of delivery, apgar score at 5 minutes, NCU (Neonatal Care Unit) admission and neonatal outcomes were recorded. Data analysis was done with the help of SPSS program. Results: The mean interval between drug administration to delivery in primipara and multipara in group i was 3.05 hours and 2.31 hours while in group ii was 4.5 hours and 3.75 hours respectively. The mean interval between drug administration and delivery was shorter in both groups of multipara. In group i, 96% had normal delivery and 4 % had vacuum delivery and in group ii 90% and 10% had normal delivery and vacuum delivery respectively. None of the participants had caeserian section. There were no perinatal mortalities. Conclusion: The administration of drug Drotaverine Hydrochloride is effective in shortening duration of labor with favorable feto-maternal outcome.  

Anterior bone cement augmentation in anterior lumbar interbody fusion and percutaneous pedicle screw fixation in patients with osteoporosis

2010 ◽  
Vol 12 (5) ◽  
pp. 525-532 ◽  
Author(s):  
Kyeong Hwan Kim ◽  
Sang-Ho Lee ◽  
Dong Yeob Lee ◽  
Chan Shik Shim ◽  
Dae Hyeon Maeng
Keyword(s):  
Vertebral Body ◽  
Interbody Fusion ◽  
Anterior Lumbar Interbody Fusion ◽  
Cement Augmentation ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Group I ◽  
Cage Subsidence ◽  
The Mean ◽  
Group Ii

Object The purpose of the present study was to evaluate the efficacy of anterior polymethylmethacrylate (PMMA) cement augmentation in instrumented anterior lumbar interbody fusion (ALIF) for patients with osteoporosis. Methods Sixty-two patients with osteoporosis who had undergone single-level instrumented ALIF for spondylolisthesis and were followed for more than 2 years were included in the study. The patients were divided into 2 groups: instrumented ALIF alone (Group I) and instrumented ALIF with anterior PMMA augmentation (Group II). Sixty-one patients were interviewed to evaluate the clinical results, and plain radiographs and 3D CT scans were obtained at the last follow-up in 46 patients. Results The mean degree of cage subsidence was significantly higher in Group I (19.6%) than in Group II (5.2%) (p = 0.001). The mean decrease of vertebral body height at the index level was also significantly higher in Group I (10.7%) than in Group II (3.9%) (p = 0.001). No significant intergroup differences were observed in the incidence of radiographic adjacent-segment degeneration (ASD) or in terms of pain and functional improvement. The incidences of clinical ASD (23% in Group I and 10% in Group II) were not significantly different. There was 1 case of nonunion and 3 cases of screw migration in Group I, but none resulted in implant failure. Conclusions Anterior PMMA augmentation during instrumented ALIF in patients with osteoporosis was useful to prevent cage subsidence and vertebral body collapse. In addition, PMMA augmentation did not increase the nonunion rate and incidence of ASD.

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